What is Restless Legs Syndrome (RLS)?

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Restless Legs Syndrome is a common sleep disturbance that usually goes untreated in most people. In fact, most physicians did not learn about this condition in their medical training and usually do not recognize the symptoms in their patients.

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Restless Leg Syndrome (RLS) is a neurological disorder characterized by an irresistible urge to move the legs, often accompanied by unpleasant sensations.

Symptoms and Impact of Restless Legs Syndrome

 

Identifying and treating Restless Legs Syndrome has improved drastically over the last ten years. This condition is commonly characterized by uncomfortable, unsettled, restless sensations in the legs or feet, usually while lying in bed at night before going to sleep:

• Urge to Move: An overwhelming and uncontrollable desire to move the legs, which is often described as a creeping, crawling, pulling, or tingling sensation.

• Unpleasant Sensations: This can include aching, throbbing, itching, or a burning feeling in the legs.

 

A person with these sensations obtains brief relief by movement of the extremities. As a result, they will shift their legs frequently while trying to fall asleep. Once asleep, almost everyone with Restless Legs Syndrome will have brief movements of their legs, each lasting 1 to 5 seconds and occurring about every 20 to 40 seconds.

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These movements, called Periodic Limb Movements of Sleep, do not necessarily occur all night long but rather during various periods throughout the night. The leg twitches may range from very mild muscle contractions to larger kicking movements. Nonetheless, the periodic pattern of these movements is the diagnostic feature that makes this phenomenon unique.

 

The Restless Legs Syndrome may cause Insomnia. The affected individual may take hours to fall asleep, frequently tossing and turning to relieve the restless sensations. In some cases, the person may even get out of bed to pace the floors in order to settle down the restless sensations.

 

This condition may be caused by other medical problems such as Anemia, Kidney disease, Neuropathy, or Spinal Cord disease. Although these conditions can cause Restless Legs Syndrome, most patients do not have one of these conditions. In fact, the cause of Restless Legs in most patients is unknown.

 

Studies recently published have demonstrated that in some people, Restless Legs Syndrome can be inherited. That is not to say that all cases are inherited, and not everyone who has it will pass it on to their children. Stimulants, such as caffeine, may also worsen symptoms.

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Treatment Pathways for Restless Legs Syndrome

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There are many causes for this condition, but the most encouraging is the fact that this condition can finally be effectively treated. There are many treatments for this condition, including (but not limited to):

• Lifestyle Interventions: Reduce caffeine intake, hydrate regularly, engage in moderate exercise, receive leg massages, and take warm baths.

• Medical Treatments: Iron supplementation (if low ferritin), dopaminergic agents (e.g., pramipexole), alpha-2-delta ligands (gabapentin/pregabalin), and newer options.

• Managing PLMS: Tailored treatment to reduce leg movements and restore sleep quality.

 

 

In the past, patients were given sedative medications so they would “sleep through” their symptoms. Now there are more specific treatments that eliminate the restless sensations and decrease or eliminate the leg movements during sleep as well.

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If you have this condition, or you know someone with this condition, be sure the problem is discussed with a physician. If your doctor is not yet familiar with treating Restless Legs Syndrome or is unsure of the new treatment approaches available, then have them contact Comprehensive Sleep Medicine Associates, PA. (CSMA) for more information, and if needed an appointment can be arranged.

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Further Reading

Get the Inside Scoop on Restless Kicking During Sleep
Medical Matters News, September 28, 2010 article: Victoria Wright, Sadler Clinic.