Restless Legs Syndrome

Restless legs syndrome (RLS) is a neurological disorder that causes unpleasant sensations in the legs. Symptoms often occur during periods of inactivity, making it difficult to rest or sleep. RLS is often genetic and is more common in older people.

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Understanding Restless Legs Syndrome

What is restless legs syndrome (RLS)?

Restless legs syndrome is a sleep disorder that can cause unpleasant sensations in the legs, which are described as:

  • Creeping.
  • Crawling.
  • Tingling.
  • Pulling.

Symptoms of RLS often occur during periods of inactivity, such as when you sit or lie down at night. This discomfort can keep you from falling asleep. RLS is more common in older people and tends to run in families. Overuse of caffeine or alcohol may make symptoms worse. Iron deficiency, diabetes, or kidney problems can contribute to RLS.

You usually have these sensations in the calf, but they may be felt anywhere from the thigh to the ankle. One or both of your legs may be affected. Some people may have the sensations in the arms. With RLS, you have an irresistible urge to move the affected limb when the sensations occur. Moving often briefly relieves the limb discomfort.

Sleep problems are common with RLS because of the difficulty it causes in getting to sleep. Severe daytime fatigue can also be a big problem.

What causes RLS?

The cause of RLS is still unknown. Some cases are believed to be inherited. Some cases have been linked with nerve damage in the legs due to diabetes, kidney problems, or alcoholism.

As many as 1 in 10 people in the U.S. may have RLS.

What are the symptoms of RLS?

Sensations occur when you lie down or sit for a prolonged time. This causes:

  • The need to move the legs for temporary relief of symptoms by:
    • Stretching or bending.
    • Rubbing the legs.
    • Tossing or turning in bed.
    • Getting up and pacing.
  • Worsening symptoms when lying down, especially when trying to fall asleep at night, or during other forms of inactivity, including just sitting.
  • A tendency to feel the most discomfort late in the day and at night.

How is RLS diagnosed?

Your doctor can diagnose RLS based on your signs and symptoms, a complete medical history, and a physical exam. In addition, tests, such as lab tests or a sleep study, may be done. Currently, there is not a definitive test to diagnose restless legs syndrome.

How is RLS treated?

Your doctor will consider your age, overall health and other factors when advising treatment for you.

Treatment options for restless legs syndrome may include:

  • Trying good sleep habits.
  • Stopping activities that worsen symptoms.
  • Avoiding caffeine, alcohol, and tobacco, which may worsen symptoms.
  • Regular, moderate exercise.
  • Maintaining a well-balanced diet.
  • Treating underlying chronic conditions.

Medications, including:

  • Dopaminergic agents (drugs that increase dopamine) which are largely used to treat Parkinson's disease.
  • Benzodiazepines such as clonazepam and diazepam.
  • Opioids such as codeine, propoxyphene, or oxycodone.
  • Anticonvulsants such as gabapentin and pregabalin.

Consult your doctor for more information regarding the treatment of restless legs syndrome.

What can you do?

Symptoms of restless leg syndrome (RLS) can be treated. Together, you and your healthcare provider can work on your treatment plan. If needed, medicines may be prescribed. Also learn what you can do to ease your discomfort. Good sleep habits and a healthy lifestyle will help you rest better at night and have more energy during the day.

Working with your healthcare provider

RLS may occur on its own and may be passed on in families. It is sometimes linked to other medical problems. Low iron may cause some RLS symptoms. Your healthcare provider may order a lab test to check your iron level. Other medical problems associated with RLS are kidney disease, diabetes, Parkinson disease, and multiple sclerosis. Your doctor may prescribe medicines to reduce your symptoms and help you sleep better.

Tips for temporary relief

To reduce your discomfort, try the following:

  • Walking or stretching.
  • Rubbing your legs.
  • Having a massage.
  • Taking a hot or cold bath.
  • Doing activities that make muscles in your hands or legs work.
  • Relaxing with yoga or meditation.

Good sleep habits

Even though you have RLS, you can still have restful sleep. Try these good sleeping habits:

  • Keep a regular sleep schedule. Go to bed and get up at the same time each day.
  • Avoid or limit naps.
  • Make sure the bedroom is quiet, dark, and not too hot or too cold.
  • Use your bed only for sleep and sex.

Healthy lifestyle

Your lifestyle affects your health and your sleep. Here are some healthy habits:

  • Eat a balanced diet. To get enough vitamins and minerals, you may also need to take supplements.
  • Manage stress and learn ways to relax. Deep breathing techniques and visualization can help to relax your muscles and calm your mind.
  • Exercise regularly. It can help reduce stress. Also, you will have more energy during the day and be more tired at bedtime. Afternoon exercise is best. Nighttime exercise may affect how well you sleep.

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