Restless legs syndrome in oncology palliative medicine: prevalence and impact

To determine the prevalence and severity of restless legs syndrome (RLS) in patients with advanced cancer receiving palliative care.

A cross-sectional, single-centre study was conducted in a palliative oncology wars and outpatient clinics of a tertiary hospital in Spain. Adult oncology patients with palliative needs were examined by a physician, specialised in palliative care, and trained in RLS, to diagnose RLS according to established criteria of the consensus of the International RLS Study Group (IRLSSG). Subsequently, only RLS -positive patients responded to the RLS Severity-Rating Questionnaire (IRLSSG), to assess symptom severity. Functional status was evaluated using Eastern Cooperative Oncology Group performance status. Demographic variables, comorbidities, and treatments were collected, and associations between RLS and potential precipitating factors were analysed.

A total of 135 patients were included. 16 patients (11.85%) met diagnostic criteria for RLS. None of them had been previously diagnosed. The mean age of RLS-positive patients was 66.4 and the most frequent cancers were digestive, respiratory and gynaecological cancers. RLS severity was mild in six patients (37.50%) and moderate in five patients (31.25%); no patients presented with severe or very severe symptoms. Sleep disturbance related to RLS was reported by a minority of affected patients. Only Alcohol consumption was the only factor significantly associated with RLS (p=0.008).

RLS is relatively common and underdiagnosed in patients with advanced cancer receiving palliative care, with predominantly mild to moderate symptoms. Systematic clinical assessment of RLS in palliative oncology settings may help identify a treatable contributor to impaired quality of life.