Restless Leg Syndrome

 

 

Restless legs syndrome (RLS) is a very common sleep-related movement disorder in which there is an irresistible urge to move the legs (below the knee joints) at night or during rest. This urge is usually accompanied by unusual feelings or sensations, called “paresthesia,” occurring deep in the legs. These uncomfortable sensations often are described as a burning, tingling, prickling or jittery feeling. In some people these unpleasant feelings become painful. In severe cases, some may tie the legs with rope/ cloth or need a massage or may sleep with their legs elevated on a pillow to reduce their symptoms.

 

 The symptoms of RLS become worse when lying or sitting still and can be relieved instantly, but temporarily, by walking or moving the legs. The urge to move the legs worsens in the evening or at night, with feeling better in the morning. Onset can occur at all ages, from early childhood to late adult life. In children, RLS often is wrongly diagnosed as “growing pains” and ignored/ neglected by the family members/ pediatricians. It can be especially difficult for young children to describe the symptoms of RLS.

Symptoms usually vary widely from one day to the next, with a waxing and waning course and they are provoked by long periods of inactivity/ standing/ sitting. Symptoms are most common in the legs but can also occur in the arms and other body parts.  Initially, RLS may occur with great irregularity and long periods of remission. Symptom progression involves greater intensity, frequency and severity and more rapid provocation by rest, and can also occur during daytime naps.

 

It can cause severe sleep deficiency of the patient as well as the bed partner, fatiguability, reduction in daytime energy and productivity, depression, anxiety and all other consequences of chronic sleep deprivation including inceasing cardio metabolic risks.

 

It can be diagnosed appropriately by a Sleep Physician with detailed history taking and work up. Sometimes, a polysomnography test may be required to confirm its diagnosis or to rule out other sleep disorders. It can be treated very effectively with the correct medications.