Hoge mate van rusteloze benen syndroom bij fibromyalgie: recente studie

Een studie in het 15 oktober nummer van het  Journal of Clinical Sleep Medicine  bleek dat volwassenen met fibromyalgie hadden een veel hogere prevalentie en het risico van rusteloze benen syndroom dan gezonde controles. De studie suggereert dat de behandeling van RLS slaap en kwaliteit van leven bij mensen met fibromyalgie kunnen verbeteren.

afbeelding resultaat

Results show that the prevalence of restless legs syndrome was about 10 times higher in the fibromyalgia group (33 percent) than among controls (3.1 percent). After statistical adjustments for potential confounders such as age, gender and ethnicity, participants with fibromyalgia were 11 times more likely than controls to have RLS (odds ratio = 11.2). As expected, considerable sleep disruption was reported by participants with fibromyalgia using the Pittsburgh Sleep Quality Index, Insomnia Severity Index and Epworth Sleepiness Scale. In the fibromyalgia group these sleep problems were more severe among people who also had RLS.

“Verstoring van de slaap komt vaak voor bij fibromyalgie, en vaak moeilijk te behandelen”, aldus bijdragende auteur Dr. Nathaniel F. Watson, associate professor neurologie aan de Universiteit van Washington in Seattle, Wash. “Het is duidelijk uit onze studie dat een aanzienlijk deel van verstoring van de slaap bij fibromyalgie is het gevolg van rusteloze benen syndroom.”

. Het onderzoeksteam onder leiding van Dr Watson en de hoofdauteur Dr. Mari Viola-Saltzman van Loyola University Medical Center in Maywood, Ill, bestudeerden 172 mensen met fibromyalgie die een gemiddelde leeftijd van 50 jaar had; 93 procent waren vrouwen. Zij werden vergeleken met 63 gezonde controles, die een gemiddelde leeftijd van 41 jaar had.

Fibromyalgie werd geïdentificeerd door zelfrapportage of herziening van de medische dossiers, en het werd bevestigd op het onderzoek volgens de gepubliceerde richtlijnen met betrekking tot de aanwezigheid van pijn die chronische en wijdverbreid. Pijn werd beoordeeld door subjectief is en door objectieve meting met een dolorimeter een veerbelaste meter die wordt gebruikt gestandaardiseerde tarieven toepassen van druk op punt en inschrijving op de armen en benen.

Volgens het Nationaal Instituut van artritis en spier-en Skin Diseases, kan fibromyalgie aanzienlijke pijn en vermoeidheid veroorzaken. Het is naar schatting 5.000.000 Amerikanen leeftijd van 18 jaar of ouder, en tussen de 80 en 90 procent van de mensen gediagnosticeerd met fibromyalgie zijn vrouwen. De oorzaken van fibromyalgie nog steeds onbekend.

Restless legs syndroom werd gediagnosticeerd met behulp van een self-toegediend, gevalideerde vragenlijst. RLS is een slaap-gerelateerde bewegingsstoornissen die een drang om de benen die gewoonlijk gepaard gaat met of veroorzaakt ongemakkelijk en onaangenaam gevoel in de benen te bewegen omvat. Deze drang begint of verergert tijdens periodes van rust of inactiviteit, wordt geheel of gedeeltelijk opgelost door beweging, en verergert of gebeurt alleen ‘s nachts. RLS treedt op 1,5 tot twee keer vaker voor bij vrouwen dan bij mannen.

Watson merkte op dat de behandeling van rusteloze benen syndroom één van de sleutels tot het verminderen van vermoeidheid en het verbeteren van de kwaliteit van leven bij mensen met fibromyalgie kan zijn. RLS vaak met succes kan worden behandeld met een geneesmiddel zoals pramipexol of ropinirol.

“Sinds rusteloze benen syndroom is een behandelbare aandoening, diagnose en behandeling van RLS bij fibromyalgie patiënten heeft de potentie om hun slaap te verbeteren”, aldus Watson.

Volgens de auteurs, heeft de cross-sectionele aard van de studie niet toe dat voor een onderzoek van de causaliteit. Echter, een aantal aspecten van de twee syndromen wijzen op een logische overlap. Beide aandoeningen omvatten gevoelsstoornissen, en een soortgelijke pathofysiologie van het systeem dat de neurotransmitter dopamine regelt is voor beide syndromen voorgesteld. Verder kan RLS veroorzaakt worden door antidepressiva, waarbij een voorkomende behandeling van pijn bij fibromyalgie en depressie zijn. Ook is de oefening is aangetoond dat de symptomen van beide syndromen te verbeteren.

De studie werd ondersteund door het Nationaal Instituut van artritis en spier-en Skin Diseases van de National Institutes of Health en door de Nationale Fibromyalgie Research Association.

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