What is restless legs syndrome?

Restless legs syndrome is a neurological sleep disorder that causes you to have uncomfortable feelings and the urge to move your legs. Restless legs syndrome makes it difficult to get comfortable enough to fall asleep. The symptoms are usually worse in the evening and at night. The sensation is difficult for some people to describe. It has been described as a crawling or creeping sensation. You may lie down and begin to feel itching inside your legs. If you move your legs or get up and walk around, these symptoms may go away. The discomfort may return when you try again to go to sleep.

In some restless legs syndrome cases, you may have trouble sitting still for long periods. Long car rides or airplane travel may be difficult.

Many people wait years to seek treatment because they do not view it as a serious concern. If left untreated, you may notice that your symptoms become more frequent and severe.

Restless legs syndrome may cause you to get fewer hours of sleep each night. Many people with severe cases get less than five hours of sleep per night. Milder cases may not disturb your sleep as much, though the sleep may be of poorer quality.

The accumulated sleep loss from restless legs syndrome can make you excessively sleepy during the daytime, cause you to be irritable and make concentration difficult. This may have a major impact on your professional and personal life. People with restless legs syndrome are more likely to have depression or anxiety.

Restless legs syndrome is usually manageable through lifestyle changes or medication.

RLS can develop at any age. Approximately 2% of children meet all the diagnostic criteria for RLS, and up to 13% of adults have RLS. Women are nearly twice as likely as men to develop the disorder. If you have a family member with restless legs syndrome, you are more likely to develop the symptoms before you are 45 years old. More than half of people with restless legs syndrome have a pattern of it in their family, as the risk is about three to six times greater.

What are causes of restless legs syndrome?

The causes of restless legs syndrome vary from person to person. In some cases, the cause is unknown, or it can be caused by or made worse by other health issues or medication. This may include:

Low iron levels

This can cause problems with brain cell communication that can lead to restless legs syndrome. If you think you have restless legs syndrome caused by low iron, talk with your doctor and do not attempt to take supplements on your own.

Diabetes

This lifelong condition can damage blood vessels and nerves that affect leg muscles causing restless legs syndrome. By properly managing your diabetes, you may help prevent or improve your restless legs syndrome. The prevalence of restless legs syndrome in people with diabetes is the same as in the general population. Diabetes causes neuropathy. Neuropathy needs to be managed differently and is not the same as restless legs syndrome, although some symptoms may overlap with restless legs syndrome symptoms.

Kidney failure

Restless legs syndrome is common in patients with kidney failure, but the exact cause is unknown. Some medications that are used to treat restless legs syndrome may not be appropriate for those with kidney failure.

Pregnancy

Many women have restless legs syndrome when they are pregnant. It usually goes away within a month of giving birth.

Medications

Some medications can cause restless legs syndrome or make it worse:

Allergy medications
Many antidepressants
Antihistamines and over-the-counter sleep aids
Nearly all centrally active dopamine-receptor antagonists, including anti-nausea medications

What are symptoms of restless legs syndrome?

The primary symptom of restless legs syndrome is a sensation of discomfort in the legs that is often difficult to describe. The feeling is different from leg cramps or numbness from circulation problems. Patients have used the following words to describe this sensation:

Itchy
Crawling
Creepy
Throbbing

Usually this feeling is paired with the urge to move your legs. The desire usually worsens when you lie down or rest.

The symptoms of restless legs syndrome are frequently worse in the evening and at night, rather than in the morning.

A related problem is that your leg muscles might tighten or flex while you are still. These movements can be out of your control. In some cases, they may be periodic limb movements while awake or during sleep.

How to diagnose restless legs syndrome?

Self-test

Do you have difficulty falling asleep because of an urge to move your legs?

Do you feel an itching or crawly sensation in your legs when you lie down to go to sleep?

Do your legs seem to feel better when you walk, stretch or make other movements in the evening or at night?

If you answered yes to any of these questions, you may have restless legs syndrome.

Diagnosis

Talk to a sleep doctor if you think you have restless legs syndrome. The doctor will ask you about your medical history and if you are on any medications.

The sleep doctor may ask that you keep a sleep diary for two weeks to show when you sleep and for how long. You may also rate how sleep is affecting your daily life using a simple questionnaire. Make sure to tell your doctor if you or a relative have ever had a sleep disorder.

Your doctor may order blood tests, including measuring ferritin and an iron panel.

A sleep study is not required to make the diagnosis of restless legs syndrome. However, in some cases, your doctor may recommend a sleep study. A sleep study may be used to detect sleep apnea or other sleep disorders that may be causing sleep disruption.

How to treat restless legs syndrome?

There are several options available to reduce RLS symptoms, including lifestyle changes, activities and medications.

Several lifestyle changes may help ease the symptoms of RLS. These include:

Get some exercise every day.
Eat a well-balanced diet, including foods rich in iron.
Limit caffeine and alcohol and do not smoke. All of these can worsen RLS.
Reduce your level of stress.

These activities may provide relief for mild RLS symptoms:

Stretch or massage the legs when you notice RLS symptoms.
Safely use heating pads on your legs when you are awake.
Take a warm bath to reduce symptoms.
Distract yourself by doing something interesting to help you focus less on the RLS symptoms.

Your doctor may recommend iron supplements if your ferritin or iron levels are low.

Prescription medications can be helpful if you have more severe symptoms. Your doctor will help you decide if a medication is the best option for you. Medications prescribed for RLS include medications that work through the gaba or dopamine neurochemicals in the brain and opioids.

Additionally, your doctor may recommend the use of a wearable device. It gently stimulates the nerves in your legs and may help reduce RLS symptoms.

Sometimes RLS symptoms can be managed by treating other underlying chronic conditions, such as diabetes, kidney disease or obstructive sleep apnea. Some medications also can cause RLS symptoms as a side effect.

Patient Support

For additional restless legs syndrome patient support contact the partner below:

Restless Legs Syndrome Foundation