Skip to main content

Advertisement

SpringerLink
Log in

Mindfulness-Based Stress Reduction for Restless Legs Syndrome: a Proof of Concept Trial

  • ORIGINAL PAPER
  • Published:
Mindfulness Aims and scope Submit manuscript

Abstract

Psychological interventions for the management of restless legs syndrome (RLS) have yet to be thoroughly investigated. The aim of the present pilot study was to investigate whether mindfulness-based stress reduction (MBSR) can be used as a feasible and acceptable treatment option for the RLS patient population. Eight participants (four men and four women, with ages ranging from 44 to 67 years; M = 56.28, SD = 8.11) seeking treatment for RLS at a sleep clinic attended a 6-week MBSR group program. Five of these participants also participated in a focus group, 3 months post-intervention, to provide their experiences and opinions of the program. The findings revealed group and individual improvements in RLS symptom severity (d = 0.75), RLS-specific quality of life (d = 1.09), sleep quality (d = 1.47), and daytime sleepiness (d = 1.15). Results also revealed significant reductions in general psychopathology (d = 1.96), and overall significant improvement in mindfulness (d = 2.00) and mental health status post-intervention (d = 2.12) with stable improvements at a 3-month follow-up. Qualitative findings showed that participants found the program to be highly beneficial. The findings of the current study suggest that MBSR could be a promising treatment option in the management of RLS and associated conditions. This proof-of-concept study provides a strong rationale for further research to examine mindfulness-based interventions for RLS using larger sample sizes and randomized controlled trials.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Abetz, L., Vallow, S. M., Kirsch, J., Allen, R. P., Washburn, T., & Earley, C. J. (2005). Validation of the restless legs syndrome quality of life questionnaire. Value in Health, 8(2), 157–167. doi:10.1111/j.1524-4733.2005.03010.x.

    Article  PubMed  Google Scholar 

  • Allen, R. P. (2006). Restless legs syndrome and periodic limb movement disorder: nightwalkers. Philadelphia: Taylor & Francis.

    Google Scholar 

  • Allen, R. P., Stillman, P., & Myers, A. J. (2010). Physician-diagnosed restless legs syndrome in a large sample of primary medical care patients in western Europe: prevalence and characteristics. Sleep Medicine, 11(1), 31–37. doi:10.1016/j.sleep.2009.03.007.

    Article  PubMed  Google Scholar 

  • Allen, R. P., Bharmal, M., & Calloway, M. (2011a). Prevalence and disease burden of primary restless legs syndrome: results of a general population survey in the United States. Movement Disorders, 26(1), 114–120.

    Article  PubMed  Google Scholar 

  • Allen, R.P., Ondo, W.G., Ball, E., Calloway, M. O., Manjunath, R., Higbie, R. L.,…Nisbet, P. A. (2011). Restless legs syndrome (RLS) augmentation associated with dopamine agonist and levodopa usage in a community sample. Sleep Medicine, 12(5), 431–439.

  • Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45. doi:10.1177/1073191105283504.

    Article  PubMed  Google Scholar 

  • Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the hospital anxiety and depression scale. An updated literature review. Journal of Psychosomatic Research, 52(2), 69–77.

    Article  PubMed  Google Scholar 

  • Bohlmeijer, E., ten Klooster, P. M., Fledderus, M., Veehof, M., & Baer, R. (2011). Psychometric properties of the Five Facet Mindfulness Questionnaire in fepressed adults and development of a short form. Assessment, 18(3), 308–320.

  • Brand, S., Beck, J., Hatzinger, M., Savic, M., & Holsboer-Trachsler, E. (2011). Unfavorable polysomnographic sleep patterns predict poor sleep and poor psychological functioning 3 years later in patients with restless legs syndrome. Neuropsychobiology, 63(2), 92–102. doi:10.1159/000317549.

    Article  PubMed  Google Scholar 

  • Brazier, J. E., Harper, R., Jones, N. M., O’Cathain, A., Thomas, K. J., Usherwood, T., & Westlake, L. (1992). Validating the SF-36 health survey questionnaire: new outcome measure for primary care. British Medical Journal, 305, 160–164.

    Article  PubMed  PubMed Central  Google Scholar 

  • Buysse, D. J., Reynolds, C. F., III, Monk, T. H., Berman, S. R., & Kupfer, D. J. (1988). The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Research, 28, 193–213.

    Article  Google Scholar 

  • Chiesa, A., & Serretti, A. (2011). Mindfulness based cognitive therapy for psychiatric disorders: a systematic review and meta-analysis. Psychiatry Research, 187(3), 441–453. doi:10.1016/j.psychres.2010.08.011.

