Restless legs syndrome

What is restless legs syndrome?

Restless legs syndrome (RLS) is a nervous system disorder that causes an overpowering urge to move your legs. It’s also known as Willis-Ekbom disease.

Doctors consider it a sleep disorder because it usually happens or gets worse while you’re at rest. You might have trouble sleeping or sitting for a long time. It may get worse if you don’t get treatment. Over time, a lack of sleep can cause problems at work or home.

Anyone can get it, but it’s more common in women, and middle-aged people are more likely to have severe symptoms.

Sometimes, doctors don’t recognize RLS, especially if symptoms are mild or don’t happen often. But once it’s diagnosed, treatment can often stop it.

Symptoms

People with restless legs syndrome have unusual feelings in their legs (like itching, crawling, pulling, aching, throbbing, or pins and needles) and a powerful urge to move their legs to make the sensations go away. The condition can also happen in other areas like the arms, chest, or head. The feelings usually happen on both sides of the body. They can also happen on only one side, or they might start on one side and then move to the other.

The severity of RLS symptoms ranges from mild to intolerable. Symptoms can come and go, and the intensity can vary between episodes. The symptoms are generally worse in the evening and at night. For some people, symptoms may cause severe nightly sleep disruption that can significantly impair their quality of life.

Symptoms almost always go away in the early morning, so people who have RLS can often sleep well then.

Causes

Doctors don’t know what causes most cases of restless legs syndrome, but your genes might play a role. Nearly half of the people with RLS also have a family member with the condition.

It might also be tied to:

• Chronic diseases. Certain long-term medical conditions include RLS symptoms, including iron deficiency, Parkinson’s disease, kidney failure or renal disease, diabetes, and peripheral neuropathy.
• Medications. Some drugs might make symptoms worse, including anti-nausea meds, antipsychotics, some antidepressants, and cold and allergy medications that have antihistamines.
• Pregnancy. Some women have RLS during pregnancy, especially in the last trimester. Symptoms usually go away within a month after delivery.
• Lifestyle. A lack of sleep or another sleep disorder like apnea can trigger symptoms or make them worse. So can alcohol, tobacco, and caffeine use.

Diagnosis

There’s no medical test for RLS. Your doctor might want to talk to your sleep partner about what they’ve noticed.

The five basic criteria for a diagnosis of RLS are:

• An overwhelming urge to move your legs, especially along with uncomfortable or unusual feelings
• An urge that starts or gets worse while you’re at rest
• An urge that goes away, either partly or totally, when you move
• An urge that starts or gets worse in the evening.

Your doctor may use lab tests to rule out other conditions. A neurological exam can check for nerve damage or blood vessel problems. A sleep study called polysomnography can tell them if you have other sleep disorders that might cause RLS.

Treatment

There’s no cure for restless legs syndrome itself, but treatments can help control it so you can get a good night’s sleep.

If another condition is causing your restless legs, such as an iron deficiency, your doctor will treat it.

Treatment for RLS itself will target your symptoms. If your RLS is mild or moderate, some small changes to your everyday life might help: getting regular exercise; following a sleep schedule; and avoiding caffeine, alcohol, and tobacco.

Other ways to treat RLS without drugs include:

• Leg massages
• Hot baths
• Heating pads or ice packs on your legs
• A vibrating pad called Relaxis.

Medications help some people. But a drug that eases symptoms in one person may make them worse in another, or a drug that works for a while may stop working.

Drugs to treat RLS include:

• Dopaminergic drugs, which act on the neurotransmitter dopamine in your brain. The FDA has approved pramipexole (Mirapex), ropinirole (Requip), and rotigotine (Neupro) for moderate to severe RLS.
• Benzodiazepines, a type of sedative, may help with sleep, but they can cause daytime drowsiness.
• Narcotic pain relievers
• Anticonvulsant or antiseizure drugs, such as carbamazepine (Tegretol), gabapentin (Neurontin), gabapentin enacarbil (Horizant), and pregabalin (Lyrica)

Prognosis

Restless legs syndrome is a lifelong condition that might get worse with age. But some people go into remission and don’t have symptoms for days to years.

Keep your doctor updated on how you’re doing. If you start to feel worse, they might suggest different lifestyle changes or medications.

Source: WEB MD

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