Restless Legs Syndrome (RLS) Interdisciplinary Approach

APRESENTAÇÃO
Maria José Vilela de Varela, Luís Fabiano Marin, Maite Vilela de Varela, Marcelo Casemiro, Marco António Ferreira Alves, Clarisse Potasz, Marília Rezende *Luciane Bizari Coin de Carvalho, João Eduardo Coin de Carvalho, Lucila Bizari Fernandes do Prado, *Gilmar Fernandes do Prado.

Neuro-Sono, Department of Neurology and Department of Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.
E-mail: gilmarunifesp@yahoo.com.br / neuro.sono.unifesp@gmail.com / mazevarela2@gmail.com

Introduction: Restless Legs Syndrome (RLS) is a sleep disorder, characterized by an irresistible urge to move the legs, unpleasant sensations, mostly at night, improving with movement. These symptoms induce insomnia, cognitive deficit, depression, anxiety, interfering in daily activities.

Objective: To verify if education, regular physical activity, and CBT are an adequate RLS intervention.

Methods: Among 2,200 medical files of Neuro-Sono outpatients clinic, Unifesp, we identified 100 patients (65 females), aged 20-86 years, with confirmed RLS diagnosis by a physician, according to International RLS Study Group. 20 patients (17 females) were assessed and treated by an Interdisciplinary Group for 3 months. Physician evaluated patients who were treated with non ergolinic dopaminergic agonists. Psychologist assessed history of life, International RLS Severity Scale, BDI, BAI, RLS Quality of Life Instrument, ESS. Occupacional Therapist provides information about lifestyle and environment factors. Monthly, physical therapists and educators promoted physical activities in group. At the end of each session, RLS Quality of Life Instrument was applied.

Results: This pilot study showed that one week after treatment RLS severity reduced from severe to mild in 80% of patients, but many patients were still complaining of insomnia and anxiety index were also high, besides lower than before drug therapy. Interdisciplinar approach started at the second visit, including CBT and the above cited interventions. Anxiety level, depression, and insomnia reduced drastically and a significant bind to the health care team developed, helping to improve self confidence and quality of life. The overall impression was that a more broad approach accelerated the improvement and discloses a state of happiness hidden for many years in our sample of RLS patients.

Conclusion: Interdisciplinary approach provided a better understanding of patient and illness, showing to therapists and patients how to deal with complex features of RLS, connecting effective treatment to a better lifestyle.

* Supported by FAPESP (# 00/07513-3, # 99/08189-6) and Uniter-Sono.