Restless Legs Syndrome

Introduction

Restless Legs Syndrome (RLS) is an unusual neurological disorder distinguished by bothersome sensations in one’s legs and the irresistible necessity to move them. RLS is typically encountered when one is attempting to sleep. As of now, approximately 5-15% of Australians currently suffer from RLS.

RLS usually emanates in the calves of the legs, and this strange sensation has been described as experiencing a muscle cramp or an internal muscle crawling sensation. Some liken these sensations to brief episodes of jolting electricity. The feelings range in severity from mildly uncomfortable to irritating and outright pain.

What Is Restless Legs Syndrome?

As mentioned above, RLS is a neurological sleep disorder that causes one to have an overpowering urge to move one’s legs. According to the RAGP, RLS syndrome can be classified into primary and secondary forms. A substantial genetic influence contributes to primary RLS. Secondary forms are typically associated with pregnancy, iron deficiency, and, occasionally, renal (kidney) failure. Importantly, recent research has provided deeper insights into the causes of RLS and has recommended evidence-based treatments.

Photo by Burst

Why is Restless Legs Syndrome considered a Sleep Disorder?

Restless legs syndrome is considered a sleep disorder, as it is a nervous system dysfunction that primarily occurs when one attempts to sleep. RLS is also identified as Willis-Ekbom disease.

Medical practitioners consider RLS a sleep disorder because it usually appears or becomes more distressing while someone is trying to relax and rest. Sufferers tend to have difficulty sleeping or lying/resting for a lengthy time, such as sitting in a movie theatre or a vehicle during long drives. RLS also has a propensity to worsen if sufferers do not seek treatment. However, if someone’s rest has been disturbed over time, a lack of quality sleep can cause difficulties functioning both at the workplace and at home.

What are some of the causes of Restless Legs Syndrome?

Medical researchers do not know the root cause of most cases of RLS. One aspect researchers agree with and confirm is that one’s genes directly correlate to RLS. Sadly, approximately 50% of patients diagnosed with RLS have identified a family member who has suffered the same condition.

The following causes and conditions have been medically linked to RLS:

• Chronic and Persistent Diseases: Some medical conditions include specific RLS symptoms, including Parkinson’s, iron deficiency, renal disease or kidney failure, peripheral neuropathy, and diabetes.
• Prescription Medication: Sufferers who take medication for other ailments might make RLS symptoms worse, including antipsychotics, anti-nausea medications, specific antidepressants, allergy medications, and antihistamines.
• Pregnancy – Late Term: Some pregnant women experience RLS during their pregnancy, particularly in the last trimester. These symptoms usually alleviate entirely within a month or two after childbirth.
• Lifestyle Choices: A chronic lack of quality sleep or other sleep disorders such as sleep apnoea have been known to become a trigger for RLS symptoms—likewise, tobacco smoking, drinking alcohol, and excessive caffeine use.

What are some of the Treatments for Restless Legs Syndrome?

Notably, several current prescription medications on the market are available to reduce restless legs syndrome symptoms- interestingly, most of these medications were designed and developed to treat other diseases.

These medications include the following:

• Medications that increase Dopamine: Dopamine is the crucial ‘messenger’ protein neurotransmitter within the brain, and drugs that increase this organic chemical component have been known to alleviate chronic RLS symptoms in patients.
• Drugs affecting Calcium levels: Certain medications that increase the body’s calcium levels have also alleviated RLS symptoms in patients.
• Opioids: Narcotic medication drugs can reduce mild to severe RLS symptoms, but they must be used with strict guidance from your doctor. They may become addictive if used in significantly high doses.
• Sleep Medication and Muscle Relaxants: Drugs prescribed for sleeping may help with a good night’s rest, but they do not reduce restless leg sensations and may contribute to daytime fatigue. These medications are commonly only prescribed if no other medical treatment relieves symptoms.

Importantly, these medications’ short-term side effects are customarily mild and may include nausea, light-headedness, and fatigue. However, they may also create impulse control disorders, such as chronic gambling and daytime drowsiness.

Other non-medical and lifestyle tips that RLS patients recommended are the following:

• Reducing or quitting caffeine and alcohol consumption.
• Reducing or quitting tobacco smoking.
• Having a healthy sleep routine and sleeping habits.
• Managing stress using lifestyle choices and herbal remedies.
• Leg massages that focus on the calves and lower legs.
• Hot baths can help significantly reduce the symptoms of RLS.
• Alternating heating pads and ice packs on the lower leg areas is the most effective treatment.

Unfortunately, restless legs syndrome is a lifelong condition requiring active management.

Successfully managing RLS requires developing personal coping strategies that should be tried to see which ones work for sufferers:

• Talk, Discuss and Share your condition with others: Sharing relevant information about RLS and coping with it will help everyone understand it and see RLS patients trying to cope with their symptoms.
• Start and Maintain a Sleep Diary. Keep a daily record of the symptoms, medicines and strategies that help (or hinder) managing RLS. This detailed diary/account is helpful to share with a patient’s doctor.
• Leg Stretches and Massages: RLS patients should attempt to start and end every day with leg stretching exercises or a gentle lower leg massage.
• Seek Advice and Help: RLS support groups (both online and in-person) bring together fellow RLS sufferers.

Doctors have been known to refer RLS patients to a neurology specialist to explore the cause of RLS and advise of specific further treatment.

Conclusion

Unfortunately, RLS is a common but under-recognised neurological disorder. If patients are experiencing even light to mild symptoms, no drug treatment or medication may be required. Typically, the first treatment prescribed for patients who suffer from challenging and relentless symptoms is Dopamine-based medicine. In some cases, patients with restless legs syndrome may build up a tolerance to the medications they take over time.