Restless leg syndrome (RLS) is nothing to be sniffed at. Although a common sleep disorder, affecting approximately five out of 100 people at some time in their life, it can be highly distressing and harder to treat then you might think. Those with RLS have a constant desire to move their legs to stop uncomfortable leg sensations such as tingling, creeping, crawling or aching.
RLS usually occurs in the evenings and at the time just before sleep. For some, RLS is a mild disorder that can be treated (although not cured) while for others it can be severe, making sleep impossible. Usually RLS affects both legs but many people report unpleasant sensations in only one leg.
Technically speaking - along with being a sleep disorder becasuse it affects the sufferers’ sleep - RLS is a movement disorder as those affected are forced to move their legs to find relief. However, it is more specifically classified as a neurological sensory disorder as the brain produces the symptoms.
Symptoms of restless leg syndrome
Common signs and symptoms of RLS include:
- An irresistible urge to move one or both legs
- The urge to move one or both legs is relieved – either temporarily, partially or totally – by leg movements
- The urge to move is accompanied by unusual sensations that are quite different from those that don’t suffer the disorder. E.g., aching, throbbing, pulling, crawling or itching
- The symptoms occur mainly at night time, either in the early evening or before sleep time and improve in the early hours of the morning
- Sufferers of the condition are often sleep deprived (a secondary symptom) due to the above symptoms
Who can suffer from RLS?
Anyone can suffer from restless leg syndrome; however, women are more affected by the condition than men and individuals are affected more severely in their middle ages or older.
What causes RLS?
RLS is often misdiagnosed because the symptoms can be related to – or accompany – other disorders that unlike the primary condition itself can be successfully treated, thus removing the symptoms. For example, the following conditions or factors appear to be related to RLS.
- Iron deficiency – RLS can be a common problem once a particular level of Iron deficiency is reached
- End-stage renal disease and haemodialysis
- Pregnancy – particularly in the last trimester with symptoms resulting approximately four weeks after childbirth
- Alcohol and drug use including nicotine
- Nerve damage (neuropathy)
- Particular medications – e.g., anti-nausea drugs, anti-psychotic drugs, serotonin increasing at the antidepressants, some cold and allergy medications
If we were to strip away all related conditions, however, researchers think that there’s considerable evidence to suggest that RLS is connected to dysfunction in one of the sections of the brain that controls movement (the basal ganglia). The basal ganglia uses the much talked about brain chemical and neurotransmitter called dopamine. It needs dopamine to pass messages from the brain to produce smooth, purposeful muscle movement. Without enough dopamine, the body can experience involuntary muscle twitching movements.
This connection between RLS and dopamine is why those with Parkinson’s disease, a condition caused by a loss of dopamine-secreting neurons in the brain, have an increased likelihood of suffering from restless leg syndrome.
Scientists also think there is a genetic component to RLS which can be found in families with symptoms occurring before the age of 40. Also, researchers think there is a strong link between iron deficiency and restless leg syndrome.
Diagnosing restless leg syndrome
There’s no formal diagnosis or blood test for restless leg syndrome. Instead, your doctor will first rule out other conditions via blood tests and examinations. Once you’re given the all clear, your doctor will then diagnose your condition based on your symptoms, as outlined above.
Treating restless leg syndrome
Addressing underlying conditions
Addressing underlying health problems or conditions that are known aggravators of RLS such as iron deficiency, menopause, pregnancy or drug and alcohol use can decrease or eliminate symptoms.
Iron supplementation
Given the strong correlation with iron deficiency and restless leg syndrome, it is highly recommended that sufferers have their iron levels checked, and if required, have supplementation in the form of oral tablets or IV infusions to lift iron levels.
Lifestyle changes
Regular sleep time, regular exercise, avoiding alcohol and nicotine, massages, warm baths, applying hot or cold packs and stretches have all been known to provide some relief for mild symptoms.
Dopaminergic agents
Drugs used to increase the dopamine effect are often used to treat Parkinson’s disease and have been shown to reduce RLS symptoms when taken at night time. These drugs are usually well tolerated but can cause nausea, dizziness or other side-effects. Unfortunately, though, long-term use can rebound, with symptoms worsening over time.
Opioids & benzodiazepines
Both opioids, such as codeine or oxycodone, and benzodiazepines, such as Clonazepam and Lorazepam can be used to successfully treat symptoms. However, they can cause unwanted side-effects and be addictive.
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