Restless Leg Syndrome
Q. What is restless legs syndrome (RLS)?
A. Restless legs syndrome (RLS) is a sleep disorder in which a person experiences unpleasant sensations in the legs described as creeping, crawling, tingling, pulling, or painful. These sensations usually occur in the calf area but may be felt anywhere from the thigh to the ankle. One or both legs may be affected; for some people, the sensations are also felt in the arms. These sensations occur when the person with RLS lies down or sits for prolonged periods of time, such as at a desk, riding in a car, or watching a movie. People with RLS describe an irresistible urge to move the legs when the sensations occur. Usually, moving the legs, walking, rubbing or massaging the legs, or doing knee bends can bring relief, at least briefly.
RLS symptoms worsen during periods of relaxation and decreased activity. RLS symptoms also tend to follow a set daily cycle, with the evening and night hours being more troublesome for RLS sufferers than the morning hours. The severity of symptoms varies from night to night and over the years as well. For some individuals, there may be periods when RLS does not cause problems, but the symptoms usually return. Other people may experience severe symptoms daily.
Q. Are there any other symptoms or disorders that accompany Restless Legs Syndrome?
A. Many people with RLS also have a related sleep disorder called periodic limb movements in sleep (PLMS). PLMS is characterized by involuntary jerking or bending leg movements during sleep that typically occur every 10 to 60 seconds. Some people may experience hundreds of such movements per night, which can wake them, disturb their sleep, and awaken bed partners. People who have RLS and PLMS have trouble both falling asleep and staying asleep and may experience extreme sleepiness during the day. As a result of problems both in sleeping and while awake, people with RLS may have difficulties with their job, social life, and recreational activities.
Q. What are some common characteristics of Restless Legs Syndrome?
A. Some common symptoms of RLS include:
- Unpleasant sensations in the legs (sometimes the arms as well), often described as creeping, crawling, tingling, pulling, or painful;
- Leg sensations are relieved by walking, stretching, knee bends, massage, or hot or cold baths;
- Leg discomfort occurs when lying down or sitting for prolonged periods of time;
- The symptoms are worse in the evening and during the night.
Other possible characteristics involuntary leg (and occasionally arm) movements while asleep difficulty falling asleep or staying asleep; sleepiness or fatigue during the daytime; cause of the leg discomfort not detected by medical tests; and family members with similar symptoms.
Q. What causes Restless Legs Syndrome (RLS)?
A. Although the cause is unknown in most cases, certain factors may be associated with Restless Legs Syndrome. RLS is known to run in some families--parents may pass the condition on to their children. Some women experience RLS during pregnancy, especially in the last months but the symptoms usually disappear after delivery. Patients with low iron levels or anemia may be more prone to developing RLS. The symptoms may improve once the iron level or anemia is corrected. Kidney failure quite often leads to RLS. Other chronic diseases such as diabetes, rheumatoid arthritis, and peripheral neuropathy may also be associated with RLS. Decreasing caffeine consumption may improve symptoms.
Q. Who gets Restless Legs Syndrome (RLS)?
A. RLS occurs in both sexes. Symptoms can begin any time, but are usually more common and more severe among older people. Young people who experience symptoms of RLS are sometimes thought to have "growing pains" or may be considered "hyperactive" because they cannot easily sit still in school.
Q. How can physicians know if a patient has RLS?
A. There is no laboratory test that can make a diagnosis of RLS and, when someone with RLS goes to see a doctor, there is usually nothing abnormal the doctor can see or detect on examination. Diagnosis therefore depends on what a person describes to the doctor. To help make a diagnosis, the doctor may ask about all current and past medical problems, family history, and current medications. A complete physical and neurological exam may help identify other conditions that may be associated with RLS, such as nerve damage (neuropathy or a pinched nerve) or abnormalities in the blood vessels. Basic laboratory tests may be done to assess general health and to rule out anemia. Further studies depend on initial findings.
Q. Can Restless Legs Syndrome (RLS) be cured or treated?
A. In mild cases of RLS, some people find that activities such as taking a hot bath, massaging the legs, using a heating pad or ice pack, exercising, and eliminating caffeine help alleviate symptoms. In more severe cases, medications are prescribed to control symptoms. Unfortunately, no one drug is effective for everyone with RLS. Individuals respond differently to medications based on the severity of symptoms, other medical conditions, and other medications being taken. A medication that is initially found to be effective may lose its effectiveness with nightly use; thus, it may be necessary to alternate between different categories of medication in order to keep symptoms under control. A nondrug approach called transcutaneous electric nerve stimulation may also improve symptoms in some RLS sufferers who also have PLMS.
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