Sleep: Restless Legs Syndrome

Restless Legs Syndrome 

Restless Legs Syndrome (RLS) is a movement disorder that interferes with sleep.  It is described as unusual sensations in the legs (or arms) relieved by movement, like walking. RLS symptoms worsen when a person is at rest, usually in the evening or while sleeping. Most people with RLS also have periodic limb movements of sleep (PLMS)-repetitive movements of the legs while sleeping. 

RLS is related to changes in body function. Two of them are iron deficiency and dopamine (one of the brain chemicals) metabolism. It is likely that genetic factors may also be involved. And, it may also be related to other conditions, like severe kidney disease, and pregnancy

What Are The Symptoms of Restless Legs Syndrome?

Sensations

You may have difficulty trying to describe the symptoms. They include a strong urge to move the legs and uncomfortable sensations deep inside the legs. You may use terms like restless, twitchy, need to move, tension, itching, painful, or burning to describe the sensations.

Location

Most often the sensations involve the lower legs, but they may affect other areas (e.g. your thighs or arms).

The symptoms usually affect both legs, but may go back and forth from one leg to the other. Rarely, RLS affects only one leg. 

Varied Symptoms

The frequency of symptoms vary - they range from rarely to daily. They may also be different from one episode to the next

Sleep

Due to the timing of the symptoms, RLS disrupts sleep. You may have trouble falling asleep and may wake up often during the night. Daytime fatigue is common and may cause challenges at work or school or with your other activities.

How Is Restless Leg Syndrome Diagnosed?

RLS is diagnosed based on a person’s description of symptoms. Your doctor will ask you questions about your symptoms, their location, and how they impact your sleep. The questions will also help the doctor rule out other conditions with similar symptoms.

There are no tests to determine whether or not a person has the condition. One exception is a sleep study that can identify periodic leg movements of sleep (PLMS). Again, PLMS is often present with RLS.

What Is The Treatment of Restless Legs Syndrome?

Treatment may or may not be necessary. A big factor is the degree to which RLS disrupts sleep and daily functioning. 

Medicines

Once diagnosed, your doctor may recommend one or more medicine. Two are regularly prescribed in the U.S. Both are dopamine agonists: pramipexole (Mirapex™) and ropinirole (Requip™). Their names and availability vary from country to country.

There are other types of medicines that may also be prescribed. For those with iron deficiency, an iron supplement may be recommended.

Non-prescription Approaches

Several other approaches may be used including:

  • Cognitive Behavioral Therapy (CBT), a type of talk therapy (psychotherapy)

  • Wearing [pneumatic] compression devices, which are inflatable cuffs around the legs

  • Exercise therapy 

Although treatment can help relieve symptoms, there is no cure.

For More Information

American Academy of Sleep Medicine (2020). Restless Legs Syndrome - Overview and Facts. Retrieved on 10-15-2020 from http://sleepeducation.org/essentials-in-sleep/restless-legs-syndrome

National Institute of Neurological Disorders and Stroke (2020). Restless Legs Syndrome Fact Sheet. Retrieved on 10-15-2020 from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet.