Suicidal thought and behavior in individuals with restless legs syndrome

Background: Restless legs syndrome (RLS) is associated with an unrelenting urge to move at night, which can cause chronic sleeplessness, depression, and despondency; thus increasing risk of suicide. We aimed to determine frequency of suicidal ideation and behavior in RLS.

Methods: RLS and control participants were recruited through community and RLS Foundation advertisements. RLS diagnosis was confirmed using the Cambridge-Hopkins RLS Questionnaire and severity was assessed using the International RLS Study Group Severity Scale (IRLSS). Lifetime suicidal ideation (plan) and behavior (attempt) was assessed using the Suicidal Behavior Questionnaire-revised. The Brief Lifetime Depression Scale evaluated lifetime depression history. Forward stepwise logistic regression determined the odds of suicidal ideation or behavior.

Results: In this study, 192 RLS and 158 control participants were comparable for age, sex, race, and other potential demographic confounders. In general, RLS was moderate-to-severe (mean IRLSS 26.4 ± 7.5). Significantly more RLS than control participants had lifetime suicidal ideation or behavior (27.1% vs. 7.0%; p < 0.00001) or lifetime depression history (65.6%% vs. 22.8%; p < 0.00001). The odds of having a lifetime suicidal ideation or behavior was higher in those with RLS [2.80 (1.29,6.11)], even after accounting for depression and other confounders. In RLS, the odds of lifetime suicidal ideation or behavior was increased if there was lifetime depression [7.37 (2.65,20.47)] or if RLS in the past was severe or very severe [2.36 (1.03,5.40)].

Conclusions: Lifetime suicidal ideation or behavior is prevalent in RLS sufferers, and its likelihood is dependent on RLS severity and depression history.