Sleep Disorder Guide: Restless Leg Syndrome (RLS)
Waking frequently throughout the night can lead to loss of concentration, daytime fatigue and a decrease in productivity.
There are many reasons why you may not be getting an adequate amount of sleep. It’s possible that you have an underlying sleep disorder.
Restless Leg Syndrome (RLS) is a commonly misdiagnosed sleep condition that may be interrupting your sleep.
This guide will cover the details you need to know about RLS, including what it is, why it happens, and how it can be treated.
What is Restless Leg Syndrome?
Restless leg syndrome is a condition that causes an uncomfortable and sometimes painful sensation in the legs while a person is either sleeping or in a sedentary position.
This feeling, often described as “pins and needles,” can only be relieved by shaking or moving one’s leg. Because symptoms are at their worst while someone is resting, they can cause significant disruptions to sleep.
RLS is best described as a disorder of the nervous system due to the symptoms being produced by the brain. However, it is also categorized as a sleep disorder because of its impact on a person’s sleep quality.
Types of Restless Leg Syndrome
1. Primary RLS
Primary RLS is the most common type and often occurs sporadically. Research indicates the cause is likely genetic, so symptoms may appear as soon as childhood.
Once it begins, this type of RLS is lifelong and conditions may worsen with time.
2. Secondary RLS
A sudden onset of RLS symptoms may be the result of an underlying medical condition or disease. This is described as secondary RLS.
Secondary RLS often begins to flare up after the age of 45 and may worsen with time.
Who Gets Restless Leg Syndrome?
Most cases of restless leg syndrome affect those who are middle aged or older. However, RLS may begin at any age.
About 15% of Canadians deal with symptoms of RLS. It is also more common for women to have RLS than men.
Pregnancy is a common reason for an increase in symptoms. Those diagnosed with RLS will often report that their symptoms worsen while they’re pregnant.
Furthermore, women who have never experienced the sleep disorder often experience it for the first time when they become pregnant.
It’s unknown why this is the case, but likely factors include low levels of iron, lack of sleep and a change in hormones. Symptoms are reportedly at their worst in the third trimester.
Causes of Restless Leg Syndrome
Because the cause of restless leg syndrome is unknown, doctors will often misdiagnose it.
That being said, here are some factors that have been linked to RLS:
- Genes: When the onset of RLS happens before the age of 40, it is assumed that the disorder is hereditary and due to a specific gene variant
- Diseases: Secondary RLS may be due to medical conditions such as Parkison’s disease, kidney failure, diabetes or an iron deficiency
- Medications: These include anti-nausea pills, antidepressants and even cold medication
- Dopamine imbalance: This chemical in the brain is responsible for helping your muscles move smoothly and with purpose
- Pregnancy: Hormone changes and lack of sleep may contribute to higher rates of RLS in pregnant women; however, symptoms fade quickly after the baby is born
Alcohol, nicotine and sleep deprivation can also worsen RLS symptoms.
Restless Leg Syndrome Symptoms
The symptoms of restless leg syndrome are pretty distinct among those affected.
Patients frequently describe the sensation of RLS as an ache, a throb or a crawling feeling inside their leg. This feeling is only relieved by motion—through stretching, shaking, or walking.
Though the symptoms are most commonly felt in the legs, a person’s arms, chest and head may also be affected. The sensation may be felt in both the left or right side of the body, sometimes alternating between the two.
RLS symptoms often worsen at night, making it very difficult to stay asleep.
Frequency and severity of symptoms vary among those who are diagnosed with this sleep disorder.
People with moderate cases of RLS experience the sensations only once or twice a week. Though not extreme, these few nights of restlessness can still impact a person’s daytime performance and levels of fatigue.
If symptoms occur more than two times a week, this is considered to be a severe case of RLS.
In these types of cases, daytime function is significantly affected due to lack of sleep resulting in irritability, loss of concentration and poor work performance.
Sometimes a person will go a long time before realizing that their sleeplessness is due to RLS.
Talk to your doctor if you are experiencing any of these symptoms.
How to Diagnose Restless Leg Syndrome
Because there are no actual tests to diagnose restless leg syndrome, doctors will try to diagnose the condition based on an evaluation of five distinct pieces of criteria:
- The first and most telling sign of RLS is the urge to move your legs to relieve an uncomfortable sensation.
- The next thing a doctor will ask is if the urge gets worse while you are resting or sedentary.
- Another sign is that the sensation is relieved by moving your legs.
- If the condition gets worse at night, it’s likely RLS.
- The last thing a doctor will do is check if the symptoms are being caused by an unrelated medical condition, like arthritis.
They may also conduct a neurological and physical exam to help them determine the problem. Lab tests will reveal if there are any underlying health issues, such as kidney failure.
Family history also plays a role in helping a doctor diagnose a patient because RLS can be hereditary.
Furthermore, a blood test may be conducted to help a doctor identify if an iron deficiency is the cause of the problem.
Children often go untreated for RLS because of their inability to accurately describe the symptoms. Diagnosing children is difficult because signs of the condition are often mistakenly attributed to growth pains.
Restless Leg Syndrome Treatments
Unfortunately, restless leg syndrome is a lifelong disorder that has no cure.
That said, there are many ways to treat the symptoms and lessen their impact on a person’s sleep hygiene and daytime function.
Relieving symptoms can be done by treatment of the underlying medical condition.
If RLS is happening because of an iron deficiency, dietary supplements or medication can be prescribed to help lessen the sensations.
A change in lifestyle, including eliminating caffeine, nicotine and alcohol from your diet may help relieve symptoms.
Self care can also go a long way, including stretching, sitting in a hot tub, getting massages and using vibration machines to stimulate the legs.
A good sleep routine, combined with healthy eating and regular exercise may also improve the symptoms of RLS. Experimenting with different room temperatures can also help on occasion.
Some medications that have been shown to help reduce symptoms of RLS include anti-seizure drugs, dopaminergic agents (commonly used to treat Parkinson’s disease), and opioids such as methadone and codeine.
If the RLS is mild and does not disturb a person’s sleep quality, the condition can go untreated without impacting a person’s health.