Restless Legs Syndrome (RLS): Causes, Symptoms, Diagnosis

Restless legs syndrome (RLS), also called Willis-Ekbom disease, is a sleep disorder that causes an intense, often irresistible urge to move your ... NowschedulingCOVID-19vaccinesforages5+,boostersandthirddoses Scheduleyourappointment COVID-19vaccineFAQs GoingtoaClevelandCliniclocation? Newvisitationguidelines Masksrequiredforpatientsandvisitors(evenifyou'revaccinated) Home / HealthLibrary / Disease&Conditions RestlessLegsSyndrome Restlesslegssyndrome(RLS),alsocalledWillis-Ekbomdisease,isadisorderthatcauseastrongurgetomove.Italsocausessensationsdescribedascreeping,itching,pulling,crawling,tugging,throbbing,burning,orgnawing.RLSrunsinfamiliesandisalsoassociatedwithmanyconditionsanddiseasesandmedications. Appointments866.588.2264 Appointments&Locations ContactUs Overview SymptomsandCauses DiagnosisandTests ManagementandTreatment RestlessLegsSyndrome Overview SymptomsandCauses DiagnosisandTests ManagementandTreatment BackToTop Overview Whatisrestlesslegssyndrome(RLS)? Restlesslegssyndrome(RLS),alsocalledWillis-Ekbomdisease,isasleepdisorderthatcausesanintense,oftenirresistibleurgetomoveyourlegs(andevenyourarmsorbody).Itoccursalongwithothersensationsinyourlimbsdescribedaspulling,creeping,tugging,throbbing,itching,aching,burningorcrawling. Thesesensationsusuallyoccurwhenlyingdowninbedorwhensittingforlongperiodsoftime,suchaswhiledrivingorwhileatatheater.RLStypicallyoccursintheevening,makingitdifficulttofallasleep.OftentimespeoplewithRLSwanttowalkaroundandshaketheirlegs(orarms)tohelprelievetheuncomfortablesensations. Whogetsrestlesslegssyndrome(RLS)? Peopleofanyage,includingchildren,canhaveRLS.SymptomsofRLSmaybegininchildhoodoradulthood,butthechanceofhavingthesyndromeincreasessignificantlywithage.RLSismorecommoninwomenthaninmen.Upto10percentoftheUnitedStatespopulationhasRLS. SymptomsandCauses Whatcausesrestlesslegssyndrome(RLS)? Restlesslegssyndrome(RLS)hasbeenfoundtobeageneticsyndromeinsomecases,meaningthatparentswithRLScanpassitdowntotheirchildren.Upto92%ofpatientswithRLShaveafirst-degreerelativewiththedisorder.Thesepatientstendtodevelopsymptomsearlierinlife(beforeage45)thanthosewithRLSwithoutthegeneticlink. Inadditiontothegeneticsource,manymedicalproblemsarecloselyassociatedwiththedevelopmentofRLS,including: Lowlevelsofiron(irondeficiency). Uremia(aconditionassociatedwithworseningkidneyfunction). Hypothyroidism. Depression. Fibromyalgia. Parkinson'sdisease. Kidneydisease. Diabetes. Rheumatoidarthritis. Peripheralneuropathy. Pregnancy. Dialysis. MedicationscanalsocontributetothedevelopmentofRLS.Suchknownmedicationsincludeantidepressants,allergydrugsandanti-nauseamedications.Caffeine,nicotineandalcoholcanalsomakesymptomsworse. Whatarethesymptomsofrestlesslegssyndrome(RLS)? Symptomsofrestlesslegssyndromeinclude: Leg(orarm)discomfort:Theseuncomfortablelimbsensationsareoftendescribedbyadultsascreeping,itching,pulling,crawling,tugging,throbbing,burning,orgnawing.Thesesensationsusuallyoccuratbedtimebutcanoccuratothertimesoflimbinactivity. Urgetomovelegs(orarms):Torelievelimbdiscomfort,youhaveanuncontrollableurgetomoveyourlimbsespeciallywhenresting,suchaswhensittingorlyingdown. Sleepdisruption:Additionaltimeisoftenneededtofallasleepbecauseoftheurgetomoveyourlimbstorelievethediscomfort.Sometimesstayingasleepmayalsobedifficult. Bedtimebehaviorproblems:Becauseofthediscomfort,youmayneedtogetoutofbedtostretchyourlimbstorelievethediscomfort. Daytimesleepiness:Problemswithfallingasleepandstayingasleepmayresultindaytimesleepiness. Behaviorandworkperformanceproblems:Again,duetosleepdisruption,problemsmayemergeindaytimebehavior(irritability,moodiness,difficultyconcentrating,hyperactivity,etc)andworkperformance. DiagnosisandTests