Restless Leg Syndrome: Symptoms, Causes, Treatment

Restless Leg Syndrome: Symptoms, Causes, Treatment

Written by Nectarsleep editorial team

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Last Updated on Apr 27, 2022

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    In 1944, Professor Karl-Axel Ekbom coined the term "restless leg syndrome." The syndrome is also known by the name "Ekbom's disease." It is considerably different from the normal shaking of the legs.

    In this guide, we shall learn what restless leg syndrome is, its symptoms, causes, and treatments.

    What Is Restless Leg Syndrome?

    Restless leg syndrome is an unusual condition. It's not just sitting at a desk or chair and bouncing your legs because you feel restless or bored. It's been described as “bubbles in my legs”, or a “Coca-Cola feeling”, or an unusual sensation through the legs that subsides when somebody stands up and moves around. But obviously, when someone is trying to get to sleep at night, that's not always the most practical thing to do!

    Restless legs syndrome is also called Willis-Ekbom disease. It can hamper sleep and consequently affect your daily activities adversely. Comedians make fun of restless leg syndrome, thinking it's just a kind of bouncing around. But, if you have experienced a restless leg, it can be an interminable type of sensation, and it can be very disruptive to normal sleep. RLS affects every 1 out of 10 Americans.

    There are different medications used for restless leg syndrome treatment. These can be used to help control symptoms of restless leg syndrome. However, home remedies and lifestyle changes can also help.

    Restless Leg Syndrome Symptoms

    Symptoms of restless leg syndrome are likely to occur when the patient is awake in a closed space, such as at the cinema or on an airplane. RLS causes difficulty in falling or staying asleep, no matter how tired the person may be. This adversely affects the overall performance and mental peace of the person.

    Lack of sleep ultimately leads to depression, mood swings, decreased immunity, irritability, and other health conditions.

    People suffering from RLS complain of an uncomfortable urge to move their legs, arms, or other body parts. The urge:

    • Is triggered when the person is not moving or is still;
    • Is momentarily relieved when the affected body part is made to move;
    • Occurs only, or significantly worsens, in the late evening and during the night; and,
    • May also be connected to a condition known as periodic limb movement of sleep. It causes your limbs, especially your legs, to twitch or kick while you are sleeping.

    Restless Leg Syndrome Causes

    The causes of restless leg syndrome are not completely clear. Yet, most people with symptoms of RLS have a family history of the same. Moreover, pregnant women often report experiencing symptoms of RLS. 

    Hereditary

    There may be a genetic predisposition. So, having family members that have this condition increases your risk of having it as well, and if the onset of this condition occurs early in life, for instance, in children, it's more likely that the child has a family history of restless leg syndrome.

    Pregnancy

    Being pregnant or experiencing hormonal fluctuations may temporarily accentuate RLS symptoms. Some women may experience RLS for the very first time during pregnancy, particularly during the last trimester. However, symptoms of RLS usually vanish after delivery.

    What Are the Risk Factors For Restless Leg Syndrome?

    There's no fixed age for RLS's onset, and thus, it can begin at any stage of life and, in most cases, worsen with time. Women are at greater risk of developing it than men.

    Generally, RLS doesn't portend a serious underlying medical situation. But, it is sometimes associated with other conditions like:

    • Iron deficiency: Iron deficiency and iron deficiency anemia are associated conditions that can lead to restless leg syndrome. Bleeding from the stomach or bowels, experiencing heavy menstrual flow, and frequent blood donation can increase the chances of iron deficiency.
    • Vitamin B12 deficiency: It is also another risk factor for experiencing restless leg syndrome. Being deficient in vitamin B12 can decrease the production of dopamine, and therefore, RLS may be a harbinger of this deficiency.
    • Kidney disease: Patients with kidney disease, especially those with end-stage renal disease, are at a higher risk of having this condition. Having a problem with your kidney depletes the iron stored in your blood.
    • Peripheral nerve conditions: Certain peripheral nerve conditions, such as chronic damage to the nerves in your limbs, can also increase the risk of restless leg syndrome.

