Skip to main content
Erschienen in: Zeitschrift für Gerontologie und Geriatrie 4/2015

01.06.2015 | CME

Schlaf und Schlafstörungen beim alten Menschen

Teil 3: Restless-legs-Syndrom

verfasst von: PD Dr. H. Frohnhofen, J. Schlitzer

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 4/2015

Einloggen, um Zugang zu erhalten

Zusammenfassung

Das Restless-legs-Syndrom (RLS) ist mit einer Prävalenz von etwa 10 % eine häufige Erkrankung. Frauen sind öfter betroffen als Männer. Es wird das primäre RLS von der sekundären Form unterschieden. Als Auslöser des sekundären RLS gelten Eisenmangel, schwere Niereninsuffizienz und zahlreiche Medikamente. Die Therapie ist immer symptomatisch. Neben der Behandlung auslösender Erkrankungen steht eine dopaminerge Therapie im Vordergrund. Für die Pharmakotherapie sind Levodopa (L-Dopa) sowie die Dopaminagonisten Pramipexol, Rotigotin und Ropinirol zugelassen. Eine ernste Komplikation einer dopaminergen Therapie ist die sog. Augmentation. Bei nichtausreichender Wirksamkeit, starken Beschwerden oder Augmentation ist Oxycodon/Naloxon jetzt auch für die Behandlung des RLS zugelassen.
Literatur
1.
Zurück zum Zitat American Academy of Sleep Medicine (2014) ICSD - International classification of sleep disorders, revised: Diagnostic & Coding Manual. Chicago, Illinois American Academy of Sleep Medicine (2014) ICSD - International classification of sleep disorders, revised: Diagnostic & Coding Manual. Chicago, Illinois
3.
Zurück zum Zitat Ekbom K (1945) Restless legs. A clinical study of a hitherto overlooked disease in the legs characterized by peculiar paresthesia (anxietas tibiarum), pain and weakness and occurring in two main forms, asthenia crurum paraesthetica and asthenia crurum dolorosa. Acta Med Scand Suppl 158 Ekbom K (1945) Restless legs. A clinical study of a hitherto overlooked disease in the legs characterized by peculiar paresthesia (anxietas tibiarum), pain and weakness and occurring in two main forms, asthenia crurum paraesthetica and asthenia crurum dolorosa. Acta Med Scand Suppl 158
4.
Zurück zum Zitat Garcia-Borreguero D, Williams A (2014) An update on restless legs syndrome (Willis-Ekbom disease): clinical features, pathogenesis and treatment. Curr Opin Neurol 27:493–501PubMedCrossRef Garcia-Borreguero D, Williams A (2014) An update on restless legs syndrome (Willis-Ekbom disease): clinical features, pathogenesis and treatment. Curr Opin Neurol 27:493–501PubMedCrossRef
5.
Zurück zum Zitat Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J (2003) Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 4:101–119PubMedCrossRef Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J (2003) Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 4:101–119PubMedCrossRef
6.
Zurück zum Zitat Walters AS, LeBrocq C, Dhar A et al (2003) Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med 4:121–132PubMedCrossRef Walters AS, LeBrocq C, Dhar A et al (2003) Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med 4:121–132PubMedCrossRef
7.
Zurück zum Zitat Walters AS (1995) Toward a better definition of the restless legs syndrome. The International Restless Legs Syndrome Study Group. Mov Disord 10:634–642PubMedCrossRef Walters AS (1995) Toward a better definition of the restless legs syndrome. The International Restless Legs Syndrome Study Group. Mov Disord 10:634–642PubMedCrossRef
8.
Zurück zum Zitat Walters AS, LeBrocq C, Dhar A et al (2003) Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med 4:121–132PubMedCrossRef Walters AS, LeBrocq C, Dhar A et al (2003) Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med 4:121–132PubMedCrossRef
9.
Zurück zum Zitat o A (2012) Leitlinie Restless-Legs-Syndrom (RLS) und Periodic Limb Movement Disorders (PLMD).Thieme, Stuttgart o A (2012) Leitlinie Restless-Legs-Syndrom (RLS) und Periodic Limb Movement Disorders (PLMD).Thieme, Stuttgart
10.
