Restless legs syndrome: All you need to know

Restless legs syndrome causes twitching and pain in the legs, which commonly occurs after going to bed. This is classified as a sleep disorder since it can lead to insomnia.

Restless legs syndrome (RLS) can occur as a result of mental or physical issues, or as a side effect of certain drugs. Willis-Ekbom disease is another name for it.

The severity of restless legs syndrome is determined by the frequency and intensity of the symptoms, as well as how easily the symptoms may be eased by moving around and how much disruption they create.

It affects up to http://www.nhs.uk/conditions/Restless-leg-syndrome/Pages/Introduction.aspxone out of every ten people at some point in their lives.

The large number of RLS cases will go away on their own with time or with minor lifestyle modifications.

Symptoms

Restless legs syndrome

When a person is awake in a confined place, such as an airplane seat or a theater, symptoms might emerge.

Because RLS makes it difficult to fall and remain asleep, the individual may feel weary throughout the day. Learning, work, focus, and ordinary duties and activities may all be affected.

Sleep deprivation can cause mood changes, anger, sadness, a weakened immune system, and other physical and mental health issues.

How does it make you feel?

RLS causes a peculiar and uncomfortable sensation in the legs, and occasionally the arms, as well as a strong desire to move them. These sensations have been described as:

similar to electric shocks

  • tingling
  • crawling
  • aching
  • burning
  • itching
  • tugging
  • creeping

The only method to get rid of the pain is to move your legs. Not only do the feelings happen at night, but they also happen when the person is resting or inactive. Symptoms usually intensify in the evenings and at night, and are eased for a brief period in the morning.

How long will you have restless legs syndrome?

Primary or idiopathic RLS symptoms usually intensify with time, however some people may go weeks or months without experiencing any symptoms. If the RLS is caused by a condition, sickness, pregnancy, or medicine, it may disappear after the trigger is removed.

Pregnancy

RLS can be problematic for pregnant women.

RLS sufferers may notice that their symptoms worsen during pregnancy. Pregnancy, on the other hand, can cause RLS in and of itself. Symptoms tend to worsen as the pregnancy advances, with the third trimester being the most common.

Although the explanation of the increased RLS incidence during pregnancy is uncertain, the following elements are thought to be involved:

  • changes in the hormones
  • increased sensitivity of the senses
  • low levels of minerals or vitamins, such as iron and folate
  • sleep deprivation as a result of changes in the body and discomfort

During pregnancy, little study has been done on this condition. However, several pharmacological therapies that are commonly used outside of pregnancy, such as rotigotine and gabapentin, have not been evaluated for safety in pregnant women.

Behavioral interventions for women during pregnancy, such as modest exercise and a healthy sleeping pattern, are frequently advised as a first-line therapy.

Oral iron supplements are acceptable to administer during pregnancy if iron levels are low and suspected to be the cause of RLS. Higher quantities may be given intravenously (IV) through a drip in extreme situations.

If a different cause is detected that may necessitate medication and the above therapies are ineffective, medications should be provided at the lowest feasible dosage to minimize risk.

Treatment

If a person is unable to control RLS symptoms on their own, medicines may be administered.

Medication

The medicine used will be determined by the person, however it may include the following:

  • Dopaminergic agents: These drugs increase dopamine levels in the brain, which is a neurotransmitter. They can help with the uncomfortable leg feelings that RLS causes. Dopaminergic drugs such as levodopa and carbidopa are often used.
  • Dopamine agonists: These also help to relieve unpleasant leg sensations by increasing dopamine levels in the brain. They may have negative consequences in elderly persons, while some people report that levodopa has more side effects.
  • Iron: Iron supplementation may benefit people with low iron levels. This, in turn, may aid in the alleviation of symptoms.
    Alpha 2 agonists: These may assist with primary RLS, but they will have no effect on periodic limb movement during sleeping.
  • Painkillers: A non-steroidal anti-inflammatory medicine (NSAID) called ibuprofen may assist with mild symptoms.
  • Anticonvulsants: Pain, muscular spasms, neuropathy, and daytime symptoms are all treated with them. Neurontin, often known as gabapentin, is a widely used anticonvulsant.
  • Opiates: RLS symptoms might be relieved by treating pain. When other drugs have failed, doctors may prescribe them. Low-dose opiates include codeine and propoxyphene, whereas high-dose opiates include oxycodone hydrochloride, methadone hydrochloride, and levorphanol tartrate.
  • Benzodiazepines: These are sedative drugs that assist people with RLS sleep through their symptoms, both severe and minor. Examples are Restoril, or temazepam, Xanax, or alprazolam, and Klonopin, or clonazepam.