    How Is Restless Leg Syndrome Diagnosed?

    There is no standardized test for RLS. In order to diagnose RLS, the doctor examines your medical history and asks you for a description of your symptoms. There's a set of criteria to diagnose RLS, they are: 

    •  A strong, irresistible urge to move your legs with a feeling of discomfort.
    • Your symptoms start or become unbearable when you're sitting, lying down, or resting.
    • Your symptoms will abate or disappear as soon as you start to walk or stretch. 
    • Your symptoms worsen during the night hours.

    Doctors prefer to conduct a neurological and physical exam together. Blood tests, especially to diagnose iron deficiency, may be prescribed to eliminate other potential causes of the same symptoms.

    Your doctor would also like to recommend you to a sleep specialist. This can include an overnight stay at the sleep clinic. Sleeping overnight under doctors' supervision will let them study your behavior while you're asleep and see if you have some other condition, such as sleep apnea.

    Home Remedies for Restless Leg Syndrome

    Although the reason behind RLS is still not deciphered properly, researchers do believe that there is a liaison between your lifestyle and the frequency of occurrence of symptoms. Below are a few lifestyle changes that are considered possible remedies for restless leg syndrome.

    Hot and Cold Compress

    The symptoms of RLS vary from uncomfortable to agonizing. You can try alternate hot and cold compresses on the affected area to relieve pain. You may want to take a hot bath as well or massage your muscles to help them relax.

    Dietary Habits

    Having a healthy diet aids in good sleep. Keep control over your alcohol or caffeine consumption, and certainly avoid them before you go to sleep.

    Smoking

    Smoking makes you feel jittery and can disrupt your sleep. It also has serious negative effects on various parts of the body, especially the lungs, and can even cause cancer. Look to cut down on smoking or quit it altogether.

    Medications

    You might currently be on medication for some other condition that is making it difficult for your body to relax or causing insomnia. Visit your doctor and ensure that you stay away from any medication that is contributing to your symptoms. Even magnesium supplements can help improve the symptoms in case of deficiency.

    Medications for Restless Leg Syndrome

    Let's now examine in detail the medications that are the most commonly prescribed for treating RLS. These medicines are given alone or, in some cases, with another. Your doctor can best prescribe the medications and dosage as per your treatment plan.

    Dopamine Agonists

    In most cases of RLS, dopamine agonists are among the first medicines prescribed. These drugs, such as Rotigotine (Neupro), Pramipexole (Mirapex), and Ropinirole, act similar to dopamine in the brain. Side effects of these drugs include nausea, lightheadedness, and daytime sleepiness.

    Dopaminergic agents

    These drugs increase the level of dopamine inside the brain, and thereby, can help decrease the effect of RLS. Dopaminergic drugs include Sinemet, a fusion of carbidopa and levodopa. However, continued use can worsen RLS conditions in some other people. Side effects may manifest in the form of hallucinations, nausea, vomiting, and dyskinesias.

    Opiates

    Opiates are usually used to treat pain. However, they can also come in handy for relieving symptoms of RLS. Due to their addictiveness, opiates are very addictive. They are usually used only when other drugs don't work. Examples of opiates are Vicodin and Norco.

    Anticonvulsants

    Anticonvulsants include medicines such as Gabapentin Enacarbil (or Horizant) and Gabapentin (or Neurontin). They may help with the symptoms of RLS and also relieve any chronic or nerve pain.

    Restless Leg Syndrome in Children

    In the USA, children and adolescents with RLS exceed 1.5 million. Nearly 35% of patients who reported having RLS said that it started before they turned 20.

    The exact reason for restless legs syndrome differs from child to child. In some, the cause remains unknown. In others, RLS may be associated with a deficiency of iron or with diabetes. However, a renal or neurological disease can also cause RLS in children. Sometimes, RLS is hereditary (runs in families) and has genetic origins. 

    Restless Leg Syndrome and Pregnancy

    RLS in pregnant women is common. Every 1 in 3 women who are pregnant report experiencing symptoms of RLS. So what is the connection between RLS and pregnancy?

