Autonomic dysfunction in restless legs syndrome

  • Yuksel ErdalEmail author
  • Ozlem Akdogan
  • Mecbure Nalbantoglu
  • Gokce Kavasoglu
  • Ufuk Emre
Sleep Breathing Physiology and Disorders • Original Article



Autonomic dysfunction in patients with RLS has been described in some domains; however, detailed studies on this subject are limited and report conflicting results. In this study, we aimed to evaluate autonomic functions electrophysiologically and clinically in patients with restless legs syndrome (RLS).


Fifty-two adult patients with RLS and 40 healthy controls were enrolled in this prospective study. Electrophysiological tests of sympathetic skin response (SSR) and RR interval variability (RRIV) analysis were performed, and the SCOPA-AUT questionnaire was applied to evaluate autonomic functions.


There was no significant difference in terms of SSR results between patients and controls (p > 0.05). However, there were significant differences between the patient and control groups in terms of RRIV analyses at rest, deep breathing, and valsalva, and also valsalva ratio (p = 0.037, p = 0.049, p = 0.017, p = 0.020). The mean SCOPA-AUT total score was higher in the RLS group compared with the control group (20.7 ± 10 vs 14.2 ± 8; p = 0.003). Significant differences were found regarding gastrointestinal, urinary, and cardiovascular domains (p = 0.01, p = 0.007, p = 0.049); on the other hand, pupillomotor, thermoregulatory, and sexual function did not significantly differ (p > 0.05).


Autonomic functions should be questioned in detail as well as motor and sensory symptoms of RLS, and care should be taken especially on cardiac dysfunction.


Restless legs syndrome Sympathetic skin response RR interval variability, SCOPA-AUT Autonomic dysfunction 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of NeurologyIstanbul Training and Research HospitalIstanbulTurkey
  2. 2.Department of NeurologyDemiroglu Bilim University Medical FacultyIstanbulTurkey

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