We then prescribed pramipexole 0.25 mg/d. The patient’s symptoms subsequently resolved, and she no longer experienced insomnia. This favorable response to dopamine agonist therapy supported the diagnosis of restless abdomen. The patient continues to take the pramipexole to prevent a relapse.
THE TAKEAWAY
Insomnia is a common presenting complaint in primary care and sleeping pills may be prescribed without adequate investigation of the cause. However, some patients may have serious underlying diseases.11
Although restless abdomen is a disorder that causes severe sleep disturbance and impairs the patient’s quality of sleep and life, it is not widely recognized by clinicians and may be misdiagnosed. When recognized, insomnia due to restless abdomen can be relieved by a simple therapy: oral dopamine agonists. Therefore, primary care physicians should consider restless abdomen as a potential cause of insomnia with abdominal symptoms.
CORRESPONDENCE
Hirohisa Fujikawa, MD, Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; hirohisa.fujikawa@gmail.com