Restless Leg Syndrome
-Treatment, Symptoms and Causes


  What is RLS?

 Restless leg syndrome or RLS, also known as Wittmaack-Ekbom Syndrome, is a neurological disorder with uncomfortable sensations in the legs when a person sits or lies down, especially at the end of the day and can interfere with much needed sleep.

-People who suffer from RLS typically struggle with symptoms of insomnia as well. The discomfort caused by restless legs can keep you awake night after night, making it tough to fall asleep.



  Diagnosing Restless Leg Syndrome

 In diagnosing RLS, your doctor will base the diagnosis on past medical and family history along with other important criteria.

The doctor will rely on how you describe your symptoms.

Do you have an urge to move your legs, in most cases because of the crawling, tingly, nervous sensations you feel in the legs?

Is this need to move the legs most often seen and is it worse at night?

Do you feel the need to pace or other physical activity?

Does the discomfort and urge to move the legs get worse during inactivity, and is it always relieved (at least partially) by movement?

Is the relief often short-lived and does it remain only  during  the activity?


  How Many People Have RLS?

 RLS is a common ailment, studies indicate about 1 in 10 people have restless leg syndrome symptoms, but many go undiagnosed.

-Most often, people over the age of forty or older are more likely to have RLS symptoms. Women are twice as likely as men to develop the condition, and more than 1 million children also have RLS.



  RLS Symptoms and Hardships

# 1  -Involuntary movements of the legs during the day, usually begins after a period of inactivity, like a long ride or after a movie, etc.

# 2-  Unpleasant sensations in the legs, making it nearly impossible to keep from moving the legs to relieve the  twitchy, crawly, pulling  and  nervous  feeling that is restless leg syndrome. The urge can be hard to resist.

-It can be described as trying  not  to sneeze, or  not  to itch poison ivy.

# 3  -Urge to move the legs occurs most often when at rest or lying still.

# 4-  Restless leg syndrome symptoms are usually much worse at night, especially while lying down at the end of the day.

# 5  -The longer at rest, the more likely the symptoms will appear, and the stronger and more uncomfortable the sensations will become.

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# 6  -RLS symptoms are relieved, usually completely when the legs are moved, and relief remains as long as the activity continues. Often when the movement stops, symptoms re-appear.

# 7-  Insomnia is a common occurrence with RLS, as the need to move the legs often keeps you from sleeping, as well as getting back to sleep once awake.

# 8  -RLS can often lead to daytime fatigue, which in turn can result in depression, anxiety and a lack of concentration.

# 9  -The symptoms are generally much worse at times of stress or when emotionally upset or anxious.

# 10-  Although restless leg syndrome usually occurs in the legs, it can occasionally appear in the feet and arms.


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 Another condition, a sleep disorder known as  Periodic Limb Movement Disorder  (PLMD) appears to be related to RLS.

-PLMD, however, does not occur voluntarily as a  result  of sensations, (like RLS) but rather occurs quite  involuntarily . In fact the person may not even be aware the movements occur. (Kicking and twitching during the night)

  Often it is the sleep partner who feels the movements or kicks.

-In a recent study, 80% of those with restless leg syndrome also have periodic limb movement disorder. Conversely, the opposite is not true; those with PLMD did not also have RLS.


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  RLS Causes and Contributors

 Although research is ongoing the cause remains unknown, suspected restless legs syndrome causes or contributors are:

  • Genetics  -Although a specific gene has not been found as yet for RLS, it does appear to run in families, even more so if developed at a young age. 1 in 2 people with restless leg syndrome symptoms also have a family member with the disorder. 
    -This is known as  Primary  RLS or Familial RLS.
  • Secondary RLS is when RLS symptoms appear to be the result of, or are aggravated by another medical condition. (Not known to be caused by any other serious underlying health condition, in most cases)
  • Restless leg syndrome symptoms are often present in people receiving treatment for the later stages of kidney disease. (Dialysis)
  • The iron deficiencies and anemia often associated with kidney disease also appear to aggravate RLS symptoms as well.

