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SleepMed Insomnia Index may help characterize insomnia symptoms in patients with RLS; scores correlate with RLS severity

Thursday, December 13 2007 | Comments
Evidence Grade 0 What's This?
The SleepMed Insomnia Index (SMI) helps characterize insomnia symptoms in patients with moderately severe restless legs syndrome, new data indicate. In addition, unlike scores on the Epworth Sleepiness Scale (ESS), SMI scores correlate with RLS severity, as assessed using International Restless Legs Scale Scores (IRLSS).

The SMI is a 10-item, patient-administered questionnaire. Possible total scores range from 0 to 40, with higher scores indicating greater sleep-related problems. In their responses to the questionnaire, individuals rate various aspects of their sleep using a scale ranging from 0 (no sleep problems) to 4 (substantial sleep problems; sleep impacts all aspects of daily life). Questions address an individual's overall sleep satisfaction; insomnia symptoms, including difficulty with sleep onset and maintenance; and the impact of sleep quality on next-day function.

The authors noted that the SMI has previously identified a high likelihood of sleep disruption or sleep process abnormality in patients with an SMI score of >20.

In this analysis, investigators used the SMI to assess features of insomnia in 19 patients with untreated moderately severe RLS. In addition, they evaluated correlations between SMI and IRLSS scores, ESS and IRLSS scores, and ESS and SMI scores. All participants with RLS completed the SMI, the IRLSS, and the ESS. In addition, 22 controls completed the SMI and the ESS.

Among individuals with RLS, the mean SMI score was 28 (range, 21-34), the mean ESS score was 11 (range, 2-19), and the mean IRLSS was 28 (range, 20-35). Among controls, the mean SMI score was 4 and the mean ESS score was 5.

A correlation existed between IRLSS and SMI scores (P=.03), but not between IRLSS and ESS scores (P=.49) or between SMI and ESS scores (P=.27).

As a result of these findings, the study authors suggested that the SMI may be a useful tool for characterizing the specific features of an insomnia complaint in individuals with RLS and for assessing a response to treatment. (Turner JA, et al. P07.148.)

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