Restless Legs Syndrome
February 08, 2007
It's been around for years. Though it affects up to 25% of the population and can significantly disrupt sleep, it often goes undiagnosed and untreated. No, it's not sleep apnea. It's restless legs syndrome. Dr. Mom has more.
What is restless legs syndrome?
Approximately 10% of the population is affected by restless legs syndrome (RLS), a neurological disorder characterized by unpleasant sensations in the legs usually in the evening or late at night when at rest. The unpleasant or painful sensations are described as burning, creeping, tugging, or like insects crawling inside the legs and an uncontrollable urge to move them for relief. The sensations go away when one gets up and moves around.
- The sensations begin while you are lying down or sitting for an extended period of time.
- The sensation of RLS lessens if you get up and move.
- Symptoms are primarily felt at night
- RLS is associated with periodic limb movements of sleep (PLMS) or kicking movements in your sleep. With PLMS you involuntarily flex and extend your legs while sleeping, resulting in restless sleep for your bed partner.
Causes
The cause of RLS is unknown. However, recent studies at Johns Hopkins and Pennsylvania State Colleges have found evidence for brain iron deficiency as a cause for primary RLS. Stress tends to worsen the symptoms of RLS. Pregnancy or hormonal changes may temporarily worsen RLS signs and symptoms.
- Peripheral neuropathy. This damage to the nerves in your hands and feet is sometimes due to chronic diseases such as diabetes and alcoholism
- Iron deficiency. Even without anemia, iron deficiency can cause or worsen restless legs syndrome.
- Kidney failure. If you have kidney failure, you also may have iron deficiency.
Available Treatment
Your primary care physician may:- Suggest lifestyle changes and activities to reduce or eliminate symptoms.
- Suggest decreased use of caffeine, alcohol, and tobacco
- Check for a vitamin or iron deficiency
- Look at medications you may be taking which make RLS worse. These may include drugs used to treat high blood pressure, heart conditions, nausea, colds, allergies and depression.
- Looking at any herbal and over-the-counter medicines you may be taking to see if they could be worsening your RLS
- Taking a hot bath
- Massaging your legs
- Use a heating pad or ice pack
- Walking
- Practicing relaxation techniques
- Stretching
- Live a healthy lifestyle
In 2005, the Food and Drug Administration (FDA) approved ropinirole specifically for the treatment of moderate to severe RLS. However, a recent article in the Journal of General Internal Medicine by Irene Richard, MD, and Roger Kurlan, MD, warns primary care physicians that long-term success cannot be expected simply by prescribing ropinirole, which works by activating dopamine receptors in the brain. If the drug is taken too long, it can actually backfire, making the symptoms worsen. Instead, the team recommends that physicians may need to rotate some patients through different types of medications.
Do you have restless legs syndrome:- When you sit or lie down do you have a strong desire to move your legs?
- Does your desire to move your legs feel impossible to resist?
- Have you ever used the words unpleasant, creepy-crawly, creeping, itching, pulling, or tugging to describe your symptoms to others?
- Does your desire to move occur when you are resting or sitting still?
- Does moving your legs make you feel better?
- Do these symptoms worsen at night?
- Does your bed partner complain that you keep them away at night with the jerking movements of your legs
- Do you ever have involuntary leg movements while you are awake?
- Are you tired or unable to concentrate during the day?
- Do any of your family members have similar complaints? (RLS often runs in families)
If you answered "yes" to most of these questions, talk with your primary care physician.
Helpful websites: