Restless leg syndrome?
Restless leg syndrome, or RLS, is a neurological disorder. RLS is also known as Willis-Ekbom disease, or RLS/WED.
RLS causes unpleasant sensations in the legs, along with a powerful urge to move them. For most people, that urge is more intense when you’re relaxed or trying to sleep.
The most serious concern for people with RLS is that it interferes with sleep, causing daytime sleepiness and fatigue. RLS and sleep deprivation can put you at risk for other health problems, including depression if not treated.
RLS affects about 10 percent of Americans, according to the National Institute of Neurological Disorders and Stroke. It can occur at any age, though it’s usually more severe in middle age or later. Women are twice as likely as men to have RLS.
At least 80 percent of people with RLS have a related condition called periodic limb movement of sleep (PLMS). PLMS causes the legs to twitch or jerk during sleep. It can happen as often as every 15 to 40 seconds and can continue all night long. PLMS can also lead to sleep deprivation.
RLS is a lifelong condition with no cure, but medication can help manage symptoms.
Symptoms of RLS
The most prominent symptom of RLS is the overwhelming urge to move your legs, especially when you’re sitting still or lying in bed. You might also feel unusual sensations like a tingling, crawling, or pulling sensation in your legs. Movement may relieve these sensations.
If you have mild RLS, symptoms may not occur every night. And you might attribute these movements to restlessness, nervousness, or stress.
A more severe case of RLS is challenging to ignore. It can complicate the simplest activities, like going to the movies. A long plane ride can also be difficult.
People with RLS are likely to have trouble falling asleep or staying asleep because symptoms are worse at night. Daytime sleepiness, fatigue, and sleep deprivation can harm your physical and emotional health.
Symptoms usually affect both sides of the body, but some people have them on only one side. In mild cases, symptoms may come and go. RLS can also affect other parts of the body, including your arms and head. For most people with RLS, symptoms worsen with age.
People with RLS often use movement as a way to relieve symptoms. That might mean pacing the floor or tossing and turning in bed. If you sleep with a partner, it may well be disturbing their sleep as well.
Mechanisms behind RLS?
More often than not, the cause of RLS is a mystery. There may be a genetic predisposition and an environmental trigger.
More than 40 percent of people with RLS have some family history of the condition. In fact, there are five gene variants associated with RLS. When it runs in the family, symptoms usually start before age 40.
There may be a connection between RLS and low levels of iron in the brain, even when blood tests show that your iron level is normal.
RLS may be linked to a disruption in the dopamine pathways in the brain. Parkinson’s disease is also related to dopamine. That may explain why many people with Parkinson’s also have RLS. Some of the same medications are used to treat both conditions. Research on these and other theories is ongoing.
It’s possible that certain substances like caffeine or alcohol can trigger or intensify symptoms. Other potential causes include medications to treat:
Primary RLS isn’t related to an underlying condition. But RLS can actually be an offshoot of another health problem, like neuropathy, diabetes, or kidney failure. When that’s the case, treating the main condition may resolve RLS issues.
There isn’t one single test that can confirm or rule out RLS. A large part of the diagnosis will be based on your description of symptoms.
To reach a diagnosis of RLS, all the following must be present:
- overwhelming urge to move, usually accompanied by strange sensations
- symptoms get worse at night and are mild or absent in the early part of the day
- sensory symptoms are triggered when you try to relax or sleep
- sensory symptoms ease up when you move
Even if all the criteria are met, you’ll probably still need a physical examination. Your doctor will want to check for other neurological reasons for your symptoms.
Be sure to provide information about any over-the-counter and prescription medications and supplements you take. And tell your doctor if you have any known chronic health conditions.
Blood tests will check for iron and other deficiencies or abnormalities. If there’s any sign that something besides RLS is involved, you may be referred to a sleep specialist, neurologist, or other specialist.
It may be harder to diagnose RLS in children who aren’t able to describe their symptoms.
Self therapy for RLS
Self therapy, while unlikely to completely eliminate symptoms, may help reduce them. It may take some trial and error to find the remedies that are most helpful.
