Some people consider nights to be a time of discomfort, restlessness, and pain.
These are the symptoms of Restless Legs Syndrome (or RLS).. RLS can be a sensory or motor disorder that affects a person’s ability to fall asleep, stay asleep, and/or remain still for prolonged periods of time.
Restless Legs Syndrome, also known as Willis-Ekbom Disease or Willis-Ekbom Disease is a neurological disorder that can be combined with a sleep disorder.. This condition can cause discomfort in the limbs and an overwhelming desire to move to relieve those sensations.
RLS is estimated to affect 8% of the US population. However, this may be due to under-diagnosis. Although the disorder is not life-threatening, it can cause serious sleep and health problems as well as a decrease in quality of your life.
Notice: While the content of Sleepopolis can be considered informative, it should not replace professional medical advice. You should consult your healthcare provider immediately if you suspect you might have a sleep disorder or other medical condition.
Restless Legs Syndrome Symptoms
RLS is a disorder that follows a circadian rhythm. This means that symptoms such as discomfort and restlessness often worsen at night. It can disrupt a person’s ability to fall asleep and/or stay asleep.
Restless Legs Syndrome cases are usually classified as primary, idiopathic, and secondary.Primary or idiopathic RLS is not known.
Primary RLS is more common that secondary RLS and is often associated with positive family history.Secondary RLS is usually caused by another medical condition, drug or vitamin/mineral deficiency.Secondary RLS can be treated. Secondary RLS can resolve if the precipitating disorder has been treated.
The following symptoms are present in both the primary and second forms of Restless Legs Syndrome.:
- Itchy sensations in the legs, such as crawling, pulling, throbbing, achy, throbbing or achy. You may feel the sensation on either one side of your body or alternate between them. The sensations of discomfort can also occur on the head, feet, arms, chest or legs.
- The strong urge to move your legs to relieve the discomfort associated with the disorder.
- Temporarily, you can move or stretch your limbs to relieve the symptoms. The symptoms return when you stop moving.
- The symptoms are more severe in the evening, when the person is sitting or lying down for prolonged periods of time. These sensations can occur while the person is sitting or lying down, on a plane or long car ride.
RLS Fact: Sir Thomas Willis, an English physician, first described Restless Legs Syndrome in medical literature in 1672.
What Causes Restless Legs Syndrome?
Although the exact mechanism of RLS is not known, it is most likely due to a combination genetic and environmental factors.
These factors include:
- Dopamine dysfunction.Strong evidence suggests that RLS could be caused by an imbalance in dopamineDopamine, a brain chemical that regulates muscle movement, reward, attention and memory. Involuntary movements, which are typical of RLS, may be caused by disruption of dopamine pathways.
- Iron deficiency. Although effective dopamine-based drugs are used to treat this condition, there is a strong link between RLS and dopamine.The disorder may also be caused by a lack of iron in your brain. RLS patients often have iron levels that are normal but not sufficient in their brains. RLS is more likely if there are conditions that reduce the iron levels in the body.
- Genetics.Primary Restless Legs Syndrome affects up to 50% of those who have it.. This supports the idea that genes play an important role in the development of the disorder.
- The possibility of nighttime aggravation of RLS symptoms could be due to the release of Melatonin, a hormone that is produced by the pineal gland in our brains in preparation for sleeping.
RLS symptoms can be triggered by or made worse by certain drugs and conditions.:
- Antidepressants, antipsychotic drugs and anti-nausea medications, as well as calcium channel blockers and cold and allergy medication containing antihistamines may cause brain dopamine receptors to be blocked.
- Vitamin and mineral deficiencies. A link may exist between vitamin B-12 and magnesium deficiency.
- Pregnancy.Some women may experience Restless Legs Syndrome symptoms during pregnancy, especially in the last trimester.. Most women who have RLS triggered by pregnancy will feel relief within one month.
- Sleep deprivation. RLS can cause sleep deprivation. Sleep deprivation could in turn lead to symptoms of RLS
- You can drink alcohol, caffeine, or nicotine.
RLS Fact: RLS may be associated with Attention Deficit/Hyperactivity disorder, another neurological condition that affects the dysfunction of dopamine (an essential neurotransmitter).
These factors are in addition to medications, genetic and environmental factors.RLS may be triggered by serious medical conditions.. The connection between RLS, certain medical conditions, and genetics could also be explained by genetics.
