Understanding Restless Leg Syndrome Todd A.

Hoover, MD
Restless legs syndrome (RLS) is a disorder than can disturb your sleep. People with this specific issue often describe an irresistible urge or discomfort that makes them move their feet or legs during the sleep. The most common time for this to occur is during period on trying to fall asleep, but may persist through the entire night. Some patients describe a kind of numbness, or not right feeling, in the legs which is relieved temporarily by repositioning the leg. Up to 10% of adults in the United States suffer from RLS i. The symptoms may be mild or not that noticeable, or much more severe which can be associated with very poor sleep quality. Some patients even feel the need to get out of bed and pace. This issue does not appear to be related to circulation, as leg cramping and coldness of the legs may be. The exact mechanism is unknown, but some theories point to a problem with brain metabolism. Specifically, there may be an issue arising in a specific part of the brain called the Basal Ganglia, which is most well known to be involved with Parkinsons disease. Patients who have Parkinsons disease often suffer from RLS, but the majority of people with RLS do not have Parkinsons disease. Lack of sufficient iron levels in the brain may be another factor associated with RLS. Some other medical factors may make RLS worse or more likely to occur in the first place. These factors include: Peripheral nerve problems Chronic Kidney disease Diabetes mellitus Medications including antipsychotic, antidepressant, antihistamine, and anti-nausea drugs The final months of pregnancy (this tends to be temporary)

Unfortunately, there is no blood or other medical test for RLS. Your health care provider must make the diagnosis based upon your clinical findings. These include: Symptoms that occur at night, but not usually during the day Strong urges to move the legs (or arms) Sensations of vague pain, numbness, or just not right feeling in the limbs that are worse when resting or going to sleep Symptoms improve when the limbs are moved

Again, your healthcare provider should differentiate these symptoms from other problems like circulation issues, back problems, or other disorders that may mimic these symptoms. Proper diagnosis with your healthcare provider is your first step toward getting the right treatment. Treatments for RLS are not always effective. Iron supplements may be helpful to patients whose iron levels are not optimal. Iron supplements do have some risk as excess iron in the body is associated with joint pain, discoloration of the skin, and even increased risk for certain cancers.

Medications are sometimes used including drugs that are typically used for Parkinsons disease, benzodiazepines (like valium), and even anti-seizure drugs. These medicines have significant side effects and should only be used if other treatment methods fail. Some integrative therapies that may be helpful for RLS include acupuncture, homeopathy, herbal medicine, and nutritional therapies. Data for both integrative therapies and conventional medical treatment is sorely lacking for this disorder. In general, choosing the treatment that is safest, and still likely to help, is the best first step in treating any health condition. Your first step is to see your health care provider to determine your exact diagnosis. They should lay out both a diagnostic and treatment plan for you.

National Institute of Neurological Disorders and Stroke. U.S. National Institutes of Health. Restless Legs Syndrome Fact Sheet. Available online at: http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm. Last downloaded May 23, 2012. Last updated November 25, 2011.
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