PT  - JOURNAL ARTICLE
AU  - Garrison, Scott R.
AU  - Dormuth, Colin R.
AU  - Morrow, Richard L.
AU  - Carney, Greg A.
AU  - Khan, Karim M.
TI  - Seasonal effects on the occurrence of nocturnal leg cramps: a prospective cohort study
AID  - 10.1503/cmaj.140497
DP  - 2015 Mar 03
TA  - Canadian Medical Association Journal
PG  - 248--253
VI  - 187
IP  - 4
4099  - http://www.cmaj.ca/content/187/4/248.short
4100  - http://www.cmaj.ca/content/187/4/248.full
SO  - CMAJ2015 Mar 03; 187
AB  - Background: It has been anecdotally reported that nocturnal leg cramps in pregnant women are worse in summer. We analyzed population-level data to determine whether the symptom burden of nocturnal leg cramps is seasonal in the general population.Methods: We examined time-series data for 2 independent measures of the symptom burden of leg cramps: (a) new quinine prescriptions (reflecting new or escalating treatment of leg cramps) from December 2001 to October 2007 among adults aged 50 years and older, which were obtained from linked health care databases that contain the prescribing information for the 4.2 million residents of British Columbia, Canada; and (b) the Internet search volume from February 2004 to March 2012 for the term “leg cramps” (reflecting public interest), which we obtained from Google Trends data and geographically limited to the United States and Australia. We assessed seasonality by determining how well a least-squares sinusoidal model predicted variability in the outcomes.Results: New quinine prescriptions and Internet searches related to leg cramps were both seasonal, with highs in mid-summer and lows in mid-winter, and a peak-to-peak variability that was about two-thirds of the mean. Seasonality accounted for 88% of the observed monthly variability in new quinine prescriptions (p < 0.001) and 70% of the observed variability in Internet searches related to leg cramps (p < 0.001).Interpretation: New quinine prescriptions and Internet searches related to leg cramps were seasonal and roughly doubled between the winter lows and summer highs. Why a disorder of peripheral motor neurons displays such strong seasonality warrants exploration.See also commentary on page 237 and at www.cmaj.ca/lookup/doi/10.1503/cmaj.150044