People suffering from restless legs syndrome (RLS) have an almost tripled risk of self-harm and suicide compared to those without the condition, according to a new study by Penn State researchers published in JAMA Open Network.
RLS, sometimes referred to as Willis-Ekbom disease, is a neurological disorder that involves the urge to physically move and stretch to stop strange and unpleasant sensations within the body. While it often affects the legs, it can also affect other parts of the body, such as the arms and head, and can lead to varying levels of pain and discomfort. The condition often interrupts sleep as it tends to get worse at night when a person goes to bed and begins to relax. According to the charity RLS-UK, the sensation has been described as a “creepy-crawly feeling”, as if there's “fizzy water inside the legs”.
It is perhaps unsurprising that being haunted by unpleasant bodily sensations might take a toll on mental health, and the researchers discovered that patients are 2.7 times more likely to harm themselves or take their own life than their healthy counterparts. The team analyzed data incorporating 24,179 RLS patients and 145,194 healthy people and controlled for factors such as depression, sleep disorders, and diabetes. Age and sex did not appear to affect the connection between RLS and suicide risk.
"After controlling for these factors, we still didn't see the association decrease, meaning RLS could still be an independent variable contributing to suicide and self-harm," said Penn State’s Muzi Na in a statement. "We still don't know the exact reason, but our results can help shape future research to learn more about the mechanism."
Our knowledge of RLS is still lacking, despite the fact that it affects around 5 percent of the population. It can be difficult to diagnose and occurs in both children and adults, with those in middle age being the worst affected. The exact cause of the disease is still unclear; it is thought to have a genetic component and has also been linked to iron deficiency, diabetes, certain medications, and pregnancy, among other things. RLS has also been connected to high blood pressure and heart attacks, as well as depression and suicidal thoughts.
"Our study suggests that restless legs syndrome isn't just connected to physical conditions, but to mental health, as well," explained Xiang Gao, director of Penn State’s Nutritional Epidemiology Lab. "And, with RLS being under-diagnosed and suicide rates rising, this connection is going to be more and more important. Clinicians may want to be careful when they're screening patients both for RLS and suicide risk."
The team behind the research notes that there are a few limitations to their study. For example, they classified suicide and self-harm using ICD-9, a slightly outdated version of the International Classification of Diseases. They also point out that their cohort, despite being relatively large, may not be representative of the wider population as they were all commercially insured Americans under the age of 65.
The researchers hope that future studies may back up their findings and allow us to uncover more about the poorly understood yet distressing condition of RLS.