Written by Jill Zwarensteyn, Editor
Sometimes it’s not our minds that like to do the racing at night but rather our legs. If this sounds familiar, then there’s a good chance you’re dealing with Restless Legs Syndrome – or RLS.
For those who experience RLS, this condition may result in little or inconsistent sleep, which can be particularly stressful for folks who lead busy lives and rely on quality rest to get through the day.
From what causes it to whether it’s a sign of a more severe health issue, we’ll answer all your questions about RLS.
What is Restless Legs Syndrome?
Restless Legs Syndrome[1] is a condition in which a person feels an uncontrollable need to move their legs. In most cases, the desire to move is due to feeling uncomfortable sensations throughout the legs. Researchers believe RLS may result from an imbalance of dopamine, a chemical found in the brain that sends messages to regulate muscle movement.
RLS is also sometimes referred to as Willis-Ekbom disease. It is typically more pervasive at night and while someone is at rest, which is why it’s known to interrupt sleep.
About 5 percent of people experience Restless Legs Syndrome, however, it affects roughly 10 percent of people 65 and older[2].
What Does RLS Feel Like?
People with Restless Legs Syndrome are usually prompted to move because they feel intense sensations in their legs. Below are some ways people have described what the sensations feel like, as reported by the Mayo Clinic:
- Crawling
- Creeping
- Pulling
- Throbbing
- Aching
- Itching
- Electric
Additional RLS Symptoms
Urge to move after resting
People with RLS may start to feel sensations after periods of rest or being seated for a longer amount of time.
Feel relief with movement
Another effect of this condition is that you feel relief through movement, including stretching, shaking your legs, or walking.
Worsens in the evening
RLS usually emerges or worsens at night.
Leg twitching at night
Leg twitching or kicking may also result from a condition linked to RLS known as Periodic Limb Movement Disorder. We will cover this in-depth further below.
How Often Do Symptoms Occur?
The frequency of symptoms[3] can vary from person to person. Moderate cases of RLS typically see symptoms occur about once or twice a week, while severe cases may cause symptoms to appear more than two times a week.
Sometimes RLS symptoms may go away for weeks or months at a time before reappearing. This typically happens in the early stages of developing this condition.
Section 2
Risk Factors for Restless Legs Syndrome
While more research needs to be done to determine what causes RLS to surface in the first place, experts say there are risk factors that may increase your chances.
Runs in the Family
Evidence suggests that RLS may be hereditary[4]. Researchers reported that certain genes present on chromosomes might be connected to restless legs syndrome, and this DNA could be passed down among family members. They also found that patients who experienced RLS at a younger age had a family history of the disorder.
Pregnancy
According to the Mayo Clinic, the hormonal changes brought about due to pregnancy could cause RLS or intensify symptoms. In some cases, pregnant women may develop restless legs syndrome during their third trimester, and then the symptoms go away following delivery.
Get More Info: Restless Legs Syndrome in Pregnancy
Age
Although people can get RLS at any age, your likelihood increases as you get older.
Gender
Both men and women can experience this condition, but it is more common in women.
Section 3
Is RLS Associated with Other Conditions?
Certain health conditions may be connected to Restless Legs Syndrome.
Periodic Limb Movement Disorder (PLMD)
Periodic Limb Movement Disorder – or PLMD[5] – is when a person experiences repetitive leg movements while asleep, disrupting their rest in the process. These movements typically occur in the lower half of the body in the hips, knees, ankle, or big toes. About 80 percent of individuals with Restless Legs Syndrome also experience PLMD.
Peripheral Neuropathy
Peripheral Neuropathy is when nerves in your hands and feet are damaged due to long-term conditions like alcoholism or diabetes. Peripheral Neuropathy may also be heredity. A 2008 study found that RLS was more common among people with hereditary neuropathy[6] than those who developed it.
Low Iron
Whether brought on by anemia or not, an iron deficiency may cause or exacerbate Restless Legs Syndrome. According to Johns Hopkins Medicine, studies have shown a correlation between low iron concentration in the substantia nigra area of the brain and severe RLS symptoms. The substantia nigra is a region of the brain where dopamine-producing cells are located.
