Restless Legs Syndrome


Restless Legs Syndrome is an overwhelming urge to move the legs usually caused by uncomfortable or unpleasant sensations in the legs.

The sensations have the following features:

  • Occur during periods of inactivity
  • Become more sensitive in the evening and at night
  • Are relieved by movement of the limb
  • Often cause difficulty staying or falling asleep, which leads to feelings of daytime tiredness or fatigue
  • May cause involuntary jerking of the limbs during sleep and sometimes during wakefulness

If you do have restless legs syndrome (RLS), you are not alone. Up to 8% of the US population may have this neurologic condition. Many people have a mild form of the disorder, but RLS severely affects the lives of millions of individuals.

Do I need any tests to diagnose RLS?

After ruling out other medical conditions as the cause of your symptoms, your healthcare provider can make the diagnosis of RLS by listening to your description of the sensations. No laboratory test confirms your diagnosis of RLS; however, a thorough examination, including necessary laboratory tests, can reveal temporary disorders, such as iron deficiency, that may be associated with RLS. Some people (including those with PLMS and without the abnormal limb sensations of RLS) will require an overnight testing of sleep to determine other causes of the sleep disturbance.

Is RLS hereditary?

RLS often runs in families. Researchers are currently looking for the gene or genes that may be responsible for RLS.

Is there a known cause for RLS?

Research into the cause of RLS is ongoing and answers are limited. The type of RLS that runs in families is known as primary or familial RLS. The syndrome can also appear as a result of another condition, which worsens the underlying RLS. If you have no family history of RLS and no underlying or associated conditions causing the disorder, your RLS is said to be idiopathic, meaning without a known cause.

How common is RLS?

Rigorous epidemiologic studies into the true prevalence of RLS are underway. However, several studies have been conducted that look at the rate of response to questions such as Do you have a creepy, crawly sensation in your legs at night when you attempt to sleep? Positive rates have ranged from 3% to 15%.

What are the newest treatments for RLS?

No drugs have been approved by the U.S. Food & Drug Administration (FDA) for the treatment of RLS. Several drugs approved for other conditions have undergone clinical studies in RLS and are found to be helpful. Our Medical Bulletin contains the latest treatment information.

What non-drug treatments are recommended for RLS?

Self-directed activities that counteract your sensations of RLS appear to be very effective, although temporary, solutions to managing the disorder. You may find that walking, stretching, taking a hot or cold bath, massaging your affected limb, applying hot or cold packs, using vibration, performing acupressure, and practicing relaxation techniques (such as biofeedback, meditation, or yoga) may help reduce or relieve your symptoms. You may also find that keeping your mind actively engaged through activities such as reading a gripping novel, performing intricate needlework, or playing video games helps during times that you must stay seated, such as when you are traveling.

Can taking vitamin or mineral supplements help my RLS?

If an underlying iron or vitamin deficiency is found to be the cause of your restless legs, supplementing with iron, vitamin B or folate (as indicated) may reduce or even alleviate your symptoms. Because the use of even moderate amounts of some minerals (such as iron, magnesium, potassium, and calcium) can impair your body's ability to use other minerals or can cause toxicity, you should use mineral supplements only on the advice of your healthcare provider.

Are there any medications that can make RLS worse?

Yes. These drugs include calcium-channel blockers (used to treat high blood pressure and heart conditions), Reglan (metoclopramide), mose antinausea medications, some cold and allergy medications, major tranquilizers (including haloperidol and phenothiazines), and the antiseizure medication, phenytoin. One report indicates that medications used to treat depression increase the symptoms of RLS. Always be sure that your healthcare provider is aware of all the medicines you are taking, including herbal and over-the-counter medications.

Are there any substances that should be avoided?

The use of caffeine often intensifies RLS symptoms. Caffeine-containing products, including chocolate and caffeinated beverages such as coffee, tea, and soft drinks should be avoided. The consumption of alcohol also increases the span or intensity of symptoms for most individuals.

I suspect that my child may have RLS. Is this possible?

RLS affects people of all ages. Previously, RLS was believed to be a disorder affecting only adults. Many adults can now trace back their first symptoms to childhood when they were told their discomfort was "growing pains." Evidence connecting RLS and Attention-deficit hyperactivity disorder is growing.

 

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