교대근무자 하지불안증후군의 임상적 특성
Characteristics of Restless Leg Syndrome in Shift Workers
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목 적: 본 연구는 교대근무자와 비교대근무자간의 하지불안증후군의 유병률, 심각도, 수면/기분 이상에 대해 조사하였다. 방 법: 총 4,562명(나이 36.98±9.84세, 남성 2,150명, 여성 2,422명)의 교대근무자와 2,093명의(나이 37.79±9.73세, 남성 999명, 여성 1,094명)의 비교대근무자가 하지불안증후군, 수면, 우울에 대한 온라인 자가 설문을 작성했다. ‘하지불안증후군의 빠른 선별을 위한 단일 표준 설문’을 통해 하지불안증후군 유무를 판단하였다. 하지불안증후군의 심각도는 국제하지불안증후군 척도(International Restless Legs Syndrome Rating Scale, iRLS)로 측정하였다. 주간졸음은Epworth 졸림 척도(Epworth Sleepiness Scale, ESS), 불면증은 불면증 심각성 척도(Insomnia Severity Index, ISI), 우울증상은 단축형 우울증 역학 연구 척도(Center for Epide- miologic Studies Depression Scale, CES-D)로 평가하였다. 결 과: 교대근무자 중 1,255 (27.45%)명, 비교대근무자중 548 (26.18%)이 하지불안증후군이 있었다. 하지불안증후군 유병율은 교대근무자와 비교대근무자 간 차이가 없었다. 그러나, 하지불안증후군이 있는 경우, 교대근무자가 비교대근무자에 비해 iRLS (F=64.15, p＜0.01), ISI (F=46.09, p＜0.01), ESS (F=4.80, p=0.03), CES-D (F=33.50, p＜0.01) 가 모두 높았다. 결 론: 교대근무자가 하지불안증후군이 더 흔하지는 않았다. 그러나 하지불안증후군이 있는 경우에는 교대근무자에서 하지불안증후군 증상, 불면, 졸림, 우울증이 더 심했다. 이는 교대근무가 하지불안증후군과 관련 증상을 악화시킬 수 있는 인자임을 시사한다.
Abstract
Objectives: Both shift work and restless legs syndrome (RLS) are common and can disrupt sleep and mood. However, the ef- fects of shift work on RLS remain unclear. The current study aims to explore the prevalence, severity, and related sleep and mood symptoms of RLS in shift workers (SWs) compared to non-shift workers (Non-SWs). Methods: This study recruited 4,562 SWs (age 36.98±9.84, 2,150 males and 2,422 females) and 2,093 NSWs (age 37.79±9.73, 999 males and 1,094 females). All participants completed online self-report questionnaires regarding RLS, sleep, and depression. The presence of RLS was screened using a single standard question for rapid screening of RLS. The severity of RLS was assessed using the International Restless Legs Syndrome Rating Scale (iRLS). Additionally, the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess daytime sleepiness, insomnia, and depressive symptoms, respectively. Results: Of participants, 1,255 (27.45%) of SWs and 548 (26.18%) of Non-SWs were screened as having RLS, with no signifi- cant differences in the prevalence of RLS between the groups. However, among those with RLS, SWs with RLS showed higher iRLS scores compared to Non-SWs with RLS after controlling for age and sex (SWs: 9.55±7.26, NSWs: 6.75±6.05, F=64.15, p<0.01). In addition, SWs with RLS exhibited higher ISI scores (F=46.09, p<0.01), higher ESS scores (F=4.80, p=0.03), and higher CES-D scores (F=33.50, p<0.01) than Non-SWs with RLS. Conclusion: Although there was no significant difference in RLS prevalence between SWs and Non-SWs, SWs with RLS ex- hibited more severe RLS symptoms and RLS-related symptoms, such as insomnia, sleepiness, and depression, compared to NSWs with RLS. The current study suggests that shift work may exacerbate RLS severity and RLS-related sleep and mood symptoms, although it may not be associated with the onset of RLS.
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