Zurück zum Zitat Klawans HL, Goetz CG, Tanner CM (2003) Common movement disorders. Lippincott Williams & Wilkins, Philadelphia Klawans HL, Goetz CG, Tanner CM (2003) Common movement disorders. Lippincott Williams & Wilkins, Philadelphia
12.
Zurück zum Zitat Broughton R, Tolentino MA, Krelina M (1985) Excessive fragmentary myoclonus in NREM sleep: a report of 38 cases. Electroencephalogr Clin Neurophysiol 61:123–133PubMedCrossRef Broughton R, Tolentino MA, Krelina M (1985) Excessive fragmentary myoclonus in NREM sleep: a report of 38 cases. Electroencephalogr Clin Neurophysiol 61:123–133PubMedCrossRef
13.
Zurück zum Zitat Atkinson MJ, Allen RP, DuChane J, Murray C, Kushida C, Roth T (2004) Validation of the Restless Legs Syndrome Quality of Life Instrument (RLS-QLI): findings of a consortium of national experts and the RLS Foundation. Qual Life Res 13:679–693PubMedCrossRef Atkinson MJ, Allen RP, DuChane J, Murray C, Kushida C, Roth T (2004) Validation of the Restless Legs Syndrome Quality of Life Instrument (RLS-QLI): findings of a consortium of national experts and the RLS Foundation. Qual Life Res 13:679–693PubMedCrossRef
14.
Zurück zum Zitat Kushida CA, Allen RP, Atkinson MJ (2004) Modeling the causal relationships between symptoms associated with restless legs syndrome and the patient-reported impact of RLS. Sleep Med 5:485–488PubMedCrossRef Kushida CA, Allen RP, Atkinson MJ (2004) Modeling the causal relationships between symptoms associated with restless legs syndrome and the patient-reported impact of RLS. Sleep Med 5:485–488PubMedCrossRef
15.
Zurück zum Zitat Rothdach AJ, Trenkwalder C, Haberstock J, Keil U, Berger K (2000) Prevalence and risk factors of RLS in an elderly population: the MEMO study. Memory and morbidity in augsburg elderly. Neurology 54:1064–1068PubMedCrossRef Rothdach AJ, Trenkwalder C, Haberstock J, Keil U, Berger K (2000) Prevalence and risk factors of RLS in an elderly population: the MEMO study. Memory and morbidity in augsburg elderly. Neurology 54:1064–1068PubMedCrossRef
16.
Zurück zum Zitat Phillips B, Young T, Finn L, Asher K, Hening WA, Purvis C (2000) Epidemiology of restless legs symptoms in adults. Arch Intern Med 160:2137–2141PubMedCrossRef Phillips B, Young T, Finn L, Asher K, Hening WA, Purvis C (2000) Epidemiology of restless legs symptoms in adults. Arch Intern Med 160:2137–2141PubMedCrossRef
17.
Zurück zum Zitat Berger K, Luedemann J, Trenkwalder C, John U, Kessler C (2004) Sex and the risk of restless legs syndrome in the general population. Arch Intern Med 164:196–202PubMedCrossRef Berger K, Luedemann J, Trenkwalder C, John U, Kessler C (2004) Sex and the risk of restless legs syndrome in the general population. Arch Intern Med 164:196–202PubMedCrossRef
18.
Zurück zum Zitat Allen RP, Walters AS, Montplaisir J et al (2005) Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med 165:1286–1292PubMedCrossRef Allen RP, Walters AS, Montplaisir J et al (2005) Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med 165:1286–1292PubMedCrossRef
19.
Zurück zum Zitat Hening W, Walters AS, Allen RP, Montplaisir J, Myers A, Ferini-Strambi L (2004) Impact, diagnosis and treatment of restless legs syndrome (RLS) in a primary care population: the REST (RLS epidemiology, symptoms, and treatment) primary care study. Sleep Med 5:237–246PubMedCrossRef Hening W, Walters AS, Allen RP, Montplaisir J, Myers A, Ferini-Strambi L (2004) Impact, diagnosis and treatment of restless legs syndrome (RLS) in a primary care population: the REST (RLS epidemiology, symptoms, and treatment) primary care study. Sleep Med 5:237–246PubMedCrossRef
20.
Zurück zum Zitat Winkelmann J, Prager M, Lieb R et al (2005) „Anxietas tibiarum“. Depression and anxiety disorders in patients with restless legs syndrome. J Neurol 252:67–71PubMedCrossRef Winkelmann J, Prager M, Lieb R et al (2005) „Anxietas tibiarum“. Depression and anxiety disorders in patients with restless legs syndrome. J Neurol 252:67–71PubMedCrossRef
