Do you have trouble sleeping at night because of strange or unpleasant sensations in your legs? Would you describe these sensations as creeping, pulling, itching, burning, throbbing, or any other uncomfortable feeling? Do your symptoms occur only when relaxing or trying to rest? Do these sensations cause an uncontrollable or overwhelming urge to move your legs to relieve your discomfort? If so, you may be suffering from restless leg syndrome.
What is Restless Leg Syndrome (RLS)?
Restless Leg Syndrome is a neurological disorder that is characterized by a persistent, sometimes overwhelming need to move one's legs. The need to move the legs is often (but not always) accompanied by unpleasant sensations in the legs that can range from mildly unpleasant to quite painful. Symptoms usually manifest themselves during periods of rest and relaxation or during periods of inactivity and are generally most severe later at night. Sufferers of RLS state that moving or applying pressure to their legs is often the only temporary relief for their symptoms.
Although RLS is a neurological sensorimotor disorder it is classified as a sleep disorder because the constant need to move one's legs during rest leads to poor sleep quality, exhaustion, and excessive daytime sleepiness. Sleep Deprivation can lead to a diminished quality of life and many sufferers of RLS report difficulties at work, school, and in their social life associated with being overly tired all the time. Many also report symptoms of memory impairment, difficulty concentrating, and even depression.
It is estimated that approximately 10% of the U.S. adult population and 2% of children suffer from restless leg syndrome to some varying degree. RLS is often misdiagnosed and is instead attributed to symptoms of insomnia, nervousness, anxiety, arthritis, stress, and muscle cramps.
While RLS most commonly affects the legs, similar symptoms have been reported by people in other areas of their bodies including the arms, torso, and head.
Causes of Restless Leg Syndrome
While there is no exact known cause of RLS, there are several risk factors for the disorder. RLS can affect both men and women of any age, but is twice as likely to occur in women than in men, and severe symptoms of RLS are more common in the elderly than in children, and as a sufferer of RLS ages their symptoms generally worsen if left untreated. Researchers believe that there may be a genetic component to RLS as up to half of those with RLS have a family history of the disorder.
There is a growing body of evidence suggesting that RLS is linked to an imbalance of the neurotransmitter dopamine. Dopamine promotes smooth muscle movements and a disruption to its production or pathways results in involuntary movements.
Risk factors and conditions associated with RLS
° Parkinson's Disease
° Iron Deficiency
° Kidney Failure
° Peripheral Neuropathy
° Some women experience RLS or have their symptoms worsen during pregnancy, especially during the third trimester. However, after birth the symptoms usually abate or disappear within 4 weeks.
• Medications and Drugs- Some medications and drugs can aggravate or worsen symptoms of RLS
° Antinausea drugs (prochlorperazine or metoclopramid)
° Antipsychotic drugs (haloperidol or phenothiazine derivatives)
° Antidepressants that increase serotonin
° Cold and allergy medicines containing histamine (h2) blockers.
• Other Risk Factors
° Alcohol, tobacco, and caffeine use
° Sleep Deprivation
° Vericose veins
Treatment for Restless Leg Syndrome
Currently there is no cure for Restless Leg Syndrome. However, there are many treatment options available that can greatly reduce symptoms and help alleviate negative side effects of the disorder.
• Treating the underlying condition can often relieve symptoms of RLS. If the cause is determined to be associated with iron deficiency, diabetes, Parkinson's disease, or peripheral neuropathy, talk to your primary care physician about treatment options that will relieve your RLS symptoms.
• Lifestyle changes
° Establish a regular exercise routine to get plenty of daily movement in the legs.
° Cut back on possible triggers such as alcohol, caffeine, and tobacco use.
° Maintain a regular sleep pattern.
° If iron deficiency is believed to be the cause, discuss with your primary care physician about taking iron supplements.
° Regularly massage legs.
° Take hot baths or alternate use between heat pad and cold packs.
° If Parkinson's Disease is the underlying cause, dopaminergic agents (used to increase dopamine production) taken before bedtime have been shown to alleviate symptoms of RLS. These drugs have also been found to work for RLS without Parkinson's as the underlying cause of the disorder.
° Anti seizure medications often used for treatment of epilepsy have been shown to relieve symptoms of restless leg syndrome such as gabapentin and pregabalin.
° Muscle relaxants and sleep medications. Medications such as benzodiazepines may be used to help promote sleep. However, many medications of this type still can cause daytime drowsiness.
° Narcotic pain relievers (opiods) may be prescribed to help patients whose RLS is causing severe pain symptoms.
It's important to note that many medications used to treat symptoms of RLS and underlying causes of the disorder can have a whole slew of negative side effects including from nausea, dizziness, excessive daytime sleepiness, light-headedness, addiction, and aggravate other sleep disorders such as sleep apnea.
If you believe that you may be suffering from restless leg syndrome, discuss your symptoms with your primary care provider or contact a sleep clinic for a sleep study. At The Alaska Sleep Clinic, we help diagnose and treat hundreds of Alaskans every year with sleep disorders. Regular, quality sleep is one of the most important aspects of leading a healthy and happy life. Having an untreated sleep disorder such as restless leg syndrome can not only hamper the quality of your daily life, it can lead to severe health conditions and even accidents from drowsiness if left untreated. If you live in Alaska and want to get a free sleep assessment from one of our sleep educators, click the link below and get on your way to sleeping restfully through the night.