Here are a few you can try:
- Reduce or eliminate your intake of caffeine, alcohol, and tobacco, especially in the evening before bedtime.
- Strive for a regular sleep schedule, with the same bedtime and wake-up time every day of the week.
- Get some exercise every day, such as walking or swimming.
- Massage or stretch your leg muscles in the evening.
- Soak in a warm water with espom salts before bed.
- Practice yoga or meditation.
When scheduling things that require prolonged sitting, such as a car or plane trip, try to arrange them for earlier in the day rather than later.
If you have an iron or other nutritional deficiency, ask your doctor or nutritionist how to improve your diet. Talk to your doctor before adding dietary supplements. It can be harmful to take certain supplements if you aren’t deficient.
These options may be useful even if you take medication to manage RLS.
Food recommendations for people with RLS
There aren’t any specific dietary guidelines for people with RLS. But it’s a good idea to review your diet to make sure you’re getting enough essential vitamins and nutrients. Try to cut high-calorie processed foods with little or no nutritional value.
Some people with symptoms of RLS are deficient in particular vitamins and minerals. If that’s the case, you can make some changes to your diet or take dietary supplements. It all depends on what your test results show.
If you’re deficient in iron, try adding more of these iron-rich foods to your diet:
- dark green leafy vegetables
- dried fruit
- red meat and pork
- poultry and seafood
- iron-fortified foods such as certain cereals, pasta, and bread
Vitamin C helps your body absorb iron, so you might also want to pair iron-rich foods with these sources of vitamin C:
- citrus juices
- grapefruit, oranges, tangerines, strawberries, kiwi, melons
- tomatoes, peppers
- broccoli, leafy greens
Caffeine is tricky. It can trigger symptoms of RLS in some people, but actually helps others. It’s worth a little experimentation to see if caffeine affects your symptoms.
Alcohol can make RLS worse, plus it’s known to disrupt sleep. Try to avoid it, especially in the evening.
Sleeping Considerations with RLS
Those strange sensations in your legs can be uncomfortable or painful. And those symptoms can make it almost impossible to fall asleep and stay asleep.
Sleep deprivation and fatigue are dangerous to your health and well-being.
In addition to working with your doctor to find relief, there are a few things you can do to improve your chances of restful sleep:
- Inspect your mattress and pillows. If they’re old and lumpy, it may be time to replace them. It’s also worth investing in comfortable sheets, blankets, and pajamas.
- Make sure window shades or curtains block outside light.
- Remove all digital devices, including clocks, away from your bed.
- Remove bedroom clutter.
- Keep your bedroom temperature on the cool side so you don’t get overheated.
- Put yourself on a sleep schedule. Try to go to bed at the same time each night and get up at the same time each morning, even on weekends. It’ll help support a natural sleep rhythm.
- Stop using electronic devices at least one hour before bedtime.
- Just before bedtime, massage your legs or take a hot bath or shower.
- Try sleeping with a pillow between your legs. It might help prevent your nerves from compressing and triggering symptoms.
Pregnancy Considerations with RLS
Symptoms of RLS can spring up for the first time during pregnancy, usually in the last trimester. Data suggests that pregnant women may have two or three times higher risk of RLS.
The reasons for this aren’t well-understood. Some possibilities are vitamin or mineral deficiencies, hormonal changes, or nerve compression.
Pregnancy can also cause leg cramps and difficulty sleeping. These symptoms can be hard to distinguish from RLS. If you’re pregnant and have symptoms of RLS, talk to your doctor. You may need to be tested for iron or other deficiencies.
You can also try some of these home care techniques:
- Avoid sitting still for prolonged periods, especially in the evening.
- Try to get a little exercise every day, even if it’s just an afternoon walk.
- Massage your legs or perform leg stretching exercises before bed.
- Try using heat or cold on your legs when they’re bothering you.
- Stick to a regular sleep schedule.
- Avoid antihistamines, caffeine, smoking, and alcohol.
- Make sure you’re getting all the nutrients you need from your diet or from prenatal vitamins.
I hope this gives you guys a comprehensive background of what is RLS, its causes, and possible lifestyle modifications for treatment.
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