21.
Zurück zum Zitat Kushida CA (2007) Clinical presentation, diagnosis, and quality of life issues in restless legs syndrome. Am J Med 120(1 Suppl1):S4–S12 Kushida CA (2007) Clinical presentation, diagnosis, and quality of life issues in restless legs syndrome. Am J Med 120(1 Suppl1):S4–S12
22.
Zurück zum Zitat Allen RP, Earley CJ (2001) Restless legs syndrome: a review of clinical and pathophysiologic features. J Clin Neurophysiol 18:128–147PubMedCrossRef Allen RP, Earley CJ (2001) Restless legs syndrome: a review of clinical and pathophysiologic features. J Clin Neurophysiol 18:128–147PubMedCrossRef
23.
Zurück zum Zitat Winkelman JW, Chertow GM, Lazarus JM (1996) Restless legs syndrome in end-stage renal disease. Am J Kidney Dis 28:372–378PubMedCrossRef Winkelman JW, Chertow GM, Lazarus JM (1996) Restless legs syndrome in end-stage renal disease. Am J Kidney Dis 28:372–378PubMedCrossRef
25.
Zurück zum Zitat O'Keeffe ST, Gavin K, Lavan JN (1994) Iron status and restless legs syndrome in the elderly. Age Ageing 23:200–203PubMedCrossRef O'Keeffe ST, Gavin K, Lavan JN (1994) Iron status and restless legs syndrome in the elderly. Age Ageing 23:200–203PubMedCrossRef
26.
Zurück zum Zitat Salih AM, Gray RE, Mills KR, Webley M (1994) A clinical, serological and neurophysiological study of restless legs syndrome in rheumatoid arthritis. Br J Rheumatol 33:60–63PubMedCrossRef Salih AM, Gray RE, Mills KR, Webley M (1994) A clinical, serological and neurophysiological study of restless legs syndrome in rheumatoid arthritis. Br J Rheumatol 33:60–63PubMedCrossRef
27.
Zurück zum Zitat Hening W (2004) The clinical neurophysiology of the restless legs syndrome and periodic limb movements. Part I: diagnosis, assessment, and characterization. Clin Neurophysiol 115:1965–1974PubMedCrossRef Hening W (2004) The clinical neurophysiology of the restless legs syndrome and periodic limb movements. Part I: diagnosis, assessment, and characterization. Clin Neurophysiol 115:1965–1974PubMedCrossRef
28.
Zurück zum Zitat Trenkwalder C, Paulus W (2004) Why do restless legs occur at rest? – pathophysiology of neuronal structures in RLS. Neurophysiology of RLS (part 2). Clin Neurophysiol 115:1975–1988PubMedCrossRef Trenkwalder C, Paulus W (2004) Why do restless legs occur at rest? – pathophysiology of neuronal structures in RLS. Neurophysiology of RLS (part 2). Clin Neurophysiol 115:1975–1988PubMedCrossRef
29.
Zurück zum Zitat Montplaisir J, Lorrain D, Godbout R (1991) Restless legs syndrome and periodic leg movements in sleep: the primary role of dopaminergic mechanism. Eur Neurol 31:41–43PubMedCrossRef Montplaisir J, Lorrain D, Godbout R (1991) Restless legs syndrome and periodic leg movements in sleep: the primary role of dopaminergic mechanism. Eur Neurol 31:41–43PubMedCrossRef
30.
Zurück zum Zitat Connor JR, Wang X, Allen RP et al (2009) Altered dopaminergic profile in the putamen and substantia nigra in restless leg syndrome. Brain 132:2403–2412PubMedCentralPubMedCrossRef Connor JR, Wang X, Allen RP et al (2009) Altered dopaminergic profile in the putamen and substantia nigra in restless leg syndrome. Brain 132:2403–2412PubMedCentralPubMedCrossRef
31.
Zurück zum Zitat Salminen AV, Rimpilä V, Polo O (2014) Peripheral hypoxia in restless legs syndrome (Willis-Ekbom disease). Neurology 82:1856–1861PubMedCrossRef Salminen AV, Rimpilä V, Polo O (2014) Peripheral hypoxia in restless legs syndrome (Willis-Ekbom disease). Neurology 82:1856–1861PubMedCrossRef
32.
Zurück zum Zitat Rottach KG, Schaner BM, Kirch MH et al (2008) Restless legs syndrome as side effect of second generation antidepressants. J Psychiatr Res 43:70–75PubMedCrossRef Rottach KG, Schaner BM, Kirch MH et al (2008) Restless legs syndrome as side effect of second generation antidepressants. J Psychiatr Res 43:70–75PubMedCrossRef
