Restless Legs Syndrome - Learn About This Disorder That Can Disrupt Your Sleep

February 23, 2024

What is restless legs syndrome?

Restless legs syndrome (RLS)—also known as Willis-Ekbom Disease, primary RLS, or idiopathic RLS—is a neurological disorder that causes unpleasant or uncomfortable sensations in your legs and an irresistible urge to move them. Symptoms commonly occur in the late afternoon or evening hours and are often most intense at night when you are resting. RLS can severely disrupt your sleep, making it difficult to fall asleep or return to sleep after waking up. Moving the legs or walking typically relieves the discomfort but the sensations often recur once the movement stops.

RLS is both a sleep disorder, because the symptoms are triggered by resting and attempting to sleep, and a movement disorder, because people with RLS are forced to move their legs in order to relieve symptoms.

It is estimated that up to 10 % of the Indian population may have RLS, which can begin at any age. It occurs in both males and females, although females are more likely to have it. Many individuals who are severely affected are middle-aged or older, and the symptoms typically become more frequent and last longer with age.

Symptoms

People typically describe RLS symptoms as compelling, unpleasant feelings in the legs or feet. They usually happen on both sides of the body. Less commonly, the sensations affect the arms.

The sensations are felt within the leg rather than on the skin. They're described as:

Crawling
Creeping
Pulling
Throbbing
Aching
Itching
Electric

At times, these could also be felt in the arms. Since the syndrome strikes when you’re resting and inactive, it worsens in the evening or at night. RLS may leave you tired and sleepy during the day, thereby affecting your daily activities,” says Dr Rashi Goel, MPT, Zanskar Health.

Causes

Causes can be primary or secondary. Primary RLS has a cause and is familial in 25 to 75% cases. Secondary RLS may be due to peripheral neuropathy, iron, folate, magnesium, or Vitamin B12 deficiency, rheumatoid arthritis, Parkinson’s disease, kidney failure, venous disorder, thyroid disorder or a neurological disorder. Antidepressants, painkillers, alcohol and caffeine can cause or exacerbate the symptoms.

Pregnancy

Pregnancy or hormonal changes may worsen RLS symptoms. Some people get RLS for the first time during pregnancy, especially during the last trimester. However, symptoms usually disappear after delivery.

Diagnosis

Tests to analyse Complete Iron Panel, Blood Urea Nitrogen, Fasting Blood Glucose, Magnesium, Vitamin B12 and Thyroid Stimulating Hormone help in diagnosis. Sometimes, muscle or nerve tests are also recommended.

Treatment

Treatment for RLS is a mix of pharmacological and non-pharmacological approach. “Non-pharmacological treatment includes sleep hygiene measures and avoids nicotine, caffeine and alcohol. Pharmacological treatment includes medication,” explains Dr Goel.

Medications for RLS include:

Iron supplements
Anti-seizure drugs—Anti-seizure drugs are usually the first-line prescription drugs for those with RLS
Dopaminergic agents—These drugs, which increase dopamine in the brain, can reduce symptoms of RLS when taken at night
Benzos—Medications to treat anxiety, muscle spasms, and insomnia, and can help individuals get more restful sleep

The following lifestyle changes and activities may provide some relief if you have mild to moderate RLS:

Avoid or decrease the use of alcohol, nicotine, and caffeine
Change or maintain a regular sleep pattern
Try moderate, regular exercise
Massage the legs or take a warm bath
Apply a heating pad or ice pack
Use compression stockings
Do aerobic and leg-stretching exercises of moderate intensity

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Medical Review: This article is written by Dr Nishtha Mittal (Senior Health Content Editor at Zanskar Health) and has been medically reviewed by Dr Rashi Goel (Senior Physiotherapist at Zanskar Health). This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.