- Diabetes
- End-stage renal disease
- Fibromyalgia
- Lyme disease
- Stroke
- Multiple sclerosis (MS).
- Parkinson’s Disease
- Peripheral neuropathy (nerve injury)
- Rheumatoid arthritis
RLS can be associated with narcolepsy. This makes it less likely that the cause of RLS is genetic. RLS symptoms usually appear around ten years after the diagnosis of narcolepsy.
How Is Restless Legs Syndrome Diagnosed?
RLS is not currently diagnosed with a specific medical test. RLS is often misdiagnosed because it depends on the symptoms being reported by patients.To be considered for a clinical diagnosis of Restless Legs Syndrome, you must meet the following criteria::
- Feelings of discomfort in the limbs and strong urge to move the legs
- Restlessness that causes pacing, massaging your limbs or turning in and out of bed
- At rest, symptoms can worsen or become more severe. Activity can help relieve these symptoms.
- In the evenings and at night, symptoms increase in severity and number.
A doctor will ask questions about your family, medical history, medical conditions, daytime sleepiness, medication use, and any other health issues during an evaluation for RLS symptoms. An order for a sleep study and a blood test to determine iron levels may be made.
If sensory symptoms and restlessness start while you are walking, an adoctor won’t diagnose RLS.. To be considered Restless Legs Syndrome, symptoms must first appear at rest.
Are You At Risk Of Restless Legs Syndrome
RLS can happen at any age, but the average age of diagnosis for RLS is 46.. One third of those with RLS are younger than twenty-years old when they were diagnosed. RLS sufferers may experience their first symptoms as early as ten years old.
RLS is more likely to be diagnosed due to certain environmental and genetic factors.These are the people at greatest risk of Restless Legs Syndrome:
- RLS-related family history. RLS is a genetic condition that can be passed from one generation to the next. This means that RLS may affect up to 50% of those who have a family member with RLS.
- Multiple Sclerosis sufferers or those with certain neurological movement disorders, such as Parkinson’s Disease and Multiple Sclerosis.
- People who take medications or use substances that can exacerbate RLS (e.g. antidepressants)
- A person with abnormal brain levels of dopamine or iron
- Women who are pregnant, particularly those in their final trimester
There are also other factors that could increase your risk of RLS.:
- Gender of the female. RLS tends be more common in females
- Ageing. RLS can be affected by anyone, but it is more common in middle-aged and older people.
- Northern European descent
RLS Fact: Other conditions may also cause symptoms similar to RLS sufferers. For example, akathisia can cause inner restlessness most commonly in the legs. Akathisia can be caused by antipsychotic medication, but it is not related to sleeping.
RLS: Early-Onset Vs. Late-Onset
RLS that starts before 45 years old is considered early-onset. RLS that occurs after age 45 is considered late-onset.. RLS can be diagnosed as early as the teenage years. RLS can also occur in middle age. This secondary condition is often caused by medical conditions, medications, or other disorders of the nervous system.
RLS is more common in women than it is in men. This type of RLS is not typically painful.Insufficient sleep can be a sign of trouble, especially in children.You can. Parents and doctors may dismiss sensory symptoms as growing pains.
RLS can be progressive and last a lifetime. Sometimes, symptoms may not manifest for several decades.Early-onset RLS may have a more severe course.Remission is possible and can provide relief for months, or even years.
Late-onset RLS is not common in families. Patients may feel uncomfortable and painful sensations in their limbs.RLS with late-onset symptoms is often a secondary disorder that has been triggered by or caused by another medical condition.. If the underlying condition is treated, the late-onset disease can be treated.
The Sensations Of RLS: Dysesthesias And Paresthesias
RLS can cause uncomfortable sensations that are classified as Paresthesias or Dysethesias..
Paresthesias can be sensations that aren’t considered to be painful. They include tingling, chill feeling, prickling or numbness. Dysesthesias can be described as painful sensations that include burning, unrelieved, itching, pins or needles and electric shock sensations.
RLS paresthesias and dysethesias are not usually felt on the skin. They are felt within the limb.. Some sufferers find that movement can help to alleviate the discomfort from dysesthesias and paresthesias.
RLS sensations can be mild or severe and often are unpredictable. They can change or disappear from day to day. Some people only experience these symptoms occasionally while others are constantly affected.