33.
Zurück zum Zitat Michalek C, Wehling M, Schlitzer J, Frohnhofen H (2014) Effects of „Fit fOR The Aged“ (FORTA) on pharmacotherapy and clinical endpoints – a pilot randomized controlled study. Eur J Clin Pharmacol 70:1261–1267PubMedCrossRef Michalek C, Wehling M, Schlitzer J, Frohnhofen H (2014) Effects of „Fit fOR The Aged“ (FORTA) on pharmacotherapy and clinical endpoints – a pilot randomized controlled study. Eur J Clin Pharmacol 70:1261–1267PubMedCrossRef
34.
Zurück zum Zitat Trenkwalder C, Benes H, Poewe W et al (2008) Efficacy of rotigotine for treatment of moderate-to-severe restless legs syndrome: a randomised, double-blind, placebo-controlled trial. Lancet Neurol 7:595–604PubMedCrossRef Trenkwalder C, Benes H, Poewe W et al (2008) Efficacy of rotigotine for treatment of moderate-to-severe restless legs syndrome: a randomised, double-blind, placebo-controlled trial. Lancet Neurol 7:595–604PubMedCrossRef
35.
Zurück zum Zitat Trenkwalder C, Hening WA, Montagna P et al (2008) Treatment of restless legs syndrome: an evidence-based review and implications for clinical practice. Mov Disord 23:2267–2302PubMedCrossRef Trenkwalder C, Hening WA, Montagna P et al (2008) Treatment of restless legs syndrome: an evidence-based review and implications for clinical practice. Mov Disord 23:2267–2302PubMedCrossRef
36.
Zurück zum Zitat Allen RP, Earley CJ (1996) Augmentation of the restless legs syndrome with carbidopa/levodopa. Sleep 19:205–213PubMed Allen RP, Earley CJ (1996) Augmentation of the restless legs syndrome with carbidopa/levodopa. Sleep 19:205–213PubMed
37.
Zurück zum Zitat Stiasny-Kolster K, Kohnen R, Möller JC, Trenkwalder C, Oertel WH (2006) Validation of the „L-DOPA test“ for diagnosis of restless legs syndrome. Mov Disord 21:1333–1339PubMedCrossRef Stiasny-Kolster K, Kohnen R, Möller JC, Trenkwalder C, Oertel WH (2006) Validation of the „L-DOPA test“ for diagnosis of restless legs syndrome. Mov Disord 21:1333–1339PubMedCrossRef
38.
Zurück zum Zitat Littner MR, Kushida C, Anderson WM et al (2004) Practice parameters for the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder. Sleep 27:557–559PubMed Littner MR, Kushida C, Anderson WM et al (2004) Practice parameters for the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder. Sleep 27:557–559PubMed
39.
Zurück zum Zitat Hornyak M, Scholz H, Kohnen R, Bengel J, Kassubek J, Trenkwalder C (2014) What treatment works best for restless legs syndrome? Meta-analyses of dopaminergic and non-dopaminergic medications. Sleep Med Rev 18:153–164PubMedCrossRef Hornyak M, Scholz H, Kohnen R, Bengel J, Kassubek J, Trenkwalder C (2014) What treatment works best for restless legs syndrome? Meta-analyses of dopaminergic and non-dopaminergic medications. Sleep Med Rev 18:153–164PubMedCrossRef
40.
Zurück zum Zitat Winlow W (2005) Pramipexole in restless legs syndrome: an evidence-based review of its effectiveness on clinical outcomes. Core Evid 1:35–42PubMedCentralPubMed Winlow W (2005) Pramipexole in restless legs syndrome: an evidence-based review of its effectiveness on clinical outcomes. Core Evid 1:35–42PubMedCentralPubMed
41.
Zurück zum Zitat Winkelman JW, Sethi KD, Kushida CA et al (2006) Efficacy and safety of pramipexole in restless legs syndrome. Neurology 67:1034–1039PubMedCrossRef Winkelman JW, Sethi KD, Kushida CA et al (2006) Efficacy and safety of pramipexole in restless legs syndrome. Neurology 67:1034–1039PubMedCrossRef
42.
Zurück zum Zitat Winkelman JW, Johnston L (2004) Augmentation and tolerance with long-term pramipexole treatment of restless legs syndrome (RLS). Sleep Med 5:9–14PubMedCrossRef Winkelman JW, Johnston L (2004) Augmentation and tolerance with long-term pramipexole treatment of restless legs syndrome (RLS). Sleep Med 5:9–14PubMedCrossRef
43.
