Restless Legs Syndrome (RLS)

What Is Restless Legs Syndrome?

 

Restless legs syndrome (RLS) is a nervous system disorder that causes an overpowering urge to move your legs. It’s also known as Willis-Ekbom disease.

Doctors consider it a sleep disorder because it usually happens or gets worse while you’re at rest. You might have trouble sleeping or sitting for a long time, such as in a theater or a car. It may get worse if you don’t get treatment. Over time, a lack of sleep can cause problems at work or home.

Restless legs syndrome affects up to 10% of people in the U.S. Anyone can get it, but it’s more common in women, and middle-aged people are more likely to have severe symptoms.

Sometimes, doctors don’t recognize RLS, especially if symptoms are mild or don’t happen often. But once it’s diagnosed, treatment can often stop it.

Restless Legs Syndrome Symptoms

People with restless legs syndrome have unusual feelings in their legs (like itching, crawling, pulling, aching, throbbing, or pins and needles) and a powerful urge to move their legs to make the sensations go away. The condition can also happen in other areas like the arms, chest, or head. The feelings usually happen on both sides of the body. They can also happen on only one side, or they might start on one side and then move to the other.

RLS symptoms range from mild to unbearable. They might come and go, and the intensity can vary between episodes. They’re generally worse in the evening and at night.

Symptoms almost always go away in the early morning, so people who have RLS can often sleep well then.

The severity of RLS symptoms ranges from mild to intolerable. Symptoms can come and go and severity can also vary. The symptoms are generally worse in the evening and at night. For some people, symptoms may cause severe nightly sleep disruption that can significantly impair their quality of life.

Restless Legs Syndrome Causes

Doctors don’t know what causes most cases of restless legs syndrome, but your genes might play a role. Nearly half of the people with RLS also have a family member with the condition.

It might also be tied to:

  • Chronic diseases. Certain long-term medical conditions include RLS symptoms, including iron deficiency, Parkinson’s disease, kidney failure or renal disease, diabetes, and peripheral neuropathy.
  • Medications. Some drugs might make symptoms worse, including anti-nausea meds, antipsychotics, some antidepressants, and cold and allergy medications that have antihistamines.
  • Pregnancy. Some women have RLS during pregnancy, especially in the last trimester. Symptoms usually go away within a month after delivery.
  • Lifestyle. A lack of sleep or another sleep disorder like apnea can trigger symptoms or make them worse. So can alcohol, tobacco, and caffeine use.

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Restless Legs Syndrome Diagnosis

There’s no medical test for RLS. Your doctor might want to talk to your sleep partner about what they’ve noticed.

The five basic criteria for a diagnosis of RLS are:

  • An overwhelming urge to move your legs, especially along with uncomfortable or unusual feelings
  • An urge that starts or gets worse while you’re at rest
  • An urge that goes away, either partly or totally, when you move
  • An urge that starts or gets worse in the evening
  • Another condition, such as leg cramps, arthritis, or muscle pains, isn’t causing it

Your doctor may use lab tests to rule out other conditions. A neurological exam can check for nerve damage or blood vessel problems. A sleep study called polysomnography can tell them if you have other sleep disorders that might cause RLS.

Restless Legs Syndrome Treatment

There’s no cure for restless legs syndrome itself, but treatments can help control it so you can get a good night’s sleep.

If another condition is causing your restless legs, such as an iron deficiency, your doctor will treat it.

Treatment for RLS itself will target your symptoms. If your RLS is mild or moderate, some small changes to your everyday life might help: getting regular exercise; following a sleep schedule; and avoiding caffeine, alcohol, and tobacco.

Other ways to treat RLS without drugs include:

  • Leg massages
  • Hot baths
  • Heating pads or ice packs on your legs
  • A vibrating pad called Relaxis

Medications help some people. But a drug that eases symptoms in one person may make them worse in another, or a drug that works for a while may stop working.

Drugs to treat RLS include:

  • Dopaminergic drugs, which act on the neurotransmitter dopamine in your brain. The FDA has approved pramipexole (Mirapex), ropinirole (Requip), and rotigotine (Neupro) for moderate to severe RLS.
  • Benzodiazepines, a type of sedative, may help with sleep, but they can cause daytime drowsiness.
  • Narcotic pain relievers
  • Anticonvulsant or antiseizure drugs, such as carbamazepine (Tegretol), gabapentin (Neurontin), gabapentin enacarbil (Horizant), and pregabalin (Lyrica)

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Restless Legs Syndrome Prognosis

Restless legs syndrome is a lifelong condition that might get worse with age. But some people go into remission and don’t have symptoms for days to years.

Keep your doctor updated on how you’re doing. If you start to feel worse, they might suggest different lifestyle changes or medications.

It can help to talk to other people who know what you’re going through, whether it’s a family member who has RLS or a support group.

WebMD Medical Reference Reviewed by Christopher Melinosky on February 23, 2020

Sources

SOURCES:

News release, FDA.

The University of Washington Neuroscience for Kids: "Restless Legs Syndrome."

National Institute of Neurological Disorders and Stroke: "Restless Legs Syndrome Fact Sheet."

Restless Legs Syndrome Foundation: "About RLS: Frequently Asked Questions."

National Organization for Rare Disorders: “Restless Legs Syndrome.”

Cleveland Clinic: “Restless Legs Syndrome.”

American Academy of Sleep Medicine: “Restless Legs Syndrome.”

Merck Manual Consumer Version: “Periodic Limb Movement Disorder (PLMD) and Restless Legs Syndrome (RLS).”

American Academy of Family Physicians: “Restless Leg Syndrome.”

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