What is Restless Legs Syndrome (RLS)?

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By Dr Simon Kyle

Restless Legs Syndrome (RLS), also known as 'Ekbom syndrome', is thought to affect between 5-10% of adults. The syndrome is characterized by uncomfortable or painful feelings in the thighs, claves and feet, which result in overwhelming urges to move the legs. These feelings are often experienced as crawling or tickling sensations in the skin or leg muscles and range from the mildest of feelings, to the most severe and debilitating sensations. The symptoms of RLS may not be restricted to the nighttime and, in the most extreme situations, can significantly impact on daily quality of life.

RLS sufferers tend to begin experiencing the 'itching' or 'tickling' sensations in their legs during periods of rest, only finding relief by moving their legs and, whilst some may only experience RLS very rarely, others will report experiencing these symptoms every day.

RLS is most often discussed in relation to sleep as the urge to move the legs often proves to be strongest at rest. The majority (as much as 80%) of individuals with RLS experience several episodes of jerking leg movements during the night, called periodic limb movements (PLMs), which may seriously fragment their sleep and often without them knowing. Compromised sleep quality, sleep continuity and architecture ultimately impairs next-day functioning, through increased levels of sleepiness and fatigue.

What causes RLS?
There is still much debate and disagreement surrounding the causes of RLS, which may be associated with underlying health conditions, including anemia (iron deficieny), Parkinson's disease and reduced kidney function. In these cases, RLS would be given as a 'secondary diagnosis'. Alternatively, RLS may present on its own, being given as a 'primary diagnosis'. In these cases however, there is often no obvious cause of RLS and it may be seen to run in the individual's family.

Most research into the causes of restless legs indicates low levels of the neurotransmitter 'dopamine' to be key. Dopamine is important in the control of muscle movements meaning that low levels of the chemical may play a role in the involuntary leg movements seen in RLS.

Treatments for RLS
RLS may not require treatment if the symptoms experienced are very mild, however, several lifestyle changes may be advised. These include avoidance of caffeine and alcohol and participating regularly in exercise alongside stopping smoking if you do so.

In cases of RLS caused by other conditions, people may find that treatment for their primary diagnosis may also improve their RLS. However, in more severe cases of RLS, people may benefit from medication to adjust dopamine levels.

Please consult your doctor if you believe you might be suffering from restless legs syndrome.

Filed under: Sleep disorders