Dysesthesia and paresthesias could also be signs of another disorder.Multiple sclerosis, peripheral neuropathy, diabetes, and fibromyalgia are all possible.
Periodic Limb Movements During Sleep And RLS
RLS is often associated with irregular movements known as Periodic Limb Movements during Sleep (or PLMS).. People with RLS could also have PMLS if they are more than 80%.
PMLS is defined by repetitive movements of the lower legs and feet. This includes kicking, twitching, stretching and flexing the toes as well as bending the knees and ankles.. Sudden jerking can wake people who are afflicted or cause partial awakenings which may result in poor quality sleep.
PMLS is different from Periodic Limb Movement Syndrome, which is not secondary to RLS. Periodic Limb Movements are more common in those with RLS and the general population, but Periodic Limb Movement Disorder (PLM) is uncommon.
PMLS movements occur in non-REM sleep’s lighter stages, but they can also occur during waking time.PMLS movements and jerking may be heard every 20-30 seconds during the night..
PLMS is not seen in REM sleep due to the muscle paralysis that characterizes this stage of sleep. PLMS may occur in people who have REM Sleep Behavior Disorder. In this case, the normal paralysis that occurs during REM sleep is not present.
PMLS is also common among narcolepsy sufferersPeople who have a disturbed sleep/wake pattern, such as shift workers, or people withdrawing from the Valium benzodiazepine drug class. PMLS may be exacerbated by certain substances, such as antidepressants and caffeine. The symptoms may be worsened by stress and sleep deprivation.
Because of its effects on sleep, PLMS can cause daytime sleepiness, depression, and reduced concentration. PLMS and RLS could also be linked to hypertension and cardiovascular disease.
What Does Restless Legs Syndrome Mean For Sleep?
RLS symptoms often worsen at night so sufferers find it hard to fall asleep and stay asleep.RLS is more common in the early stages of sleep. This increases the chance of insomnia or frequent awakenings before deep sleep..
RLS can cause significant sleep disturbances in people with moderate to severe cases. Insufficient sleep may be a problem for even those with milder RLS cases.
RLS can lead to insufficient sleep, which can have negative consequences.:
- Daytime sleepiness
- Diminished quality in mood
- Difficulty in concentrating or thinking clearly
- Performance problems at school and work
- Productivity has fallen
- Increased irritability
- Memory impairment
- It is difficult to complete daily tasks
- Function of the immune system is reduced
- Higher risk of stroke, heart disease, anxiety, depression, and diabetes.
RLS Fact: RLS appears to be less common in African and Asian populations. This suggests that genetics and environment may play a role in the development of RLS.
RLS And Sleep Partners
RLS symptoms can include nightly tossing, turning, shaking, or stretching the legs.These movements can have an impact on a partner’s sleep, causing frequent disruptions to their sleep and making it difficult for them to go back to sleep.
Sleep deprivation can lead to daytime fatigue, impaired cognitive abilities, diminished immune system function, and poor work performance.
A RSL victim’s sleep partner may be able to help with some of their symptoms.:
- Encourage the RLS patient to see a doctor. The person may be able to manage their condition and symptoms better with medical treatment
- Massage the legs of your partner or provide them with cold packs or heating pads.
- If the partner’s symptoms are especially disruptive, it is a good idea to sleep in a different bedroom.
- Lifestyle changes such as exercise, healthy eating and sleep hygiene can be beneficial to RLS sufferers.
Notice: While the content of Sleepopolis can be considered informative, it should not replace professional medical advice. You should consult your healthcare provider immediately if you suspect you might have a sleep disorder or other medical condition.
Treatments For Restless Legs Syndrome
There are many treatment options available for RLS, including natural remedies, medication, lifestyle changes, and medications.You can find out more. While some treatments won’t cure RLS symptoms completely, they can help ease the severity of RLS and promote better sleep.
Restless Legs Syndrome may only cause mild symptoms that have minimal impact on sleep.
RLS may be linked to other medical conditions. Treatment could include effective management of that condition.
Lifestyle Modifications And Natural Treatments
Moderate RLS symptoms can be controlled by lifestyle changes such as:
- Moderate exercise
- Establishing a consistent sleep schedule and getting up and sleeping at the same time each day.
- Healthy weight
- Avoid the use of caffeine, alcohol, and nicotine
- Hydration is key to a healthy diet and a well-balanced lifestyle.
