Restless Legs Syndrome
What is restless legs syndrome (RLS)?
Restless legs syndrome (RLS) is a sleep disorder that causes an intense, often irresistible urge to move your legs, often accompanied by other sensations in the legs such as tingling, pulling, creeping, or pain. This sensation is brought on by lying down in bed or by sitting for prolonged periods of time, such as while driving or at a theater. RLS typically occurs in the evening, making it difficult to fall asleep. Often times, people with RLS want to walk around and shake their legs to help relieve the uncomfortable sensation.
Who gets restless legs syndrome (RLS)?
People of any age, including children, can have RLS. However, the syndrome typically strikes older adults and affects women more often than men. Young people who have RLS or who show the symptoms of RLS are usually dismissed as having "growing pains" or are considered to be overexerting themselves during physical activity. Because the symptoms of RLS are often difficult to describe, and at least initially may only occur once or twice per month, many people forget to bring up the subject to a doctor. About 5% to 10% of the U.S. population has RLS.
What causes restless legs syndrome (RLS)?
RLS has been found to be a genetic syndrome in some cases, as parents with RLS can pass it down to their children. In addition, a variety of medical problems (described below) as well as medications can contribute to the development of RLS.
How do I know if I have restless legs syndrome (RLS)?
Because there is no test that the doctor can conduct to diagnose RLS, a physician often has to diagnose the disorder by listening to patients' descriptions of their symptoms. To confirm a diagnosis of RLS, patients must have the following symptoms:
- An urge or desire to move their legs, usually accompanied by uncomfortable sensations such as numbness, tingling, crawling, itching, aching, burning, cramping, or pain.
- The urge to move or uncomfortable sensations begin or worsen during periods of rest or inactivity, such as when sitting watching television or traveling in a car or by airplane.
- The urge to move or uncomfortable sensations are partially or totally relieved by activities such as stretching, walking, or exercising the affected muscles.
- The urge to move or uncomfortable sensations are worse or occur solely in the evening or at night.
- The urge to move or uncomfortable sensations are not solely due to another medical or behavioral problem (muscle pains, leg cramps, arthritis, habitual foot tapping).
Your doctor may ask you to discuss your family health history, including family members who may have RLS. In 50% of patients, the disorder is presumed to be genetic. The chance of developing RLS increases three to six times when an immediate relative has the disorder. Also, these patients tend to develop symptoms earlier in life (before age 45) than those with RLS without the genetic link.
Other medical problems that can contribute to the development of RLS include iron deficiency, Parkinson's disease, renal disease, diabetes, rheumatoid arthritis, and peripheral neuropathy (a nervous system disease affecting nerves in the extremities). Pregnant women often note symptoms of RLS after 20 weeks of gestation, and dialysis patients are especially susceptible to developing RLS. Patients who take antidepressants, sedating antihistamines, or anti-nausea medications may develop RLS.
Your doctor will also ask if you have trouble staying awake during the day or if you have insomnia (difficulty falling asleep or staying asleep). RLS often leads to insomnia as well as daytime sleepiness, irritability, and impaired concentration brought on by a restless night of sleep.
Additionally, your doctor will conduct a full physical and neurological exam to check for nerve damage or blood vessel problems and may order a series of blood tests to rule out medical disorders associated with RLS.