Sleep Disorders

A brief overview of restless leg syndrome

Restless leg syndrome, or RLS, also known as Willis–Ekbom disease, is a disorder of a part of the nervous system that causes an involuntary movement of legs. It typically occurs during the evening or nighttime. Restless leg syndrome can occur at any age and generally worsens with age, disrupting sleep and interfering with daily activities.

Often, there is no particular cause that leads to the development of restless leg syndrome. Medical researchers suspect that it could be caused due to an imbalance of dopamine levels. Dopamine is a chemical that sends messages to the brain to help control muscle movement. Causes indicating restless leg syndrome to be hereditary have also been noted. Hormonal changes or pregnancy can temporarily worsen the symptoms of restless leg syndrome during the last trimester. However, the symptoms would disappear after the delivery.

Risk factors
Some risk factors associated with restless leg syndrome have been listed as follows:

  • Iron deficiency: Patients with a history of bleeding from their stomachs or those who experience heavy menstrual periods might experience symptoms of restless leg syndrome more often.
  • Spinal cord conditions: Administering anesthesia to the spinal cord can cause lesions in that area, increasing the risk of suffering from restless leg syndrome.
  • Peripheral neuropathy: Damages to the nerves near the feet due to underlying conditions such as diabetes and alcoholism also increase the risk of restless leg syndrome.

As discussed above, the primary symptom of restless leg syndrome is an involuntary urge to move the legs. Apart from this, some other sensations one might feel could include crawling, creeping, pulling, throbbing, itching, aching, and tingling. Most of these symptoms occur during nighttime and could interfere with one’s sleeping patterns. The symptoms fluctuate in severity and disappear for a short period of time. The person gets relief from restless leg syndrome with movements such as jiggling the legs, stretching, or pace walking.

Doctors would advise undergoing certain medical tests and ask the patients to describe their signs and symptoms. The diagnosis is based on the following criteria:

  • The symptoms get worse when the person is resting, sitting, or lying down and temporarily or partially relieved by physical activity.
  • The person has a strong feeling to move their leg and is usually accompanied by uncomfortable sensations such as crawling, creeping, and cramping.

The diagnostic criteria mentioned above are established by the International Restless Leg Syndrome study group. Based on these symptoms, doctors will conduct a physical and neurological examination and take blood samples to examine if the person is suffering from iron deficiency or any other underlying conditions.

Treatment options
Restless leg syndrome can sometimes be a result of an underlying condition such as iron deficiency or other neurological disorders. Treating these conditions through lifestyle changes such as warm baths and oil massage, exercising, establishing a consistent sleep cycle, and avoiding caffeine before going to bed could help in relieving the symptoms of acute restless leg syndrome.

However, if a person is suffering from restless leg syndrome without any associated conditions, then the primary treatment mainly focuses on lifestyle changes. For chronic symptoms, the doctors might prescribe medications to increase the dopamine levels in the brain. Opioids that are strictly prescribed by doctors help in relieving mild to severe symptoms. Muscle relaxants such as benzodiazepines help the patient sleep better. However, they don’t eliminate the involuntary sensations and may cause daytime drowsiness.