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 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 the day. The discomfort is often relieved by movement, and patients often get up and walk around 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 wake up in odd positions from moving around so much.  Also, their bed partners may comment on being periodically kicked at night.

What are the risk factors and triggers?

Risk factors for restless leg syndrome include low iron levels and 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?

The patient’s history usually diagnoses restless legs syndrome, 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 that may be causing the problem and 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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