Restless Leg Syndrome

A common sleep disorder, Restless Legs Syndrome gives a person a feeling that their legs are crawling, tingling, creeping, pulling, or painful. These sensations can occur anywhere between the ankle to the thigh, on the left leg, the right leg, or on both legs. They tend to manifest themselves when someone either sits or lies down for a certain period of time. Sitting at a desk, riding in a car or watching a movie in a theater are typical situations where Restless Legs Syndrome can occur. In most cases, moving your legs, walking, rubbing or massaging them can bring some relief.

During periods of relaxation and diminished activity, the symptoms of RLS can worsen. They can also occur following a person's regular daytime activities as night (and sleep) approaches. If you find it difficult to fall asleep or have a strong urge to walk to relieve feelings of discomfort, you may have Restless Legs Syndrome. It can vary from night to night and as a person grows older, and some people can experience severe symptoms.

Periodic Limb Movements in Sleep (PLMS)

Interestingly, many people with RLS may also have PLMS, also known as Periodic Limb Movements in Sleep. People with PLMS can find themselves involuntarily jerking their legs, or bending their legs repeatedly, sometimes as often as every 10-60 seconds. Their bed partners, as a result, may find themselves being awakened or disturbed by these patterns of behavior, causing them to lose valuable sleep in the process.

Patients with RLS and PLMS usually have trouble falling asleep and staying asleep, which causes them to experience extreme sleepiness during the day. This can cause problems with their job, their social life and their recreational activities.

What Causes Restless Legs Syndrome?

  • Some of the factors that are associated with RLS are as follows:
  • Family History
  • Pregnancy
  • Low Iron Levels Or Anemia
  • Chronic Diseases
  • Caffeine Intake

Who Gets Restless Legs Syndrome?

RLS is common among older people, but is not limited to the elderly. It can affect men as easily as women or children. Some children who have RLS are thought to have "growing pains," when it's really Restless Legs Syndrome. They are also thought of as being hyperactive in school, because they can't sit still in class.

How Do We Help You?

We take your complete medical history and examine you. We review all of the medications you may be taking to see if there are any "contraindications" that may be causing Restless Legs Syndrome or mimicking its symptoms. Neuropathy or a pinched nerve may present some of the same symptoms as RLS. Basic laboratory tests can help assess overall health and rule out anemia. An overnight sleep study may be suggested to rule out PLMS or other sleep problems that may be present.

Treatment For Restless Legs Syndrome

If your RLS is mild, taking a hot bath, massaging your legs, exercising, eliminating caffeine, and using an ice pack and/or a heating pad may be suggested as options to help alleviate your symptoms. Medication may be prescribed to control symptoms for people with more severe cases of RLS. Some medications may lose their effectiveness when used nightly, so your doctor may want to alternate different medications to prevent them from giving you diminishing relief from your symptoms.

Medications For Restless Legs Syndrome

  • Benzodiazepines depress the central nervous system and allow many patients to obtain sleep, even though they may not suppress the RLS sensations or jerking movements. People with sleep apnea should not use benzodiazepines.
  • Dopaminergic agents, often used to treat symptoms of Parkinson's Disease, can be effective for RLS and PLMS. These medications may reduce the symptoms of RLS and leg movements during the night.
  • Opioids, or relaxing, pain-killing drugs, can help suppress symptoms of RLS in some patients. Patients with severe symptoms have found relief by using opioids.

TENS

One other non-drug approach, which is the use of Transcutaneous Electrical Nerve Stimulation, or TENS, may help reduce the symptoms in those with both RLS and PLMS. Applied to an area of the legs or feet, for about 15-30 minutes before bedtime, this electrical stimulation can be helpful in some cases.

The Trinitas Sleep Disorders Center stands ready to help you determine if you have Restless Legs Syndrome and, if you do, to provide you with whatever solutions work best in your particular case. We're experienced in Sleep Medicine and we look forward to helping each and every patient achieve the best possible result. Call us at 908-994-8694 or email us at Sleep@trinitas.org for more information or to arrange an appointment.