    Article  PubMed  Google Scholar 

  • Chokroverty, S. (2011). Long-term management issues in restless legs syndrome. Movement Disorders, 26(8), 1378–1385. doi:10.1002/mds.23652.

    Article  PubMed  Google Scholar 

  • Derogatis, L. R. (1994). Symptom checklist-90-revised. Administration, scoring, and procedures manual. Towson: Clinical Psychometrics Research.

    Google Scholar 

  • Earley, C. J., & Silber, M. H. (2010). Restless legs syndrome: understanding its consequences and the need for better treatment. Sleep Medicine, 11(9), 807–815. doi:10.1016/j.sleep.2010.07.007.

    Article  PubMed  Google Scholar 

  • Garcia-Borreguero, D., Stillman, P., Benes, H., Buschmann, H., Chaudhuri, K. R., Gonzalez Rodriguez, V. M., . . . Zucconi, M. (2011). Algorithms for the diagnosis and treatment of restless legs syndrome in primary care. BMC Neurology, 11(28), 1–13. doi: 10.1186/1471-2377-11-28

  • Godau, J., Spinnler, N., Wevers, A.-K., Trenkwalder, C., & Berg, D. (2010). Poor effect of guideline based treatment of restless legs syndrome in clinical practice. Journal of Neurology, Neurosurgery, and Psychiatry, 81(12), 1390–1395. doi:10.1136/jnnp.2010.211417.

    Article  PubMed  Google Scholar 

  • Gross, C. R., Kreitzer, M. J., Reilly-Spong, M., Wall, M., Winbush, N. Y., Patterson, R., . . . Cramer-Bornemann, M. (2011). Mindfulness-based stress reduction versus pharmacotherapy for chronic primary insomnia: A randomized controlled clinical trial. Explore, 7(2), 76–87. doi: 10.1016/j.explore.2010.12.003

  • Happe, S., Reese, J. P., & Stiasny-Kolster, K. (2009). Assessing health-related quality of life in patients with restless legs syndrome. Sleep Medicine, 10(3), 295–305.

    Article  PubMed  Google Scholar 

  • Hornyak, M. (2010). Depressive disorders in restless legs syndrome: epidemiology, pathophysiology and management. CNS Drugs, 24(2), 89–98.

    Article  PubMed  Google Scholar 

  • Hornyak, M., Kopasz, M., Berger, M., Riemann, D., & Voderholzer, U. (2005). Impact of sleep-related complaints on depressive symptoms in patients with restless legs syndrome. Journal of Clinical Psychiatry, 66, 1139–1145.

    Article  PubMed  Google Scholar 

  • Hornyak, M., Grossmann, C., Kohnen, R., Schlatterer, M., Richter, H., Voderholzer, U., . . . Berger, M. (2008). Cognitive behavioural group therapy to improve patients’ strategies for coping with restless legs syndrome: A proof-of-concept trial. Journal of Neurology, Neurosurgery, and Psychiatry, 79(7), 823–825. doi: 10.1136/jnnp.2007.138867

  • Hornyak, M., Trenkwalder, C., Kohnen, R., & Scholz, H. (2012). Efficacy and safety of dopamine agonists in restless legs syndrome. Sleep Medicine, 13(3), 228–236. doi:10.1016/j.sleep.2011.09.013.

    Article  PubMed  Google Scholar 

  • Irving, J. A., Dobkin, P. L., & Park, J. (2009). Cultivating mindfulness in health care professionals: a review of empirical studies of mindfulness-based stress reduction (MBSR). Complementary Therapies in Clinical Practice, 15(2), 61–66. doi:10.1016/j.ctcp.2009.01.002.

    Article  PubMed  Google Scholar 

  • Jacobson, N. S., & Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12–19. doi:10.1037/0022-006X.59.1.12.

    Article  PubMed  Google Scholar 

  • Johns, M. W. (1991). A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep, 14(6), 540–545.

    PubMed  Google Scholar 

  • Johns, M. W. (1992). Reliability and factor analysis of the Epworth sleepiness scale. Sleep, 15(4), 376–381.

    PubMed  Google Scholar 

  • Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York: NY Bantam Dell.

    Google Scholar 

  • Klainin-Yobas, P., Cho, M. A., & Creedy, D. (2012). Efficacy of mindfulness-based interventions on depressive symptoms among people with mental disorders: a meta-analysis. International Journal of Nursing Studies, 49(1), 109–121. doi:10.1016/j.ijnurstu.2011.08.014.

