Abstract

Background: An association between restless legs syndrome and migraine has been reported recently. The clinical correlates and impact of comorbidity of RLS is not fully described in patients with migraine.

Objectives: To investigate the frequency of RLS among different primary headache disorders and its impact and clinical correlates in migraine patients.

Methods: Consecutive patients with migraine, tension-type headache (TTH) and cluster headache (CH) were recruited in a headache clinic. Each patient completed the Migraine Disability Assessment (MIDAS) questionnaire, Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and the International RLS Study Group (IRLSSG) Rating Scale. RLS was diagnosed using the IRLSSG criteria.

Results: A total of 1,041 patients (migraine 772, TTH 218, CH 51) completed the study. The frequencies of RLS in patients with migraine (11.4%) were higher than those with TTH (4.6%) or CH (2.0%) (p=0.002). In migraine patients, comorbidity with RLS was associated with higher frequencies of photophobia, phonophobia, exacerbation due to physical activities, vertigo, dizziness, tinnitus and neck pain and higher mean scores of MIDAS and HADS. Migraine patients with RLS had poorer sleep (Pittsburgh Sleep Quality Index score 11.1±4.1 vs. 8.9±4.0, p<0.001) than those without. The frequencies of RLS increased with an increasing number of migrainous symptoms (linear-by-linear association, p<0.001).

Conclusion: Our study demonstrated an association between migraine and RLS among different primary headache disorders. Comorbid RLS in migraine patients worsened sleep quality. A shared underlying mechanism may account for the correlates between migraine features and comorbid RLS.