  • _______________  

  • Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) -Both seem to be much more common in adults and especially in children that have restless leg syndrome symptoms.                
  • RLS patients should be tested for both (and vice-versa) as a more effective treatment might then be accomplished.
  • Pregnancy -Women (1 in 4), may develop RLS during pregnancy, but Restless legs syndrome symptoms often disappear soon afterward, suggesting the possibility of a hormonal connection.
  • Peripheral Neuropathy -Nerve damage in the feet and hands from chronic diseases may also aggravate RLS symptoms. Chronic alcoholism and diabetes being strong possibilities of this.
  • Because the condition appears at times in those with Parkinson's disease, researchers suspect a Dopamine imbalance could be to blame.
  • Dopamine stimulates the motor neurons in the brain that control the muscles, and when imbalanced or depleted the motor system nerves may be unable to properly control muscular movements.

  • _______________



      Medical Treatments for RLS

     With the aforementioned possibility of a connection between RLS and Parkinson's, dopamine and dopaminergic drugs and substances have been found to be helpful in the treatment of restless leg syndrome.

    -In 2005, the FDA approved  Ropinirole  (Requip) for RLS treatment, subsequently approving  Pramipexole  (Mirapex) in 2006.

     Other Parkinson's drugs that are sometimes used in treating RLS are: Carbidopa / levodopa (Sinemet), Pergoglide (Permax and Pergotoliderived) and Cabergoline (Dostinex, Cabaser).

    -Anti-Seizure drugs: Tegretol, Epitol and Neurontin have been effective for some, in relieving painful daytime RLS symptoms.

    -Prescription Painkillers -Vicodin, Percocet, Codeine and Oxycodone can provide relief in severe cases of restless leg syndrome, but their value must be weighed against their side effects and possible addiction.

    -Muscle Relaxants and Sleep Medications - Klonopin, Ambien and Sonata can be of help if restless legs syndrome symptoms keep you awake at night, but they won't stop the sensations, and may cause daytime grogginess and drowsiness as well.


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      Do Some Medications Make RLS Worse?

     Psychiatric medications for the treatment of Manic Depression (Bipolar), Schizophrenia and other serious disorders can make RLS worse.

    -Anti-depressants such as: Effexor, Elavil, Lexapro and Prozac.

    -Anti-nausea and anti-dizziness medications such as: Phenergan, Reglan and Compazine may also aggravate RLS symptoms.

    -Many over-the-counter allergy, cold and flu, and sleeping pills contain antihistamines that can also make RLS symptoms worse.

    -Discuss these with your doctor or pharmacist to be sure. Nicotine, alcohol and caffeine can also worsen the symptoms of RLS.


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      Non-Medical -RLS Treatment

  • Vitamins and Minerals -If it is determined that an iron or vitamin deficiency is the possible cause of your RLS, it's a good idea to start taking a supplement for these.Although not a medical treatment, caution must be taken because minerals such as iron and magnesium may cause toxicity as well as impairing the body's ability to use other important minerals properly.
  • Lose weight -If you're overweight, losing the extra weight can relieve the restless legs symptoms and help with sleeping.
  • Daily exercise and leg stretches can help with RLS symptoms, but avoid over-doing it, as it may actually increase the symptoms.
  • Compression stockings or leg wraps may help relieve restless leg syndrome symptoms for some, but not too tight.
  • A body pillow held between the legs may help control the nerves in the legs and might help the RLS symptoms at night, when needed most.

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     Most all of the lifestyle Insomnia treatments in addition to the herbal remedies and natural sleep aids for insomnia will also be of mutual benefit to restless legs syndrome symptoms as well.

    -Restless leg syndrome treatment is often life-long. Through trial and error you can find an RLS treatment that will work best for you. Keeping a sleep diary may help you determine what aggravates your symptoms and what helps. -Sharing this with your doctor may help you even further.

    -Download our Printable  Daily Sleep Journal . (free)


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    -For more information on RLS visit the  RLS Foundation


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