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Restless Legs Syndrome


Restless legs syndrome (RLS) causes sleeping difficulties for about 10 percent of Americans, who have overpowering urges to move their legs, especially when they are resting or sleeping. Arms and other body parts can also be affected. People with the syndrome usually describe the sensations using terms such as aching, creepy, crawly, electric, twitching, tingling, burning or prickling.

Symptoms

A collection of symptoms generally described as unpleasant sensations and an urge to move the lower legs, RLS is indicated by:

  • A desire or urge to move the limbs, often caused or accompanied by unpleasant sensations. You may feel pain deep inside your legs
  • Worsening of symptoms at rest. The urge to move or unpleasant sensations begin or worsen during periods that make you drowsy including resting, lying, sitting or otherwise being inactive. Some people have the urge to move and the unpleasant sensations after any long period of inactivity, such as during flights and while sitting in the theater
  • Partial or total relief by activity, such walking or moving around. When you move, symptoms improve immediately and relief continues for as long as you are active. The symptoms may recur as soon as you stop moving
  • Fluctuation during the day. The peak time for symptoms is around midnight, with sleep easier in the early morning hours

Symptoms of RLS affect people differently. They can occur only occasionally, in certain situations or frequently. They can range from mild to intolerable. RLS can start at any age, but most people are middle-aged or older.

Causes

Researchers don't know the cause of RLS, but they suspect a combination of factors. Brain chemicals called neurotransmitters, which influence nerve cells, are probably involved. There also seems to be a genetic link; a person with a family history of RLS may develop the condition earlier than someone with no family history of it. RLS can result from other neurological diseases, kidney dialysis, pregnancy, chronic diseases such as Parkinson's disease, iron deficiency, certain medications, alcohol and caffeine.

Treatment

If you have another condition such as a neurological disease that causes symptoms similar to RLS, this condition should be treated. Your health care provider may change medications that could cause RLS symptoms. Your provider may order a blood test to determine if you have iron deficiency.

Maintaining good sleep and healthy lifestyle habits can help relieve symptoms:

  • Go to sleep and wake up on the same schedule each day
  • Use your bed for sleep and intimacy, not for reading or other activities
  • Before bed, avoid activities or substances such as caffeine, alcohol and nicotine that might keep you awake
  • A gentle walk, a warm bath or shower; or a gentle leg massage before bed may be helpful
  • Maintaining a balanced diet and regular exercise can also help

Medications can be prescribed if the above measures don't work. Ropinirole (Requip) and pramipexole (Mirapex) are both approved by the FDA to treat RLS. They raise the level of dopamine, a naturally occurring brain chemical that plays a part in controlling movement. Other drugs that raise dopamine levels are sometimes prescribed. Sleep aids like Ambien or Lunesta may help you sleep, but will not relieve RLS symptoms. You may have to try several different medications to find something that adequately treats your symptoms. Over time, you may find that a medication stops working or does not work as well. If this happens, your healthcare provider can prescribe a different medication. 

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