Home » Sleep Disorders » Restless Legs Syndrome
August 2020 |  Reviewed by:  Reeba Mathew, MD and Imran Shaikh, MD

What is restless legs syndrome?

Restless legs syndrome is a neurological sleep disorder that causes you to have uncomfortable feelings and the urge to move your legs. Restless legs syndrome makes it difficult to get comfortable enough to fall asleep. The symptoms are usually worse in the evening and at night. The sensation is difficult for some people to describe. It has been described as a crawling or creeping sensation. You may lie down and begin to feel itching inside your legs. If you move your legs or get up and walk around, these symptoms may go away. The discomfort may return when you try again to go to sleep.

In some restless legs syndrome cases, you may have trouble sitting still for long periods. Long car rides or airplane travel may be difficult.

Many people wait years to seek treatment because they do not view it as a serious concern. If left untreated, you may notice that your symptoms become more frequent and severe.

Restless legs syndrome may cause you to get fewer hours of sleep each night. Many people with severe cases get less than five hours of sleep per night. Milder cases do not disturb your sleep as much, though the sleep may be of poorer quality.

The accumulated sleep loss from restless legs syndrome can make you excessively sleepy during the daytime, cause you to be irritable and make concentration difficult. This may have a major impact on your professional and personal life. People with restless legs syndrome are more likely to have depression or anxiety.

Restless legs syndrome is usually manageable through medication and lifestyle changes.

Most people develop restless legs syndrome after age 45 although it can develop at any age. Women are nearly twice as likely as men to develop the disorder. If you have a family member with restless legs syndrome, you are more likely to develop the symptoms before you are 45 years old. More than half of people with restless legs syndrome have a pattern of it in their family, as the risk is about three to six times greater.

What are causes of restless legs syndrome?

The causes of restless legs syndrome vary from person to person. In some cases, the cause is unknown, or it can be caused by or made worse by other health issues or medication. This may include:

Low iron levels

This can cause problems with brain cell communication that can lead to restless legs syndrome. If you think you have restless legs syndrome caused by low iron, talk with your doctor and do not attempt to take supplements on your own.

Diabetes

This lifelong condition can damage blood vessels and nerves that affect leg muscles causing restless legs syndrome. By properly managing your diabetes, you may help prevent or improve your restless legs syndrome. The prevalence of restless legs syndrome in people with diabetes is the same as in the general population. Diabetes causes neuropathy. Neuropathy needs to be managed differently and is not the same as restless legs syndrome, although some symptoms may overlap with restless legs syndrome symptoms.

Kidney failure

Restless legs syndrome is common in patients with kidney failure, but the exact cause is unknown. Some medications that are used to treat restless legs syndrome may not be appropriate for those with kidney failure.

Pregnancy

Many women have restless legs syndrome when they are pregnant. It usually goes away within a month of giving birth.

Medications

Some medications can cause restless legs syndrome or make it worse:

  • Allergy medications
  • Many antidepressants
  • Antihistamines and over-the-counter sleep aids
  • Nearly all centrally active dopamine-receptor antagonists, including anti-nausea medications

What are symptoms of restless legs syndrome?

The primary symptom of restless legs syndrome is a sensation of discomfort in the legs that is often difficult to describe. The feeling is different from leg cramps or numbness from circulation problems. Patients have used the following words to describe this sensation:

  • Itchy
  • Crawling
  • Creepy
  • Throbbing

Usually this feeling is paired with the urge to move your legs. The desire usually worsens when you lie down or rest.

The symptoms of restless legs syndrome are frequently worse in the evening and at night than in the morning.

A related problem is that your leg muscles might tighten or flex while you are still. These movements can be out of your control. In extreme cases, they may be periodic limb movements.

How to diagnose restless legs syndrome?

Self test

Do you have difficulty falling asleep because of an urge to move your legs?

Do you wake up at night because you feel like your legs are on fire?

Do you feel an itching in your legs when you lie down to go to sleep?

Do your legs seem to feel better when you walk, stretch or make other movements?

If you answered yes to any of these questions, you may have restless legs syndrome.

Diagnosis

Talk to a sleep doctor if you think you have restless legs syndrome. The doctor will ask you about your medical history and if you are on any medications.

The sleep doctor may ask that you keep a sleep diary for two weeks to show when you sleep and for how long. You may also rate how sleep is affecting your daily life using a simple questionnaire. Make sure to tell your doctor if you or a relative have ever had a sleep disorder.

Your doctor may order blood tests, including measuring iron.

In some cases, she may recommend a sleep study. A sleep study may be used to ensure that you do not have sleep apnea or other sleep disorders that may be causing sleep disruption. This is helpful but is not required to diagnose restless legs syndrome.

Patient Support

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