What Causes Restless Legs Syndrome(RSL) - Symptoms - Risk Factors - Complications - Treatment
What Causes Restless Legs Syndrome - Signs and Symptoms - Causes - Risk Factors - Complications - Treatment
Restless legs syndrome (RLS) is a condition in which you have an uncontrollable urge to move your legs, usually due to leg discomfort. It typically happens in the evenings or nights while you're sitting or lying down. Moving eases the unpleasant feeling temporarily.
Restless legs syndrome, now known as restless legs syndrome/Willis-Ekbom disease (RLS/WED), can begin at any age and generally worsens as you age. It can disrupt sleep — leading to daytime drowsiness — and make traveling difficult.
SYMPTOMS
Sensation starts after being at rest. The sensation typically begins after you've been lying down or sitting for an extended time, such as in a car, airplane or movie theater.
Relief by movement. The sensation of RLS/WED lessens with movement, such as stretching, jiggling your legs, pacing or walking.
Worsening of symptoms in the evening. Symptoms occur mainly at night.
Nighttime leg twitching. RLS/WED may be associated with another, more common condition called periodic limb movement of sleep, which causes your legs to twitch and kick, possibly throughout the night, while you sleep.
CAUSES
, There is no known cause for restless legs syndrome. Researchers suspect the condition may be due to an imbalance of the brain chemical dopamine, which sends messages to control muscle movement.
Heredity
Sometimes RLS/WED runs in families, especially if the condition starts before age 50. Researchers have identified sites on the chromosomes where genes for RLS/WED may be present.
Pregnancy
Pregnancy or hormonal changes may temporarily worsen RLS/WED signs and symptoms. Some women get RLS/WED for the first time during pregnancy, especially during their last trimester. However, signs and symptoms usually disappear after delivery.
RISK FACTORS
Restless legs syndrome usually isn't related to a serious underlying medical problem. However, RLS/WED sometimes accompanies other conditions, such as:
Peripheral neuropathy. This damage to the nerves in your hands and feet is sometimes due to chronic diseases such as Diabetes and alcoholism.
Iron deficiency. Even without Anemia, iron deficiency can cause or worsen RLS/WED. If you have a history of bleeding from your stomach or bowels, experience heavy menstrual periods or repeatedly donate blood, you may have iron deficiency.
Kidney failure. If you have kidney failure, you may also have iron deficiency, often with Anemia. When kidneys don't function properly, iron stores in your blood can decrease. This, with other changes in body chemistry, may cause or worsen RLS/WED.
COMPLICATIONS
Although RLS/WED doesn't lead to other serious conditions, symptoms can range from barely bothersome to incapacitating. Many people with RLS/WED find it difficult to fall or stay asleep.
Severe RLS/WED can cause marked impairment in life quality and can result in Depression. Insomnia may lead to excessive daytime drowsiness, but RLS/WED may prevent you from daytime napping.
TESTS AND DIAGNOSIS
Your doctor will take your medical history and ask for a description of your symptoms. A diagnosis of RLS/WED is based on the following criteria, established by the International Restless Legs Syndrome Study Group:
You have a strong, often irresistible urge to move your legs, usually accompanied by uncomfortable sensations typically described as crawling, creeping, cramping, tingling or pulling.
Your symptoms start or get worse when you're resting, such as sitting or lying down.
Your symptoms are partially or temporarily relieved by activity, such as walking or stretching.
Your symptoms are worse at night.
Symptoms can't be explained solely by another medical or behavioral condition
TREATMENTS AND DRUGS
Medication therapy
Medications that increase dopamine in the brain. These medications reduce motion in your legs by affecting the level of the chemical messenger dopamine in your brain. Ropinirole (Requip), rotigotine (Neupro) and pramipexole (Mirapex) are approved by the Food and Drug Administration for the treatment of moderate to severe RLS.
Drugs affecting calcium channels. Certain medications, such as gabapentin (Neurontin) and pregabalin (Lyrica), work for some people with RLS.
Opioids. Narcotic medications can relieve mild to severe symptoms, but they may be addicting if used in high doses. Some examples of these medications include codeine, oxycodone (Oxycontin, Roxicodone), combined oxycodone and acetaminophen (Percocet, Roxicet), and combined hydrocodone and acetaminophen (Norco).
Muscle relaxants and sleep medications. This class of medications, known as benzodiazepines, helps you sleep better at night, but they don't eliminate the leg sensations, and they may cause daytime drowsiness. Commonly used sedatives for RLS/WED include clonazepam (Klonopin), eszopiclone (Lunesta), temazepam (Restoril), zaleplon (Sonata) and zolpidem (Ambien).