Restless Legs Syndrome Can Affect Your Personal Health

When we are a sleep, our brain is not an idle machine. It stays very busy. It processes the information we have learned during the day. Sleep makes memories stronger. Sleep also finds hidden relations among memories and helps solve problems we were working on while awake (Scientific American Mind, August/September 2008).

There are at least 84 disorders of sleeping and waking that lead to a lowered quality of life and reduced personal health. Disturbed sleep can lead to traffic and industrial accidents. Restless legs syndrome (RLS) is one of those conditions which can disturb your sleep, can affect your personal health and can cause harm to others.

Sometime ago, there was an article in the New England Journal of Medicine (NEJM) on this subject. The article gives an example of a 45-year-old woman having had nightly insomnia for years. She reports having uncomfortable sensations in her legs when she lies down at night. She describes a feeling of needing to move her legs, which is relieved only by getting up and walking around.

This lady was diagnosed with RLS. It is also known as Ekbom’s syndrome. It is a movement disorder. It is not a psychological or emotional condition. It is thought to be a neurological disorder. Current studies are focused on a brain chemical known as dopamine.

About three to 15 per cent of the population is affected by RLS. It is more common in women than men. The prevalence increases with age. There may be a family history of the condition. Some medications can trigger RLS.

The following features should be present to make a diagnosis of RLS:
-A distressing need or urge to move the legs, usually accompanied by an uncomfortable, deep-seated sensation in the legs that is brought on by rest (sitting or lying down), relieved with moving or walking, or worse at night or in the evening.
-RLS can be associated with involuntary limb movements while patient is awake and/or periodic limb movements (PLM) while patient is asleep. Studies show that more than 80 per cent of people with RLS also have PLMs. But the majority of people with PLMs do not have RLS.

The diagnosis of RLS is based on the clinical history. RLS may be a symptom of iron deficiency therefore the iron status should be assessed. Overnight sleep study may be helpful. The article says that despite the distinctive clinical features of RLS, there remains substantial variability in responses to treatment and in clinical progression and outcome.

It seems all patients with RLS do not present with classical symptoms. Therefore, my impression is, many patients with leg pain go undiagnosed or inadequately treated.

Is there a good treatment for this condition?

For RLS, there are few medications in the market. But the NEJM article says that there is currently inadequate information on the efficacy of medications other than the group of drugs known as dopaminergic drugs.

For unexplained leg pain, rest as much as possible. Elevate the leg and take pain medications which you are familiar with. Gentle massage may improve comfort. Heat or cool soaks may help. If pain persists or swelling develops, see your family physician.

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