What Is Restless Legs Syndrome?

If you have restless legs syndrome (RLS), or are a physician seeing a patient with RLS, you'll probably recognize these symptoms:

- An urge to move the legs, often accompanied by uncomfortable sensations in the legs, usually described as a creeping or crawling feeling, but sometimes as a tingling, cramping, burning or just plain pain.  Some patients have no definite sensation, except for the need to move. (The arms may also be affected, but that's much less common.)

- The need to move the legs to relieve discomfort, by stretching or bending, rubbing the legs, tossing or turning in bed, or getting up and pacing the floor.  Moving usually offers some temporary relief of symptoms.

- A definite worsening of the discomfort when lying down, especially when you're trying to fall asleep at night, or during other forms of inactivity, including just sitting.

Sleep disturbances are common with RLS, primarily because of the difficulty it causes in getting to sleep.  If leg twitching or jerking is also present, a related disorder called periodic limb movements during sleep (PLMS) may be the cause.  With PLMS, the leg movements may be severe enough to awaken you.  In RLS, PLMS-like symptoms can sometimes occur during wakefulness, as well as in sleep.

HOW COMMON IS RLS?

Restless legs syndrome may affect as much as 2-5 percent of the population, with varying degrees of intensity.

WHAT CAUSES RLS?

The cause of RLS is still unknown.  Some cases are inherited and more than one family member may be affected.  Some cases have been associated with nerve damage in the legs due to diabetes, kidney problems or alcoholism.  RLS can also be a side effect of a pinched nerve root from arthritis in the lower back (sciatica).

IS RLS SERIOUS?

RLS is not considered medically serious.  However, the symptoms can range anywhere from bothersome to incapacitating.  Fluctuations in severity are common, and occasionally the symptoms may disappear for periods of time.

RLS can begin at any age, but the symptoms tend to worsen over the years and become more severe in middle-to-old age.  Pregnancy or hormonal changes may temporarily worsen RLS symptoms.  Stress, diet or other environmental factors may play a role for some people.

CAN RLS BE TREATED?

Most caes of RLS respond well to medical treatment.  There are three main classes of medication that have been shown to be effective in treating both RLS and PLMS.

- Benzodiazepines - This class includes such drugs as diazepam (Valium), clonazepam (Klonopin), temazepam (Restoril) and triazolam (Halcion).

- L-Dopa - This class enhances a brain chemical known as dopamine.  It includes such drugs as L-Dopa with carbidopa (Sinemet), pergolide (Permax) and bromocriptine (Parlodel).

- Opiates - This class generally is reserved for the more severe symptoms.  It includes codeine (active ingredient in Tylenol #3), oxycodone (active ingredient in Percocet), propoxyphene (Darvon) and methadone (in very severe cases only).

All of these medications are available by prescription only and should only be taken while under the care of a licensed healthcare professional. 

WHERE DO I GO FOR HELP?

Seek professional medical advise.  You may wish to begin by consulting your healthcare provider, or by contacting our sleep specialist.  Rocky Mountain Sleep Disorders Center is the only sleep center accredited by the American Academy of Sleep Medicine in North Central Montana.

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