Restless leg syndrome in people living with HIV: Prevalence,clinical predictors and the impact on sleep quality and psychological distress

Abstract

Background

Restless Leg Syndrome (RLS) is a common neurological disorder with a prevalence of 5-10% in Western countries. Emerging evidence suggests a higher prevalence among people living with HIV (PWHIV), though comprehensive studies are lacking. RLS may be exacerbated in PWHIV due to chronic neuro-inflammation and nutritional deficiencies. This study aimed to determine the prevalence of RLS in a Greek PWHIV population and identify associated demographic, clinical and laboratory risk factors.

Methods

This was a cross-sectional study of 194 PWHIV and 200 non-HIV controls. Data were collected via clinical interviews, validated questionnaires and medical records. We assessed RLS prevalence, clinical characteristics, sleep quality and psychological distress. Statistical analysis included Mann-Whitney U tests, Chi-square tests, and a stepwise logistic regression model to identify independent predictors of RLS.

Results

RLS prevalence was significantly higher in the PWHIV group (31%; 95% CI: 25.3–38.3%) compared to controls (15%; 95% CI: 10.2–20.2%, p < 0.001). In PWHIV, RLS was associated with shorter duration of HIV/HAART, lower CD4 cell counts at diagnosis and currently, and detectable viral load. Detectable viral load was the strongest independent predictor of RLS (OR 15.49, p < 0.001). RLS was also independently associated with poor sleep quality (OR 15.48), anxiety (OR 5.18), and depression (OR 9.22).

Conclusions

RLS is a prevalent comorbidity in Greek PWHIV, strongly associated with active viral replication and a state of advanced immunosuppression. The findings highlight the need for systematic RLS screening in this population to improve clinical outcomes and psychosocial well-being.