Restless Legs Syndrome

Tuesday, February 19, 2008

• Frequently Asked Questions

Restless legs syndrome (RLS) is a neurological disorder that is characterized by unpleasant sensations in the legs, accompanied by a desire to move the legs at rest to overcome these sensations. The symptoms are usually worse at night and are often experienced when lying down to go to sleep or when relaxing. The condition typically interferes with sleep and can produce symptoms associated with sleep impairment, such as daytime fatigue, exhaustion, impaired memory, and difficulty concentrating. Patients who have restless legs syndrome often describe the sensations in their legs as “creeping”, “itching”, “burning”, “gnawing”, or like “insects crawling on the legs”.

It has been estimated that as many of 12 million Americans have restless legs syndrome. The incidents may be higher than this. There are some individuals who have symptoms of restless legs syndrome who do not seek medical attention. Also, healthcare providers may misdiagnose the condition, with symptoms being attributed to stress, aging, or nervousness. Restless legs syndrome occurs in both men and women, but it appears to be slightly more prevalent in women. Symptoms of restless legs syndrome can appear at any age, but the severity of the disease tends to be greater with increasing age. Symptoms tend to involve both legs.

At this time, the cause of most cases of restless legs syndrome is unknown. A family history of restless legs syndrome is present approximately 50% of the time. Certain conditions can predispose to development of restless legs syndrome, including anemia, kidney failure, diabetes, peripheral nephropathy, Parkinson’s disease, as well as pregnancy. Some medications may also predispose to restless legs syndrome, including drugs used for nausea, such as prochlorperazine and metoclopramide, and drugs used for seizures, such as phenytoin and droperidol. Use of tobacco, alcohol, and caffeine may trigger symptoms in certain individuals.

The International Restless Legs Syndrome Study Group identified four basic criteria for diagnosing restless legs syndrome in 1995: 1) desire to move the limbs, often associated with paresthesias (abnormal sensations) or dysesthesias (unpleasant abnormal sensations); 2) symptoms that are worst or present only during rest and are partially or temporarily relieved by activity; 3) motor restlessness; 4) nocturnal worsening of symptoms. Approximately 80% or more of individuals who have restless legs syndrome have involuntary jerking or twitching movements of the leg during sleep. Most individuals with restless legs syndrome have sleep disturbances.

Individuals who have restless legs syndrome find temporary relief through moving their legs. It is important to identify any underlying condition that may be precipitating restless legs syndrome. Often, treatment of such an underlying medical condition, such as diabetes or anemia, improves the symptoms of restless legs syndrome. For those who have mild to moderate symptoms, prevention is key. Many physicians advise lifestyle changes, such as reducing intake of alcohol and caffeine products. Eliminating use of tobacco is recommended. Physicians may suggest supplements to correct deficiencies in certain vitamin and minerals, such as iron, folate, or vitamin B12 supplements. Taking hot baths in the evening may help with symptoms, as can leg massage. There are a variety of medications that have been tried to minimize symptoms of restless legs syndrome. If you suspect that you may have this condition, don’t merely put up with the symptoms. Seek help from your physician or healthcare provider to determine if restless legs syndrome is present and to determine if another disease or a medication may be a factor. Your healthcare provider can offer suggestions to help control your symptoms and discuss medication options if you have this condition.

• Restless Legs Syndrome Fact Sheet
• The Restless Legs Syndrome Foundation
• MayoClinic: Restless leg syndrome