- Relaxation techniques like meditation, Tai Chi and acupuncture can be used.
- Schedule long car or plane rides earlier in the morning, when symptoms are less severe
- Avoid the use of medication that could worsen RLS
- Treatment devices like a vibrating pad, pneumatic compression, and foot wraps are available for RLS sufferers.
You can also massage your legs with heating pads or ice to treat the problem areas.Calcium and magnesium supplements may help some people suffering from RLS.These effects affect the contraction and relaxation muscle fibers.
Low doses of vitamins or minerals can cause toxic effects on the body. A doctor should be consulted before starting any treatment program.
Medications
A doctor might prescribe medication or minerals to treat RLS symptoms that are severe or if lifestyle changes or natural treatments fail.Treatment options include: There are many treatment options:
- Dopamine-enhancing drugs like levodopa. These drugs affect brain dopamine levels and are often used to treat conditions like Parkinson’s Disease. Although effective in many cases, RLS treated with levodopa or similar drugs can cause what is known as augmentation. This refers to a rebound effect that causes increased symptoms.
- Intravenous iron supplementation. RLS can be treated with iron. Some studies have shown that about 20% of patients experience complete relief.
- These drugs include anticonvulsants and antiseizure medications. These drugs may help to make RLS less severe and reduce the discomfort in the legs.
- These may include sleep medications and/or muscle relaxants. These could help RLS sufferers sleep better at night.
- Calcium-lowering drugs These medications can cause RLS symptoms to improve in some people, although it is not clear why.
- Opioids, also known by the name opioids, are narcotic pain relievers. RLS symptoms such as pain in the legs and swelling can be relieved by low doses of opioids. RLS patients may have a lower tolerance to opioids than those with chronic pain syndromes such as gout.
One RLS sufferer might experience relief from symptoms, but a medication may worsen symptoms for another.. A single drug may be effective initially, but it will eventually lose its effectiveness. Side effects can occur with any medication. There may also be dependence or tolerance to opioids, sleep medications, and muscle relaxants.
Future Of RSL Research
The disorder has been extensively studied since 1995 when the diagnostic criteria for Restless Legs Syndrome were established.Although the exact cause is unknown, it is now accepted that RSL is a true disorder..
Despite the fact that RSL is still a mystery, recent advancements have allowed for more specific research. Scientists believe that iron deficiency coupled with genetics could cause the disorder. This can continue even when iron levels return to normal.
We may find that RSL can be caused by genetics in a small number of people.
Future research could focus on iron regulation in the brain and environmental stressorsThese are the factors that lead to RLS. Researchers may be able to stop the condition from developing or treat it more effectively. It doesn’t matter if RSL occurs in pregnancy, childhood or later in life. A better understanding of the condition may allow for more effective and tailored treatment options.
Refer To
- MV Svetel. Quality of Life in Patients With Primary Restless Legs Syndrome: A Community-Based Study, National Center for Biotechnology Information Aug. 2010.
- Y. Oka Secondary Restless Legs Syndrome National Center for Biotechnology Information May 2009
- M. Michaud. Arm Restlessness in Patients With Restless Legs Syndrome. Movement Disorders. Mar. 2000
- Ulrike Mitchell. Peripheral Dopamine in Restless Legs Syndrome. Frontiers in Neurology. Mar. 15,
- RP Allen, The Role of Iron In Restless Legs Syndrome, June 2008.
- Maurice M. Ohayon. Epidemiology and Restless Legs Syndrome. A Synthesis of the Literature. Sleep Medicine Review. Aug. 2012.
- M. Michaud: Circadian Rhythm of Restless Lower Legs Syndrome: Relationship to Biological Markers, Annals of Neurology. Mar. 2004
- Donald L. Bliwise Medications Associated with Restless Legs syndrome: A Case Control Study in The US Renal Data System, . October 15, 2014.
- A. Neyal: A Prospective Study on Willis-Ekbom Disease/Restless Legs syndrome During and After Pregnancy, . Sep. 15, 2016.
- DL Picchietti. Further Studies on Periodic Limb movement Disorder and Restless Legs Syndrome In Children With Attention-deficit Hyperactivity Disorder. Movement Disorders.Nov. 1999
- I. Schlesinger. Restless Legs Syndrome in Stroke Patient, Sleep Medicine,Aug.
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