Zurück zum Zitat Allen R, Becker PM, Bogan R et al (2004) Ropinirole decreases periodic leg movements and improves sleep parameters in patients with restless legs syndrome. Sleep 27:907–914PubMed Allen R, Becker PM, Bogan R et al (2004) Ropinirole decreases periodic leg movements and improves sleep parameters in patients with restless legs syndrome. Sleep 27:907–914PubMed
44.
Zurück zum Zitat Trenkwalder C (2006) The weight of evidence for ropinirole in restless legs syndrome. Eur J Neurol 13(Suppl 3):21–30PubMed Trenkwalder C (2006) The weight of evidence for ropinirole in restless legs syndrome. Eur J Neurol 13(Suppl 3):21–30PubMed
45.
Zurück zum Zitat Trenkwalder C, Beneš H, Grote L et al (2013) Prolonged release oxycodone-naloxone for treatment of severe restless legs syndrome after failure of previous treatment: a double-blind, randomised, placebo-controlled trial with an open-label extension. Lancet Neurol 12:1141–1150PubMedCrossRef Trenkwalder C, Beneš H, Grote L et al (2013) Prolonged release oxycodone-naloxone for treatment of severe restless legs syndrome after failure of previous treatment: a double-blind, randomised, placebo-controlled trial with an open-label extension. Lancet Neurol 12:1141–1150PubMedCrossRef
46.
Zurück zum Zitat Thorp ML, Morris CD, Bagby SP (2001) A crossover study of gabapentin in treatment of restless legs syndrome among hemodialysis patients. Am J Kidney Dis 38:104–108PubMedCrossRef Thorp ML, Morris CD, Bagby SP (2001) A crossover study of gabapentin in treatment of restless legs syndrome among hemodialysis patients. Am J Kidney Dis 38:104–108PubMedCrossRef
47.
Zurück zum Zitat Garcia-Borreguero D, Patrick J, DuBrava S et al (2014) Pregabalin versus pramipexole: effects on sleep disturbance in restless legs syndrome. Sleep 37:635–643PubMedCentralPubMed Garcia-Borreguero D, Patrick J, DuBrava S et al (2014) Pregabalin versus pramipexole: effects on sleep disturbance in restless legs syndrome. Sleep 37:635–643PubMedCentralPubMed
48.
Zurück zum Zitat Allen RP, Chen C, Garcia-Borreguero D et al (2014) Comparison of pregabalin with pramipexole for restless legs syndrome. N Engl J Med 370:621–631PubMedCrossRef Allen RP, Chen C, Garcia-Borreguero D et al (2014) Comparison of pregabalin with pramipexole for restless legs syndrome. N Engl J Med 370:621–631PubMedCrossRef
49.
Zurück zum Zitat Joy MS (1997) Clonazepam: benzodiazepine therapy for the restless legs syndrome. ANNA J 24:686–689PubMed Joy MS (1997) Clonazepam: benzodiazepine therapy for the restless legs syndrome. ANNA J 24:686–689PubMed
50.
51.
Zurück zum Zitat Hornyak M, Voderholzer U, Hohagen F, Berger M, Riemann D (1998) Magnesium therapy for periodic leg movements-related insomnia and restless legs syndrome: an open pilot study. Sleep 21:501–505PubMed Hornyak M, Voderholzer U, Hohagen F, Berger M, Riemann D (1998) Magnesium therapy for periodic leg movements-related insomnia and restless legs syndrome: an open pilot study. Sleep 21:501–505PubMed
52.
Zurück zum Zitat Sun Y, Valkenhoef G van, Morel T (2014) A mixed treatment comparison of gabapentin enacarbil, pramipexole, ropinirole and rotigotine in moderate-to-severe restless legs syndrome. Curr Med Res Opin 30:2267–2278PubMedCrossRef Sun Y, Valkenhoef G van, Morel T (2014) A mixed treatment comparison of gabapentin enacarbil, pramipexole, ropinirole and rotigotine in moderate-to-severe restless legs syndrome. Curr Med Res Opin 30:2267–2278PubMedCrossRef
Metadaten
Titel
Schlaf und Schlafstörungen beim alten Menschen
Teil 3: Restless-legs-Syndrom
verfasst von
PD Dr. H. Frohnhofen
J. Schlitzer
Publikationsdatum
01.06.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 4/2015
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-015-0901-4

Weitere Artikel der Ausgabe 4/2015

Zeitschrift für Gerontologie und Geriatrie 4/2015 Zur Ausgabe

Mitteilungen der DGGG

Mitteilungen der DGGG

Journal Club

Journal Club

Mitteilungen der DGG

Mitteilungen der DGG