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Oestradiol Levels During Pregnancy Linked to Increased Risk of RLS

WESTCHESTER, Ill -- February 2, 2009 -- A study in the February issue of the journal Sleep shows that the elevation in oestradiol levels that occurs during pregnancy is more pronounced in pregnant women with restless legs syndrome (RLS) than in controls.

According to the authors, the data strongly suggest that oestrogens play an important role in RLS during pregnancy. The study also supports previous reports of high RLS incidence in the last trimester of pregnancy when oestradiol is maximally elevated.

"Our findings strongly support the concept that neuroactive hormones play a relevant pathophysiological role in RLS," said principal investigator Thomas Pollmacher, MD, Center for Medical Health, Klinikum Ingolstadt, Germany, and Ludwig Maximilians University, Munich, Germany. "This information will increase the understanding of RLS in pregnancy and will assist in the development of specific therapeutic approaches."

The study involved 9 healthy pregnant women (mean age 32.9 years) who were placed in a control group and 10 pregnant women (mean age 31.6 years) who fulfilled diagnostic criteria for RLS. Eight women from the RLS group reported symptoms previous to the present pregnancy, and all members of the RLS group described worsening of symptoms during pregnancy. The mean age of onset for RLS symptoms was 22.6 years.

Sleep data and leg movements were recorded during overnight polysomnography around 36 weeks gestation and again at 12 weeks postpartum. Blood samples were taken each morning after the polysomnography and before breakfast. Accompanying questionnaires on sleep and RLS symptoms also were collected.

During the last trimester of pregnancy, levels of oestradiol were 34,211 pg/mL in women with RLS and 25,475 pg/mL in healthy controls. At 3 months postpartum, oestradiol levels had dropped to 30.73 pg/mL in the RLS group and 94.92 pg/mL in controls. Other hormone levels did not differ significantly between the study groups.

Women with RLS had more periodic limb movements (PLMs) than controls before and after delivery. PLMs decreased significantly after delivery in women with RLS and stayed low in women without RLS.

Only minor differences appeared between the 2 study groups in subjective sleep quality and objective sleep measures. One explanation suggested by the authors is that only RLS patients who did not need pharmacological treatment were selected for the study; RLS symptoms of participants were in the mild to moderate range.

SOURCE: American Academy of Sleep Medicine

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