Authors' objectives: To determine whether there is any evidence to support the existence of any causal association between Restless Legs Syndrome (RLS) and Post-Traumatic Stress Disorder (PTSD).

Authors' results and conclusions: Of the 59 studies that were retrieved in full , six were excluded due to incorrect population , one was excluded due to incorrect outcomes , 17 were excluded due to incorrect study design61 , one was an ongoing trial, and three studies were included in the original systematic review. An additional thirteen studies were excluded due to incorrect population as they were regarding Periodic Limb Movement Disorder (PLMD), a related but distinct condition. A manual search of the references revealed one additional study . One relevant systematic review on RLS and PTSD was found. For the ongoing Dutch trial (NL-OMON26242), patients with psychiatric disorder (E.g. depressive disorder, bipolar disorder, anxiety disorder, PTSD, and other disorders), will be examined for sleep disorders including sleep-movement disorders such as RLS. The primary outcome is prevalence in sleep disorders in the individual psychiatric subpopulations as well as any treatment effects on these sleep disorders. Therefore, there are 18 new published studies and one ongoing trial that are relevant to this systematic review. There were three cross-sectional studies, two pilot studies, one case control study, one prospective observational study, and eleven retrospective studies. Five of the studies had a comparator group. The evidence looking at the association of RLS and PTSD is mixed at best. Six of the 18 studies had an association between RLS and PTSD. In the original 2019 paper, there were no published studies showing a causal relationship between RLS and PTSD in any direction. In this 2024 update, there were 18 published studies and one ongoing trial that examines the existence of any causal association of RLS and PTSD. While there is some low-quality low-level evidence showing association between RLS and PTSD, it cannot be determined whether the data was clinically relevant as the majority of the studies were cross-sectional in nature. There was heterogeneity in the methods of assessing exposure (PTSD definition), inconsistent definitions of outcomes (ascertainment of RLS), and possible confounding due to side effects of PTSD medications. In conclusion, there is insufficient high quality evidence study to support the association of PTSD with RLS and change the conclusions of the 2019 systematic review on the same topic.

Authors' methods: In 2019, WorkSafeBC Evidence-based Practice Group (EBPG) commissioned a systematic review to investigate the existence of any causal association between Restless Legs Syndrome (RLS) and Post-Traumatic Stress Disorder (PTSD) . The findings concluded that there are no published studies which explored RLS and PTSD relationship beyond a cross-sectional design and therefore no sufficient evidence to make causal inferences for RLS and PTSD relationship in any direction. The current update seeks to review the literature from the last update in 2019 to determine the existence of any causal association between RLS and PTSD.A systematic literature search was started on October 16, 2024. This literature search was conducted on commercial medical literature databases employing combinations of keywords. No other limitations were implemented in any of these searches. A manual search was also planned and conducted on the references of the articles that were retrieved in full. Levels of evidence used to infer causal association in epidemiological studies rely on the Bradford-Hill framework . These include consistency of association, strength of the association, dose-response, temporal relationship, and biological plausibility.

Project Status: Completed

URL for project: https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews

Year Published: 2024

URL for published report: https://www.worksafebc.com/en/resources/health-care-providers/guides/restless-legs-syndrome-posttraumatic-stress-disorder-2024-update?lang=en

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

Copyright: WorkSafe BC