    Scientists don't exactly know the reason behind the sensations in the legs. But some like to believe that it stems from an unusual amount of a chemical (dopamine) in the brain. Dopamine generally helps the smooth function of the muscles.

    RLS during pregnancy is often associated with a state in which the body might be experiencing a lack of adequate amounts of folic acid. Some evidence also suggests that a rise in estrogen levels in pregnancy contributes to RLS.

    RLS in pregnancy can be challenging. If you are experiencing severe symptoms, so much so that it's difficult to sleep without interruption, then you will probably want to visit a doctor for treatment. 

    Drugs like Mirapex and Requip, even though used for treating RLS symptoms in pregnant women, haven't yet been examined thoroughly. Therefore, there isn't enough data to assess possible risks to the developing fetus.

    Before taking any medicine, your doctor ought to check your iron levels. If your iron levels are low, the doctor may prescribe iron supplements. In several cases wherein the stored iron in the body is not enough, a supplement should be able to rectify RLS.

    Restless Leg Syndrome and Sleep

    Restless legs syndrome often manifests in the form of a sleep disorder as well. Many individuals suffering from RLS have a difficult time falling or staying asleep as they suffer from restless legs at night. For some, the sensation may be difficult to describe.

    Often, people describe it as a creeping or crawling sensation. Hardly do you fall asleep when the itching starts in your legs. The itchiness disappears when you wake up and start to walk around but tends to return as you try to fall asleep again.

    Restless legs syndrome affects sleep badly, and the patient may not be able to sleep well. People with worse symptoms suffer more. Milder symptoms should not disrupt your sleep to a great extent.

    The accumulation of sleepiness from restless legs syndrome makes people crave sleep during the day. This sleepiness can make you irritable, anxious, depressed, and with less concentration. Eventually, it may have a bearing on your personal and professional life. 

    Diet for Restless Leg Syndrome

    While restless leg syndrome still has no cure, it would help with lessening the symptoms if you maintain a healthy diet. 

    When diagnosed with RLS, you can try these out: 

    • Eat a lot of fresh fruits and green vegetables.
    • Incorporate iron-rich substances like lean meat into your diet.
    • Include nuts, legumes, and seeds in your daily diet.
    • Reduce processed foods, deep-fried foods, and sugary drinks that cause weight gain.

    If you don't notice any significant improvement in a few weeks after making dietary changes, try talking to your doctor. He may prescribe a suitable diet along with some medications to relieve your symptoms.

    Lack of iron and vitamin D are often associated with leg cramps and accentuate restless leg syndrome. Taking iron and vitamin D supplements from natural sources like dark green vegetables and fish can help alleviate symptoms.

    Potassium is vital for treating symptoms of restless leg syndrome. It helps in the proper functioning of muscles and the nervous system.‌

    Addressing the above-mentioned diet concerns may help see positive effects on your problems.

    Restless legs can be a menace in your life. Unfortunately, most people ignore symptoms for as long as they can. Not only does RLS disrupt your normal day-to-day life, but it also has a negative long-term effect on your psyche. 

    Asking for help from a doctor and incorporating lifestyle changes can help bring positive changes.

    This article is for informational purposes and should not replace advice from your doctor or other medical professional.
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    References

    1. Restless Legs Syndrome Fact Sheet

      https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet

    2. Restless Legs Syndrome (RLS) in Children and Adolescents

      https://my.clevelandclinic.org/health/diseases/14309-restless-legs-syndrome-rls-in-children-and-adolescents

    3. Siraj Wali, Samah Alsafadi, MD, Bahaa Abaalkhail, Iman Ramadan, Badr Abulhamail, Moaiyyad Kousa, Reem Alshamrani, Hanan Faruqui, Abdulaziz Faruqui, Mohamed Alama, and Mohamed Hamed.

      The Association Between Vitamin D Level and Restless Legs Syndrome: A Population-Based Case-Control Study

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5886433/

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