Mishra A, Shukla M, Khan MA, Pal A, Kanchan A. Association of lower urinary tract symptoms with restless leg syndrome and impaired somnolence pattern in middle aged and elderly men. World J Clin Cases 2026; 14(19): 120379 [DOI: 10.12998/wjcc.v14.i19.120379]
Corresponding Author of This Article
Amit Mishra, Associate Professor, FACS, Department of Urology, All India Institute of Medical Sciences (AIIMS), Munshiganj, Dalmau Road, Raebareli 229405, Uttar Pradesh, India. amit.mishra.uro@gmail.com
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Urology & Nephrology
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Mishra A, Shukla M, Khan MA, Pal A, Kanchan A. Association of lower urinary tract symptoms with restless leg syndrome and impaired somnolence pattern in middle aged and elderly men. World J Clin Cases 2026; 14(19): 120379 [DOI: 10.12998/wjcc.v14.i19.120379]
Association of lower urinary tract symptoms with restless leg syndrome and impaired somnolence pattern in middle aged and elderly men
Amit Mishra, Mukesh Shukla, Mohd Atif Khan, Arghya Pal, Arvind Kanchan
Amit Mishra, Mohd Atif Khan, Department of Urology, All India Institute of Medical Sciences (AIIMS), Raebareli 229405, Uttar Pradesh, India
Mukesh Shukla, Department of Community Medicine, All India Institute of Medical Sciences (AIIMS), Raebareli 229405, Uttar Pradesh, India
Arghya Pal, Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Raebareli 229405, Uttar Pradesh, India
Arvind Kanchan, Department of Physiology, All India Institute of Medical Sciences (AIIMS), Raebareli 229405, Uttar Pradesh, India
Author contributions: Mishra A, Shukla M, and Pal A conceptualized and designed the research; Khan AM and Kanchan A enrolled, screened patients and acquired clinical data; Mishra A and Shukla M performed data analysis; Mishra A, Shukla M, and Khan MA wrote the paper. All the authors have read and approved the final manuscript.
AI contribution statement: The authors declare that ChatGPT was used only for paraphrasing and grammar check. No portion or entirety of the main manuscript was generated by AI. ChatGpt was used only for language polishing at specific points in the manuscript. No translation was done. Data analysis and writing of ideas/concepts was done by the authors only. No AI tool was used in the design of the study or interpretation of results. No images in the manuscript are generated by AI to the nest of the authors knowledge.
Institutional review board statement: This was obtained from the Institutional Ethics Committee of the All India Institute of Medical Sciences, Raebareli, Uttar Pradesh before the commencement of the study, No. 2023-9-IMP-5.
Informed consent statement: Informed written consent was obtained from the patients for study participation.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Data will be freely shared based on demand by the corresponding author.
Corresponding author: Amit Mishra, Associate Professor, FACS, Department of Urology, All India Institute of Medical Sciences (AIIMS), Munshiganj, Dalmau Road, Raebareli 229405, Uttar Pradesh, India. amit.mishra.uro@gmail.com
Received: February 26, 2026 Revised: March 20, 2026 Accepted: May 29, 2026 Published online: July 6, 2026 Processing time: 126 Days and 23.2 Hours
Abstract
BACKGROUND
Lower urinary tract symptoms (LUTS) are closely associated with sleep disturbances, with evidence suggesting a bidirectional relationship between urinary symptoms and impaired sleep. Restless legs syndrome (RLS), a common neurological disorder and a recognized cause of insomnia, has not been systematically evaluated in relation to LUTS despite their shared impact on sleep quality.
AIM
To investigate the association between LUTS and RLS in middle-aged to elderly men, with a focus on sleep quality parameters.
METHODS
A cross-sectional study was conducted in the Department of Urology, All India Institute of Medical Sciences (AIIMS) Raebareli, over a two-year period. Male patients aged > 50 years with clinically diagnosed LUTS were included (n = 263). Patients with congestive heart failure, chronic kidney disease, stroke, cognitive impairment, or psychiatric disorders were excluded. LUTS severity was assessed using the International Prostate Symptom Score, sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and RLS severity using the Restless Leg Syndrome Rating Scale. Statistical analysis included the Mann-Whitney U test, χ2 test, and Spearman’s correlation coefficient.
RESULTS
Among 263 patients, 113 (42.9%) were diagnosed with RLS. Patients with RLS had significantly higher mean total International Prostate Symptom Score scores compared to those without RLS (19.78 ± 6.73 vs 16.55 ± 7.38; P < 0.001). Significant differences were observed in LUTS domains including incomplete emptying (3.19 vs 2.33; P = 0.001), intermittency (2.85 vs 1.99; P = 0.002), weak stream (2.84 vs 1.87; P < 0.001), straining (2.30 vs 1.48; P = 0.005), and nocturia (3.16 vs 2.47; P < 0.001). Overall PSQI scores were comparable between groups (6.48 ± 7.17 vs 6.31 ± 5.23; P = 0.824). However, patients with RLS had significantly higher use of sleep medications (0.77 vs 0.38; P = 0.012) and greater daytime dysfunction (0.94 vs 0.52; P = 0.025). Among RLS patients, total LUTS severity showed a positive correlation with PSQI scores (r = 0.290; P = 0.002), whereas in non-RLS patients, nocturia was significantly associated with sleep quality (r = -0.277; P = 0.001).
CONCLUSION
RLS was present in 42.9% of men with LUTS and was associated with higher LUTS severity, particularly in voiding domains. While overall sleep quality scores were comparable between groups, differences were observed in sleep medication use and daytime dysfunction.
Core Tip: This study identifies a high prevalence (42.9%) of restless legs syndrome (RLS) among middle-aged and elderly men with lower urinary tract symptoms (LUTS), an area that remains relatively underexplored in urology. A significant association was observed between RLS and greater LUTS severity, particularly obstructive symptoms and nocturia. Despite comparable global sleep quality scores, patients with RLS demonstrated greater functional sleep impairment, reflected by increased sleep medication use and daytime dysfunction. These findings reveal a clinically meaningful interaction between LUTS and RLS, underscoring the importance of routine RLS screening in men with LUTS to enable more comprehensive, multidisciplinary management strategies.to enable more comprehensive and outcome-oriented management.
