Restless legs syndrome

It sounds like something made up in a cartoon – restless legs – a syndrome where you feel an irresistible urge to move your legs when you’re sitting or lying in bed.

As humorous as it might sound, restless legs syndrome (RLS) is a real condition that causes significant discomfort and problems for those who experience it. As you might have guessed this is classified as a movement disorder, but it also falls into the category of a sleep disorder because it generally causes severe sleep disturbances.

RLS is characterized by unpleasant feelings in the legs – often described as tingling, crawling, creeping or pulling feelings – when an individual is sitting or lying down for a length of time. This discomfort causes a strong urge to move the legs in order to relieve the symptoms.

All the flexing, shifting, stretching or crossing of legs leads to significant sleep disturbances and sometimes severe insomnia and daytime sleepiness.

Severity of this disorder can range from mild symptoms that occur only occasionally to relatively severe that occur every day and can happen during the day or night and in both the arms and the legs.

Symptoms may get worse in the evenings and during the night or in response to caffeine or certain medications including cold and allergy drugs, antidepressants, anti-seizure medications, or blood pressure and heart disease medications. It is quite unpredictable whether these effects will occur or be exacerbated in response to medication.

No one enjoys being tired every day and not being able to sleep at night, but simple discomfort and sleepiness are not the only ways in which RLS can negatively affect those who experience it. A recent clinical trial examined the way in which this condition affects a person’s cognitive abilities.

Results found that due to the lack of sleep, individuals with RLS had lower sleep times and efficiency than those without the condition and also scored significantly poorer on cognitive tests than individuals not suffering from restless legs.

So the syndrome with the humourous name is not something that should be taken lightly by the roughly one million Canadians who experience it.

An exact cause is not fully understood, but it is believed there is a genetic component as RLS tends to run in families. It can also occur as a secondary symptom to several other conditions including end stage renal disease, vitamin or mineral deficiencies such as anemia, pregnancy, rheumatoid arthritis, peripheral neuropathy and diabetes.

Many other individuals experience RLS without an underlying condition or a family history – in these cases, it is not known what causes the disorder.

In order to treat RLS, your doctor should first identify and treat any underlying conditions – doing this may make the restless legs symptoms lessen or go away.

Certain lifestyle recommendations may also help. These include reducing caffeine intake, avoiding alcohol and nicotine, getting sufficient physical exercise, practicing relaxation techniques and maintaining a regular sleep schedule.

Leg massage or applying hot or cold packs to the legs may also alleviate some discomfort caused by RLS.

When these measures are insufficient, several medications can be effective for some people. Dopaminergic agents are used, which increase levels of dopamine in the body – a chemical that regulates messages between cells. As well, benzodiazepines that promote sleep, opioid pain killers and anticonvulsant medications can be helpful. Speak with your doctor about options and their individual risks and potential benefits.

Most of all, if you experience restless legs syndrome you are not alone and it is not in your head. Speak with your doctor about it to learn how you can get back to having a good night’s sleep again.

 

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