Sleep Disorders: Restless Leg Syndrome

Restless legs syndrome is an overwhelming urge to move your legs, that is usually associated with a sensation of tingling, or of pins and needles in the legs.   This urge to move the legs is worse at rest and also at night, although in bad cases it can occur at all times of day.  The discomfort is often relieved by movement, and patients will often get up and walk around in order to rid themselves of this feeling.  

Restless legs syndrome can also cause problems by keeping a person from either falling asleep or staying asleep.  When people have this problem while asleep it has a different name, and is called periodic limb movement disorder. In this situation the patient’s legs (and occasionally arms) will often jerk rhythmically when they are asleep, and occasionally result in frequent brief arousals which leaves them feeling tired in the morning.

What are the signs and symptoms?

Signs and symptoms include the uncontrollable urge to move the legs, most often in the evenings or during the night.   Sometimes patients wake up in the morning feeling unrefreshed and stay tired throughout the day.  They sometimes kick the covers off the bed at night, and can wake up in odd positions from having moved around so much.   Also, their bed partners may comment on being kicked at night periodically.

What are the risk factors and triggers?

Risk factors for restless leg syndrome include low iron levels, as well as certain medications such as some antihistamines and anti-depressant medications.  Foods such as chocolate and caffeine products can also make symptoms worse.  Pregnant women and the elderly are more prone to having them, and they can be associated with certain diseases such as Parkinson’s disease, kidney failure or multiple sclerosis.

How is it diagnosed?

Restless legs syndrome is usually diagnosed by the patient’s history, but periodic limb movements sometimes require a sleep study in a laboratory. 

What is the treatment?

Treatment for restless legs syndrome often focuses on discontinuing medications which may be causing the problem, as well as by minimizing chocolate or caffeine intake.  Sometimes taking iron supplements can help fix the problem.  Often patients require prescription medications to treat the symptoms if none of the above measures work.

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