Healthcare 2022, 10, 822. https://doi.org/10.3390/healthcare10050822 www.mdpi.com/journal/healthcare Article The Prevalence and Predictors of Restless Legs Syndrome in Patients with Liver Cirrhosis Oana‐Mihaela Plotogea 1,2 , Camelia Cristina Diaconu 1,3, *, Gina Gheorghe 1,2 , Madalina Stan‐Ilie 1,2 , Ruxandra Oprita 1,2 , Vasile Sandru 2 , Nicolae Bacalbasa 1,4 and Gabriel Constantinescu 1,2 1 “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; plotogea.oana@gmail.com (O.‐M.P.); gheorghe_gina2000@yahoo.com (G.G.); drmadalina@gmail.com (M.S.‐I.); ruxandraa69@gmail.com (R.O.); nicolae_bacalbasa@yahoo.ro (N.B.); gabrielconstantinescu63@gmail.com (G.C.) 2 Department of Gastroenterology, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania; drsandruvasile@gmail.com 3 Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania 4 Department of Visceral Surgery, Center of Excellence in Translational Medicine, Fundeni Clinical Institute, 022328 Bucharest, Romania * Correspondence: drcameliadiaconu@gmail.com Abstract: Introduction and aim. Sleep disorders are highly prevalent in patients with liver cirrhosis. The aim of this study was to investigate the prevalence of restless legs syndrome (RLS), as well as its risk factors and possible predictors, in a cohort of patients with liver cirrhosis. Material and meth‐ ods. We performed a cross‐sectional prospective study over a period of 14 months and enrolled 69 patients with liver cirrhosis, after applying the inclusion and exclusion criteria. The cases of RLS were assessed according to the International Restless Legs Syndrome Study Group (IRLSSG) criteria and severity scale. Results. Out of the total number of patients, 55% fulfilled the criteria for RLS. Age, diabetes, severity of cirrhosis, serum creatinine, glomerular filtration rate (GFR), and mean hemoglobin were associated with the presence of RLS. Moreover, there was a significantly higher prevalence of RLS among patients with decompensated cirrhosis. From all the risk factors intro‐ duced into the multivariate analysis, only the GFR could predict the presence of RLS. Conclusions. This research shows that patients with liver cirrhosis have a high risk of RLS. Even though there are multiple risk factors associated with RLS, only the GFR could predict its occurrence in our cohort. Keywords: cirrhosis; restless legs syndrome; risk factors; predictors 1. Introduction Liver cirrhosis is an important cause of mortality and morbidity worldwide. Patients with cirrhosis may evolve from asymptomatic or compensated phases to symptomatic or decompensated phases, with complications such as variceal bleeding, hepatic encephalo‐ pathy, hepatorenal syndrome, and others. Most cirrhosis complications require multiple hospitalizations and result in high rates of mortality and compromised health‐related quality of life (HRQOL) [1]. Apart from life‐threatening complications, several other con‐ ditions contribute to HRQOL impairment. A shift in this paradigm has recently been em‐ braced, with more emphasis given to the extrahepatic conditions that compromise HRQOL, particularly sleep disorders and restless legs syndrome (RLS) [2–5]. RLS, also known as Ekbom’s syndrome, is a sleep‐related movement disorder charac‐ terized by sensory and motor neurological symptoms with a circadian pattern, manifested as the urge to move, primarily the legs and other extremities, during rest [6,7]. These move‐ ments are also a relief for unpleasant somatosensory sensations that worsen during the evening and night [7]. RLS has been described as a primary (idiopathic) condition, with a prevalence of 2.5–15% among the general population [8,9], and as a secondary condition, Citation: Plotogea, O.‐M.; Diaconu, C.C.; Gheorghe, G.; Stan‐Ilie, M.; Oprita, R.; Sandru, V.; Bacalbasa, N.; Constantinescu, G. The Prevalence and Predictors of Restless Legs Syndrome in Patients with Liver Cirrhosis. Healthcare 2022, 10, 822. https://doi.org/10.3390/ healthcare10050822 Academic Editor: Chrysi Koliaki Received: 22 March 2022 Accepted: 27 April 2022 Published: 28 April 2022 Publisher’s Note: MDPI stays neu‐ tral with regard to jurisdictional claims in published maps and institu‐ tional affiliations. Copyright: © 2022 by the authors. Li‐ censee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and con‐ ditions of the Creative Commons At‐ tribution (CC BY) license (https://cre‐ ativecommons.org/licenses/by/4.0/).