Kidney Failure
Kidney Failure may also be linked to RLS. This is because malfunctioning kidneys can result in an iron deficiency, possibly triggering restless legs.
Spinal Cord Injuries
The Mayo Clinic reports that damage or injuries to the spinal cord have also been linked to RLS. They add that anyone who has had anesthesia put in their spinal cord, including a spinal block, is also at an increased risk of developing Restless Legs Syndrome.
Section 4
How to Stop Restless Legs
Because it may be difficult to pinpoint the source of restless legs, treatment is usually focused on alleviating symptoms.
01
Lifestyle Changes
Health experts with the National Institute of Neurological Disorders and Stroke suggest that implementing the following changes and routines to your lifestyle may reduce restless legs.
- Limit alcohol and tobacco use
- Have a consistent sleep schedule
- Exercise regularly
- Massage your legs
- Take warm baths
- Place heating pads and ice packs on your legs
Iron Supplements
Because iron deficiency is considered a possible link to RLS, iron supplements may be able to help. Iron supplements are available over the counter, but there are some potential side effects to be aware of, including an upset stomach or constipation. In the event iron levels don’t improve with supplements, a doctor may need to administer iron through an IV line.
Anti-Seizure Drugs
According to the National Institute of Neurological Disorders and Stroke, anti-seizure drugs are rising in popularity as a prescription treatment for RLS, adding that the Food and Drug Administration has approved a drug called gabapentin enacarbil to help treat moderate to severe restless legs.
Dopamine Medications
Drugs that increase dopamine are primarily used to treat Parkinson’s Disease, and they’ve also been shown to minimize the effects of RLS when taken at night. However, experts warn that long-term use of dopamine medications may cause restless legs to worsen over time. They add that patients may also develop impulsive or obsessive behaviors.
Opioids
Low doses of opioid medications have also been shown to manage restless legs syndrome. However, there are risks to taking opioids, including constipation, dizziness, nausea, worsening sleep apnea, and addiction.
Benzodiazepines
Certain benzodiazepines are prescribed to alleviate anxiety, muscle spasms, and insomnia. In some cases, they may make sleep apnea symptoms worse and are not recommended for those with a sleep apnea disorder. Benzodiazepines may also lead to daytime fatigue, inability to focus, and less energy.
These are typically considered a “last-line” treatment.
Does RLS lead to Parkinson’s Disease?
For folks who have persistent RLS, they may be concerned that this condition is an early warning sign of Parkinson’s Disease.
The American Parkinson Disease Association reports that the majority of people with RLS do not develop Parkinson’s Disease[7]. They add that while some studies have shown RLS creates an increased risk of PD, other studies have not shown this result. Because the studies have produced inconsistent results, there is no conclusive evidence that experiencing Restless Legs Syndrome means that a person is at a higher risk for developing Parkinson’s Disease.
If you are having trouble with RLS, make sure to check out our best mattress for restless leg syndrome.
Jill Zwarensteyn
Editor
About Author
Jill Zwarensteyn is the Editor for Sleep Advisor and a Certified Sleep Science Coach. She is enthusiastic about providing helpful and engaging information on all things sleep and wellness.
Combination Sleeper
[1] “Restless Legs Syndrome”, Mayo Clinic, January 21, 2020.
[2] “Neurology and Neurosurgery”, Johns Hopkins Medicine
[3] “Restless Legs Syndrome Fact Sheet”, National Institute of Neurological Disorders and Stroke
[4] V. Dhawan, M. Ali, K.R Chaudhuri, “Genetic aspects of restless legs syndrome”, National Center for Biotechnology Information
[5] “Periodic Limb Movement Disorder (PLMD) in Adults”, Cleveland Clinic, July 21, 2012.
[6] Erin Hattan, Colin Chalk, Ronald B. Postuma, “Is there a higher risk of restless legs syndrome in peripheral neuropathy?”, Neurology, 2008.
[7] Dr. Rebecca Gilbert, “Restless Leg Syndrome and Parkinson’s Disease”, American Parkinson Disease Association, June 17, 2020.