Prevalence of Restless Legs Syndrome in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

Introduction: Restless legs syndrome (RLS) is a common sensorimotor sleep disorder, and rheumatoid arthritis (RA) is an inflammatory autoimmune disease that causes disability. Previous studies showed that the prevalence of RLS varies in different populations of RA (13.2 – 68.4%). It raises the need for a pooled metaanalysis to determine a more reliable estimate. Therefore, we aimed to perform a meta-analysis to assess the pooled prevalence of RLS in RA patients. Methods: Meta-analysis was performed according to the PRISMA checklist. Embase, MEDLINE, Ovid, Web-of-Science, and Scopus databases were used for the systematic search, and eligible studies were analyzed using R version 4.0.3. For further review, we performed sensitivity analyzes to identify influential studies. Results: Of a total of 763 studies, 11 studies (3 were from Europe, 4 from North America, and 4 from Asia) were suitable for synthesis. A total of 931 RA patients were identified, 300 of whom had symptoms of RLS. The pooled prevalence of RLS among people with RA from 11 studies was 34% (95% CI: 26-43%). The pooled prevalence of RLS in Europe, Asia, and North America was 48% (95% CI: 32-65%), 32% (95% CI: 18-45%), and 28% (95% CI: 15-42%), respectively. RLS prevalence was dramatically high in RA women patients (32% CI: 23-41%) than RA men patients (3%; 95% CI: 2-5%). Conclusion: This systematic review and meta-analysis indicates that the risk of RLS in RA patients was 34% and female patients with RA were more prone to having RLS than male patients.