See also…
Sleep Disorders
What is restless legs syndrome
(RLS)?
Restless
legs syndrome (RLS) is a sleep disorder in which a person has
unpleasant feelings or sensations in the legs. These feelings
are described as creeping, crawling, tingling, pulling, or painful.
While these sensations happen most often in the calf or lower
leg area, they can be felt anywhere from the ankle to the upper
thigh. RLS symptoms can occur in one or both legs and can also
be felt in the arms. These symptoms occur most often when lying
down, but can also occur when sitting for long periods of time,
such as at a desk, riding in a car, or watching a movie. People
with RLS talk about having an irresistible urge to move the legs.
Moving the legs, walking, rubbing or massaging the legs, or doing
knee bends can bring relief, at least for a short time.
Unlike
other conditions, RLS symptoms get worse when relaxing or lessening
activity, particularly during the evening and nighttime sleeping
hours. Many people with RLS have trouble falling asleep and staying
asleep. If not treated, RLS can cause extreme tiredness and daytime
fatigue. A person's job, personal life and daily activities can
be strongly affected due to exhaustion. A person can lose their
ability to focus and have memory loss.
Many
people with RLS also have a related sleep disorder called periodic
limb movements in sleep (PLMS). With PLMS, a person jerks or bends
their legs unintentionally during sleep. These movements can happen
every 10 to 60 seconds, or hundreds of times, during the night.
They can wake a person, disturb sleep, and wake bed partners.
People who have both RLS and PLMS have trouble falling and staying
asleep and can have extreme sleepiness during the day.
How common
is RLS?
RLS
affects about 2 to 15 percent of Americans. But, it may actually
affect more people. Some people with RLS do not seek treatment
because they fear they won't be taken seriously, their symptoms
are too mild, or that the condition can't be treated. Health care
providers sometimes think the symptoms of RLS are caused by something
else, like nervousness, insomnia (not being able to sleep), stress,
arthritis, muscle cramps, or aging.
RLS
is thought to affect women more often than men. It can start at
any age, even in young children, but most people with RLS are
middle-aged or older. And, older people with RLS have symptoms
more often and for longer periods of time. Young people who have
RLS are sometimes thought to have "growing pains" or
may be considered "hyperactive" because they cannot
sit still in school.
What are
the symptoms of RLS?
RLS
symptoms are not the same for every person. They range from uncomfortable
to painful and can vary in frequency. A person can have periods
when RLS does not cause problems, but the symptoms usually return.
Another person can have severe symptoms every day.
Common
symptoms of RLS include:
Unpleasant
or uncomfortable feelings or sensations in the legs often described
as creeping, crawling, tingling, pulling or painful, often producing
an irresistible urge to move the legs. These feelings most often
occur deep inside the leg, between the knee and ankle. While rare,
they can also occur in the feet, thighs, arms, and hands. Most
of these feelings involve both sides of the body, although they
can happen on just one side of the body.
Leg
discomfort that occurs and gets worse when lying down or sitting
for long periods of time. Long car trips, sitting in the movies,
long-distance flights, and having a cast on can trigger RLS.
Symptoms
that happen and are worse later in the day, evening, and during
the night.
The
need for constant movement of the legs (or other affected body
parts) to lessen discomfort. People may pace the floor, move their
legs when sitting, and toss and turn in bed.
Having
leg and sometimes arm movements when sleeping that you can't control.
Trouble
falling asleep or staying asleep.
Sleepiness
or tiredness during the day.
Certain
medications, such as drugs for nausea, seizures, and psychosis,
as well as some cold and allergy medicines, may make symptoms
worse. Talk with your health care provider if you are taking any
prescription or over-the-counter medicines.
What causes
Restless Legs Syndrome (RLS)?
In
most cases, the cause of RLS is not known. For about half of all
RLS cases, there is a family history of the condition. People
who have RLS in the family tend to be younger when symptoms start
and develop symptoms slowly.
RLS
is thought to be related to the following factors or conditions:
Some
women get RLS during pregnancy, especially in the last 3 months.
But the symptoms usually go away about 4 weeks after having the
baby.
People
with anemia (low iron levels) may be more likely to get RLS. Once
low iron levels or anemia is corrected, symptoms can lessen.
Chronic
diseases such as kidney failure, diabetes, Parkinson's disease,
and peripheral neuropathy (loss of feeling or numbness in the
hands and feet) may be linked to RLS.
How is
RLS diagnosed?
There
are no tests for RLS. It can be hard to diagnose and is easily
confused with other conditions. When someone with RLS goes to
see a doctor, there is often nothing wrong that the doctor can
see or detect with a physical exam. Diagnosis therefore depends
on what a person describes to the doctor. To help make a diagnosis,
the doctor may ask about all current and past medical problems,
family history, and current medications. A complete physical and
neurological exam may help identify other conditions that may
be linked with RLS, such as nerve damage (neuropathy or a pinched
nerve) or abnormalities in the blood vessels. Basic lab tests
may be done to assess overall health and to rule out anemia.
How is RLS
treated?
There
is no cure for RLS. Sometimes RLS can be controlled by diagnosing
and treating an underlying condition, such as peripheral neuropathy
or diabetes. Treating the underlying disease can relieve many
of the symptoms of RLS.
For
people who have RLS with no diagnosed cause (like an underlying
disease), treatment is focused on symptom relief. For those with
mild to moderate symptoms, lifestyle changes are often suggested
including:
reducing
or stopping use of caffeine, alcohol, and tobacco products;
taking
supplements to increase iron, folate, and magnesium in the body;
developing
and keeping a regular sleep schedule;
getting
moderate exercise;
taking
hot or cold baths, rubbing or massaging the legs or other affected
body parts, or using a heating pad or ice pack.
Health
care providers may prescribe medicine for symptom relief. Three
types of drugs are most often prescribed:
Benzodiazepines
- these drugs depress the central nervous system and allow people
to sleep more, despite the RLS symptoms. They should not be used
by people with sleep apnea (a person stops breathing on and off
during the night).
Dopaminergic
agents - are drugs used to treat Parkinson's disease. They have
been shown to reduce RLS symptoms and nighttime leg movements.
Opiods
- are painkillers and relaxing drugs that can sometimes help people
with severe RLS symptoms.
For More Information...
You can find out more about restless legs syndrome by contacting
the National Women's Health Information Center at (800) 994-9662
or the following organizations:
National Center on Sleep Disorders Research
Phone Number(s): (301) 435-0199
Internet Address: http://www.nhlbi.nih.gov/sleep
National Heart, Lung, and Blood Institute
Phone Number(s): (301) 592-8573
Internet Address: http://www.nhlbi.nih.gov
National Institute of Neurological Disorders and Stroke
Phone Number(s): (800) 352-9424
Internet Address: http://www.ninds.nih.gov
Restless Legs Syndrome Foundation, Inc.
Phone Number(s): (507) 287-6465
Internet Address: http://www.rls.org
American Academy of Sleep Medicine
Phone Number(s): 708-492-0930
Internet Address: http://www.aasmnet.org/
National Sleep Foundation
Phone Number(s): (202) 347-3471
Internet Address: http://www.sleepfoundation.org
This information was abstracted from fact sheets
developed by the National Heart, Lung, and Blood Institute, including
Facts About Restless Legs Syndrome, and the National Institute
of Neurological Diseases and Stroke Restless Legs Syndrome Fact
Sheet.
All material contained in the FAQs is free of copyright
restrictions, and may be copied, reproduced, or duplicated without
permission of the Office on Women's Health in the Department of
Health and Human Services; citation of the source is appreciated.