Howisrestlesslegssyndrome(RLS)diagnosed? Unfortunately,thereisnospecifictestforrestlesslegssyndrome(RLS).Thediagnosisismadebasedonyoursymptoms.Amedicalhistory,completephysicalandneurologicalexamandbloodtestsmaybeconductedtoruleoutanyotherpossiblehealthproblemsassociatedwithRLS.Anovernightsleepstudymayberecommendedtoevaluateforothersleepdisorders,especiallyobstructivesleepapnea. YourhealthcareproviderwillaskaboutanyfamilyhistoryofRLS.Theywillalsoaskifyouhaveanysleepcomplaints,suchasinsomnia(difficultyfallingasleeporstayingasleep)duetoyoursymptoms.Yourhealthcareproviderwillalsoaskifyouhavetroublestayingawakeduringthedayandaskaboutotherbehaviororworkperformanceproblems. ToconfirmadiagnosisofRLS,youmustmeetthefollowingfivecriteria: Haveanurgeordesiretomoveyourlegs(orarms),usuallyoccurringtogetherwithuncomfortablesensationssuchaspulling,tugging,crawling,itching,aching,orburning. Also,theurgetomoveoruncomfortablesensations: Beginorworsenduringperiodsofrestorinactivity. Arepartiallyortotallyrelievedbyactivitiessuchasstretching,walkingorexercisingtheaffectedmuscles. Areworseoroccursolelyintheeveningoratnight. Arenotsolelyduetoanothermedicalorbehavioralproblem. ManagementandTreatment Howisrestlesslegssyndrome(RLS)treated? Treatmentofrestlesslegssyndromedependsontheintensityofthesymptoms.Treatmentshouldbeconsideredifqualityoflifeisaffectedbyinsomniaandexcessivedaytimedrowsiness.IncasesofRLSduetoongoingmedicaldisorders,specifictreatmentisalsonecessary. Non-drugtreatments.Non-drugtreatmentsaretriedfirst,especiallyifsymptomsaremild.Non-drugtreatmentsinclude: Gettingregularexercise,suchasridingabike/stationarybikeorwalking,butavoidingheavy/intenseexercisewithinafewhoursofbedtime. Followinggoodsleephabits,includingavoidingreading,watchingtelevisionorbeingonacomputerorphonewhilelyinginbed;getting7to9hoursofsleepandfollowingotherhealthysleephabits.NotgettingenoughsleepcanworsenRLSsymptoms. Avoidingorlimitingcaffeinatedproducts(coffees,teas,colas,chocolates,andsomemedications[checklabels]),nicotine,andalcohol. Applyingaheatingpad,coldcompress,orrubbingyourlegstoprovidetemporaryrelieftothelegdiscomfort.Alsoconsidermassage,acupressure,walking,lightstretchingorotherrelaxationtechniques. Soakinawarmtub. Trymagnesiumsupplements.Theymaybehelpful. Reducestressasmuchaspossible.Trymeditation,yoga,softmusicorotheroptions. Ironsupplementation.IrondeficiencyisareversiblecauseofRLS.Ifbloodtestsrevealyouhavelowironlevels,yourdoctormayrecommendtakinganironsupplement. Prescriptionmedications.WhenRLSsymptomsarefrequentorsevere,yourhealthcareproviderwilllikelyprescribemedicationstotreatthedisorder.Medicationsoptionsinclude: Dopamineagonistscontroltheurgetomove,sensorysymptomsinthelegs,andreduceinvoluntarylegjerksinsleep.Ropinirole(Requip®),pramipexole(Mirapex®)andtherotigotinepatch(Neupro®)aretheFDA-approveddopamineagonistsusedforRLS. Anti-seizuremedicationscansloworblockpainsignalsfromnervesinthelegs.Examplesincludegabapentinenacarbil(Horizant®),gabapentin(Neurontin®)andpregabalin(Lyrica®).ThesedrugsareparticularlyeffectiveinpatientswithpainfulRLSduetoneuropathy.GabapentinenacarbilistheonlymedicationinthisclassthatisFDA-approvedforRLS.However,theothersmaybeeffective. Benzodiazepines,clonazepam(Klonopin®)inparticular,aresometimesprescribedforRLSbutareusuallyreservedformoreseverecasesduetotheiraddictivepotentialandsideeffectsincludingdaytimedrowsiness. Opioids,suchasmethadoneoroxycodone,canbeusedtorelievesymptomsofRLSbutbecauseoftheriskofaddiction,theyareusuallynotprescribedunlessthecaseissevereandothermedicationshavenotbeeneffective. Youandyourdoctorwilldiscussthetreatmentthatmightbebestforyou. 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