Restless Legs Syndrome

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Restless Legs Syndrome (RLS) is a neurological disorder consisting of uncomfortable sensations in the legs resulting in an uncontrollable urge to move them when at rest to alleviate the unpleasant feelings. These sensations, typically felt deep inside the leg between the knee and ankle, are often characterized as a burning, creepy-crawly or tugging feeling, and often mimic the sensation of insects crawling inside the legs. Varying degrees of RLS range from uncomfortable sensations to those that are truly painful.

The uncomfortable leg sensations associated with RLS are activated when the body is lying down or trying to relax, causing sufferers of this disorder to have trouble falling asleep and staying asleep at night. Sleep deprivation can have serious negative effects on work, relationships and health.

Affecting both men and women, RLS can begin at any age, even affecting babies, though most suffering from the severe effects of the disorder are middle-aged or older. Most cases of RLS appear to worsen with age, with older patients experiencing symptoms more frequently and for longer durations. RLS is generally a lifelong condition for which there is no cure.

Severity of Restless Legs Syndrome

• Mild Restless Legs Syndrome – Symptoms occur periodically, with only mild disruption of sleep.
• Moderately Severe Restless Legs Syndrome – Symptoms occur one to two times per week, and disrupt the ability to fall asleep, causing daytime fatigue.
• Severe Restless Legs Syndrome – Symptoms occur more than two times each week and frequently disrupt the ability to both fall asleep and stay asleep throughout the night.

Periodic Limb Movement Disorder
The majority of RLS sufferers also experience Periodic Limb Movement Disorder (PLMD), a common condition that involves an involuntary twitching or jerking of the legs during sleep, repeatedly awakening the individual with each episode. Four or more leg movements occurring between 5 to 90 seconds apart are defined as a PLM series.

Signs and Symptoms of RLS
While there isn’t currently a single test to diagnose RLS, the determination of the disorder can be made by a medical professional using the following four criteria as standards for diagnosing RLS.

• An uncontrollable urge to move your legs while at rest, experienced with uncomfortable sensations in the legs that have been characterized as itching, creeping, pulling or tugging.
• Uncomfortable leg sensations worsen during periods of rest, and increase in severity throughout the duration of the resting period.
• Relief from the uncomfortable leg sensations is experienced when moving your legs, often leaving sufferers with an irresistible urge to constantly move their legs while at rest.
• Uncomfortable leg sensations worsen when lying down and in the evening, or during periods of inactivity such as long flights, car trips or even sitting in a movie theater.

Be prepared to discuss symptoms with your medical professional, noting frequency, duration and intensity of symptoms and any disturbances to sleep patterns or daytime sleepiness. Also discuss past medical problems, family history and any current medications you may be taking. Laboratory tests, including blood tests, may be conducted to rule out other conditions, including anemia, decreased iron stores, diabetes and renal function. Sleep studies that record brain waves, heartbeat and breathing during the night can also help to identify RLS.

Common Causes of Restless Legs Syndrome
Research into the causes and treatments of RLS continues around the world. Currently, a single, underlying cause for the condition is unknown; however, the following has been determined:

• RLS often runs in families, so it may be hereditary.
• Pregnancy has led to the onset of RLS in approximately 25 percent of women, though typically disappears after giving birth.
• Low iron levels and anemia often lead to the development or worsening of RLS.
• Chronic diseases such as kidney failure, diabetes and Parkinson’s disease have been associated with RLS. Symptoms are often alleviated with treatment of the underlying disease.
• Nerve damage to the hands or feet, known as peripheral neuropathy, can contribute to RLS.

Treatments for Restless Legs Syndrome
Once RLS is properly diagnosed by a medical professional, there are several treatment options to help alleviate the symptoms, depending on the severity of the condition, including:

• Correcting iron, folate or magnesium levels or anemia may reduce symptoms.
• Avoiding caffeine, alcohol and tobacco, all of which may prompt symptoms in those predisposed to develop the condition, may help.
• Avoiding some medications that may worsen symptoms of the condition, including anti-nausea drugs, anti-seizure drugs, anti-psychotic drugs, some high blood pressure medications and some cold and allergy medications, may also relieve symptoms. Consult a medical professional to discuss the possibility of changing certain medications.
• Identifying any underlying disorder and treating it properly may reduce the symptoms of RLS.
• Lifestyle changes for those suffering from mild to moderate cases, including maintaining a regular sleep pattern and eating a healthy and balanced diet, can reduce symptoms.
• Regular moderate exercise can help sufferers sleep better, though studies have found excessive exercise may further aggravate symptoms.
• Relief experienced through a hot bath, walking, stretching, massaging the legs, or using a heating pad or ice pack.
• Engaging your mind in activities, including conversation, crafts or video games, may distract from symptoms.
• Specific medications, including those used to treat Parkinson’s disease, have been used to treat RLS. Types of medications include dopaminergic agents, sleeping aids, anticonvulsants and pain relievers.

Consult with a medical professional or sleep specialist to determine which treatment option is best for you.