December 28, 2019

New research suggests it is especially important for people and families living with RLS to pay attention to their mental health needs and to seek help if they are struggling.

In a study at Pennsylvania State University, researchers found that participants with RLS were 2.7 times more likely than others to experience suicide or self-harm, regardless of whether or not they also had depression, sleep disorders or other chronic conditions. The study was published in the Journal of the American Medical Association (JAMA) Network Open.

“Our study suggests that restless legs syndrome isn’t just connected to physical conditions, but to mental health as well,” said study co-author Xiang Gao, MD, PhD, in a press release. “And with RLS being under-diagnosed and suicide rates rising, this connection is going to be more and more important. Clinicians may want to be careful when they’re screening patients both for RLS and suicide risk.” Dr. Gao is director of the Nutritional Epidemiology Lab at Penn State.

In the study, the researchers examined medical claims data of 169,373 adult patients. Of them, 24,179 participants had a diagnosis of RLS and were matched to six participants without RLS according to sex and year of birth. The study excluded pregnant women. Participants were followed for up to six years, from 2006 to 2014.

Over the follow-up period, 119 participants had incidents of suicide and self-harm. The researchers found that those with RLS had a significantly higher chance of suicide or self-harm than other participants. This association was independent of age, sex, geographic differences, depression, sleep disorders, other chronic medical conditions, and medication use.

The reason for the higher rate of suicide is unclear, and further studies are needed to explore this, according to Dr. Gao and lead author Sheng Zhuang, MD. “We agree that sleep problems, depression and RLS-related medication could be underlying reasons for the observed suicide risk in RLS patients. However, we obtained similar results after we excluded participants with these conditions, suggesting that there might be other underlying interpretations,” says Dr. Gao.

According to the authors, theirs is the first large study to examine risk of suicide for RLS patients over time by evaluating actual suicide and self-harm incidents. Previous studies have been smaller and focused on suicidal thoughts.

Dr. Gao and Dr. Zhuang have published numerous previous epidemiological studies on RLS, including one in which they found that RLS was associated with increased risk of mortality. They say that part of their interest in studying RLS and suicide was to determine if the high mortality risk might be driven by higher suicide risk. “In the context of high prevalence of RLS and increasing suicide rate in the U.S., we think that addressing the association between RLS and suicide is of clinical and public health importance,” Dr. Gao says.

The take-away message is to be proactive in addressing mental health issues, according to Dr. Gao. “For RLS patients, they don’t have to be over worried, but should seek early help for psychological counseling to prevent self-harm, suicide or other adverse events if they experience severe or frequent mental disturbance,” he says.

If you have RLS and suffer from depression, seek care from a psychiatrist and/or a licensed psychologist, and also consider visiting the RLS Quality Care Center nearest you. Controlling RLS symptoms can go a long way toward improving mental health. Although many antidepressants are known to increase RLS symptoms, an antidepressant should be considered in treating depression; for many persons with depression, these medicines can be extremely beneficial to improve mood and overall well-being.

If you are having thoughts of attempting suicide, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). You are not alone.