Restless Legs Syndrome (RLS)

What is restless legs syndrome (RLS)?

Restless legs syndrome (RLS) is a sleep disorder in which a person experiences unpleasant sensations in the legs, which are described as:

Creeping
Crawling
Tingling
Pulling
Painful

These sensations usually occur in the calf area, but may be felt anywhere from the thigh to the ankle. One or both legs may be affected. For some people, the sensations are also felt in the arms. People with RLS have an irresistible urge to move the affected limb when the sensations occur. Moving often relieves the limb discomfort.

Some patients, however, have no definite sensation, except for the need to move. Sleep problems are common with RLS because of the difficulty it causes in getting to sleep. Severe daytime fatigue can be a significant problem for patients.

What causes RLS?

The cause of RLS is still unknown. Some cases are believed to be inherited, and some cases have been associated with nerve damage in the legs due to diabetes, kidney problems, or alcoholism.

As many as one in 10 people in the U.S. may have RLS.

What are the symptoms of RLS?

Sensations occur when the person with RLS lies down or sits for prolonged periods of time, causing:

The need to move the legs for temporary relief of symptoms by:
- Stretching or bending.
- Rubbing the legs.
- Tossing or turning in bed.
- Getting up and pacing.
A definite worsening of the discomfort when lying down, especially when trying to fall asleep at night, or during other forms of inactivity, including just sitting.
A tendency to experience the most discomfort late in the day and at night.

How is RLS diagnosed?

Your physician can diagnose RLS based on your signs and symptoms, a complete medical history, and a physical examination. In addition, tests, such as laboratory tests or a sleep study, may be performed. Currently, there is not a definitive test to diagnose restless legs syndrome.

What is the treatment for RLS?

Specific treatment for restless legs syndrome will be determined by your physician based on:

Your age, overall health, and medical history
Extent of the disease
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference

Treatment options for restless legs syndrome may include:

Implementing a good sleep habits program
Eliminating activities that worsen symptoms
Eliminating caffeine, alcohol, and tobacco intake, which may worsen symptoms
Regular, moderate exercise
Maintaining a well-balanced diet
Treating underlying chronic conditions
Medications, including:
- Dopaminergic agents (drugs that increase dopamine), which are largely used to treat Parkinson's disease.
- Benzodiazepines such as clonazepam and diazepam.
- Opioids such as codeine, propoxyphene, or oxycodone.
- Anticonvulsants such as gabapentin and pregabalin.