    Article  PubMed  Google Scholar 

  • Morone, N. E., Lynch, C. S., Greco, C. M., Tindle, H. A., & Weiner, D. K. (2008). “I felt like a new person.” the effects of mindfulness meditation on older adults with chronic pain: qualitative narrative analysis of diary entries. The Journal of Pain, 9(9), 841–848. doi:10.1016/j.jpain.2008.04.003.

    Article  PubMed  PubMed Central  Google Scholar 

  • Phillips Respironics (2012). Actiware version 5.5. Retrieved from http://www.learnactiware.com.

  • Reese, J. P., Stiasny-Kolster, K., Oertel, W. H., & Dodel, R. C. (2007). Health-related quality of life and economic burden in patients with restless legs syndrome. Expert Review of Pharmacoeconomics & Outcomes Research, 7(5), 503–521.

    Article  Google Scholar 

  • Reinhold, T., Muller-Riemenschneider, F., Willich, S. N., & Bruggenjurgen, B. (2009). Economic and human costs of restless legs syndrome. PharmacoEconomics, 27(4), 267–279.

    Article  PubMed  Google Scholar 

  • Rosenzweig, S., Greeson, J. M., Reibel, D. K., Green, J. S., Jasser, S. A., & Beasley, D. (2010). Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice. Journal of Psychosomatic Research, 68(1), 29–36. doi:10.1016/j.jpsychores.2009.03.010.

    Article  PubMed  Google Scholar 

  • Sadeh, A. (2011). The role and validity of actigraphy in sleep medicine: an update. Sleep Medicine Reviews, 15(4), 259–267. doi:10.1016/j.smrv.2010.10.001.

    Article  PubMed  Google Scholar 

  • Scholz, H., Trenkwalder, C., Kohnen, R., Riemann, D., Kriston, L., & Hornyak, M. (2011). Dopamine agonists for restless legs syndrome. Cochrane Database of Systematic Reviews, 3(1). doi: 10.1002/14651858.CD006009.pub2

  • Szentkiralyi, A., Madarasz, C. Z., & Novak, M. (2009). Sleep disorders: impact on daytime functioning and quality of life. Expert Review of Pharmacoeconomics & Outcomes Research, 9, 49–64.

    Article  Google Scholar 

  • The International Restless Legs Syndrome Study Group. (2003). Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Medicine, 4(2), 121–132.

    Article  Google Scholar 

  • Vollestad, J., Sivertsen, B., & Nielsen, G. H. (2011). Mindfulness-based stress reduction for patients with anxiety disorders: evaluation in a randomized controlled trial. Behaviour Research and Therapy, 49(4), 281–288. doi:10.1016/j.brat.2011.01.007.

    Article  PubMed  Google Scholar 

  • Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30(6), 473–483. doi:10.1097/00005650-199206000- 00002.

    Article  PubMed  Google Scholar 

  • Winbush, N. Y., Gross, C. R., & Kreitzer, M. J. (2007). The effects of mindfulness-based stress reduction on sleep disturbance: a systematic review. Explore, 3(6), 585–591. doi:10.1016/j.explore.2007.08.003.

    Article  PubMed  Google Scholar 

  • Yoakum. (1994). Night walkers: do your legs seem to have a life of their own? Your torment has a name. Modern Maturity, 55, 82–84.

    Google Scholar 

  • Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.

    Article  PubMed  Google Scholar 

  • Zintzaras, E., Kitsios, G. D., Papathanasiou, A. A., Konitsiotis, S., Miligkos, M., Rodopoulou, P., & Hadjigeorgiou, G. (2010). Randomized trials of dopamine agonists in restless legs syndrome: a systematic review, quality assessment, and meta-analysis. Clinical Therapeutics, 32(2), 222–237. doi:10.1016/j.clinthera.2010.01.028.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Health Sciences, RMIT University, PO Box 71, Bundoora, 3083, Victoria, Australia

    Vicky Bablas

  2. School of Psychology, Australian Catholic University, Locked Bag 2002, Strathfield, NSW, 2135, Australia

    Keong Yap

  3. Melbourne Sleep Disorders Centre, 5/100 Victoria Parade, East Melbourne, 3002, Victoria, Australia

    David Cunnington & John Swieca

  4. James Cook University Singapore, 149 Sims Drive, Singapore, 387380, Singapore

    Kenneth Mark Greenwood

Authors
  1. Vicky Bablas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Keong Yap
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Cunnington
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. John Swieca
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kenneth Mark Greenwood
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Keong Yap.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(DOCX 14 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bablas, V., Yap, K., Cunnington, D. et al. Mindfulness-Based Stress Reduction for Restless Legs Syndrome: a Proof of Concept Trial. Mindfulness 7, 396–408 (2016). https://doi.org/10.1007/s12671-015-0457-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12671-015-0457-9

Keywords

Search

Navigation