Objectives: Both shift work and restless legs syndrome (RLS) are common and can disrupt sleep and mood. However, the effects 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 significant 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 exhibited 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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