Restless Legs Syndrome

About 

Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings. RLS affects as many as 12 million Americans. More than 80 percent of people with RLS also experience a more common condition known as periodic limb movement disorder (PLMD).

Symptoms 

Restless legs syndrome symptoms may include:

• Difficulty falling asleep.
• Difficulty staying asleep.
• Exhaustion.
• Daytime fatigue.
• Difficulty concentrating and impaired memory.
• Burning sensation, feeling of creeping, tugging, or like insects crawling inside the legs in the legs. Sensations are mostly present when lying down or relaxing and may range in severity from uncomfortable to irritating to painful when lying down or relaxing.

Periodic limb movement disorder symptoms may include:

• Involuntary leg twitching or jerking movements during sleep that typically occur every 10 to 60 seconds, sometimes throughout the night.
• Repeated awakening.
• Severely disrupted sleep.

The cause of restless legs syndrome and periodic limb movement disorder are unknown.

Risk Factors & Prevention 

You are at a greater risk for restless legs syndrome if you:

• Have a family history of restless legs syndrome.
• Have low iron levels.
• Are anemic.
• Are diabetic.
• Have kidney failure.
• Have Parkinson's disease.
• Have peripheral neuropathy.

Follow Up Care 

Medications

Physicians may suggest a variety of medications to treat restless legs syndrome.

• Dopaminergic agents - largely used to treat Parkinson's disease, have been shown to reduce RLS symptoms and PLMD and are considered the initial treatment of choice.
• Benzodiazepines (sleeping pills) - may be prescribed for patients who have mild or intermittent symptoms. These drugs help patients obtain a more restful sleep but they do not fully alleviate RLS symptoms and can cause daytime sleepiness.
• Opioids - such as codeine or oxycodone, for more severe symptoms may be prescribed for their ability to induce relaxation and diminish pain.
• Anticonvulsants - useful for some patients, as they decrease the sensory disturbances (creeping and crawling sensations).

Unfortunately, no one drug is effective for those diagnosed with restless legs syndrome. What may be helpful to one individual may actually worsen symptoms for another. In addition, medications taken regularly may lose their effect, making it necessary to change medications periodically. Your physician will need to tailor your treatment and follow you closely to ensure your symptoms are under control.

Certain medications such as antinausea drugs, antiseizure drugs, antidepressant drugs, and caffeine, alcohol, or tobacco may induce or aggravate symptoms. Patients can talk with their physicians about the possibility of changing medications.