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Restless Legs Syndrome

Restless legs in bed

What is restless legs syndrome (RLS)?

Restless legs syndrome (RLS) is a nerve disorder characterized by throbbing, pulling, creeping or other unpleasant sensations in the legs and an uncontrollable, usually overwhelming, urge to move them.

What causes restless legs syndrome (RLS)?

Although researchers have found a genetic basis to restless legs syndrome (RLS) - meaning if one of your family members has the condition then you are at higher risk - they still don't know what causes it.

A lack of dopamine (a type of chemical transmitter in the body) or low iron is thought to play a role, and the syndrome is also strongly associated with depression or anxiety disorders. RLS may be the only complaint a person has, or it may seem to follow on from another disorder.

What are the symptoms of restless legs syndrome (RLS)?

Symptoms usually start in the evening just as you sit down to relax, and may progressively worsen throughout the night. Both legs are usually affected, although one may be worse than the other. In more severe cases, the arms and lower trunk may also be affected. Restless legs syndrome (RLS) affects more than twice as many women as men.

Four out of five people with RLS have PLMS (Periodic Limb Movement of Sleep) as well. These twitchy movements can be so violent that they often jerk the person awake, making for an exhausting night and very little sleep!

How is restless legs syndrome (RLS) diagnosed?

There is no specific examination or laboratory test a doctor can do to determine if you have restless legs syndrome (RLS). Your description of what happens to your body when you try to relax is usually sufficient.

Tell your doctor if you have:

  • An overwhelming urge to move your limbs, accompanied by an uncomfortable or tingling sensation
  • Funny sensations in your legs triggered by rest, relaxation, or sleep, and relieved with movement
  • Symptoms that are worse at night and better in the morning

Since RLS can occur because of another condition, your doctor may still run a few tests.

RLS is more common in people:

  • With iron deficiency
  • Who are pregnant, especially in the third trimester
  • With either low or high thyroid levels
  • With rheumatoid arthritis, chronic kidney disease, or diabetes
  • Taking certain medicines, such as antinausea pills (antiemetics), antipsychotics, antidepressants, and some antihistamines

How is restless legs syndrome (RLS) treated?

Restless legs syndrome (RLS) can be severe in up to 20% of sufferers and medications may be considered if symptoms are severe or distressing and daytime functioning is affected by poor sleep quality.

Medications may include:

  • Dopamine agonists
  • Levodopa/carbidopa
  • Gabapentin, Gabapentin enacarbil, pregabalin
  • Iron supplements if there is a deficiency
  • Magnesium supplements