RLS is sometimes treated with Parkinson’s disease and epilepsy medicines, which can help to minimize uncontrollable movements.

If the RLS is caused by certain underlying disorders that are addressed, the RLS may go away or improve. When it comes to iron deficiency and peripheral neuropathy, this is frequently the case.

Types

RLS is divided into two types:

Primary or idiopathic RLS

The term “idiopathic” refers to a condition where the etiology is unknown.

It’s the most prevalent, and it has the following features:

  • It may have a genetic cause.
  • Once primary RLS starts, it tends to be lifelong.
  • It usually begins before the age of 40.
  • It can start as early as childhood.

Symptoms may appear and disappear at random times, or they may increase and become more prominent over time.

In moderate situations, the person may go for lengthy periods of time without experiencing any symptoms.

Secondary RLS

Another disease or condition causes a secondary disorder.

Secondary RLS generally begins after the age of 45 years, and it is not inherited. This form of RLS is unique from the others:

  • Symptoms may be more severe.
  • Symptoms do not usually worsen over time.
  • Onset is sudden.

Secondary RLS can be caused by a variety of diseases and symptoms, including:

The exact cause of RLS is unknown, however it may be linked to how the body processes dopamine, a neurotransmitter involved in muscular control. Some drugs, like as antidepressants and selective serotonin reuptake inhibitors (SSRIs), can cause RLS. These medicines have an effect on dopamine activity.

It’s also associated with pregnancy. RLS affects about 20% of pregnant women during the third trimester, while the causes are unknown.

Periodic limb movement disorder (PLMD)

PLMD, also known as periodic limb movement during sleep, is a similar sleep condition . The limbs quiver or jerk uncontrollably in people with PLMD during sleeping. It’s also categorized as a sleeping disorder. The movement may cause the person to wake up several times during the night, compromising the quality and length of sleep. It has the potential to cause RLS.

Home remedies

The following are some lifestyle modifications and drugs that may help relieve RLS symptoms:

  • Warm baths and massages: These help to relax muscles and lessen the severity of symptoms.
  • Warm or cool packs: Some people enjoy warm temperatures, while others believe that alternating hot and cold temperatures is beneficial.
  • Relaxation techniques: Stress can exacerbate RLS, therefore exercises like yoga, meditation, and tai chi may be beneficial.
  • Exercise – Using your legs more will help you feel better. If the patient lives a sedentary lifestyle, walking instead of driving, participating in sports, or working out the legs at a gym can all assist.

Sleep hygiene for restless legs syndrome

Sleep hygiene is important since sleepiness exacerbates symptoms.

The following are some suggestions:

  • Reduce the amount of light you are exposed to for an hour before bed.
  • Avoiding or reducing alcohol consumption and tobacco.
  • Sleeping in a cool, quiet bedroom.
  • Avoid stimulating drinks, such as caffeine or sugar.
  • Going to bed at the same time every night, and getting up at the same time every morning.

Physical activity and exercise can assist with RLS, but they can sometimes make it worse. Most people benefit from modest activity, but too much might exacerbate symptoms. Exercising late in the evening may also be counterproductive.

Other alternatives

Magnesium was observed to improve the symptoms of sleeplessness in people with RLS in a short research of ten people in 1998, suggesting that it might be a viable therapy for people with PLMD. Magnesium, on the other hand, is considered experimental in the study. Magnesium should be avoided by people who have renal disease.

The University of Maryland Medical Center, citing this study, proposes that low magnesium levels may play a role in RLS. Whole grains, nuts, and green leafy vegetables are high in magnesium. Spraying magnesium oil on the problematic area has been shown to benefit some people, but this should not be done without first consulting a doctor.

Vitamin D’s effects on RLS have had inconsistent findings in research. Some studies relate greater vitamin D levels to less symptoms, while others link higher vitamin D levels to a higher incidence during the summer months.

It’s also a good idea to stay hydrated. Drinking plenty of water and avoiding coffee and alcohol can help you achieve this.

Sources:

  • https://www.eurekalert.org/pub_releases/2005-04/cp-sai040105.php
  • https://www.ncbi.nlm.nih.gov/pubmed/9703590
  • http://umm.edu/health/medical/altmed/supplement/magnesium
  • https://www.medicalnewstoday.com/articles/7882
  • http://www.nhs.uk/conditions/Restless-leg-syndrome/Pages/Introduction.aspx
  • http://www.nhs.uk/Conditions/Restless-leg-syndrome/Pages/Causes.aspx
  • https://rls-uk.org/self-management/
  • http://onlinelibrary.wiley.com/doi/10.1002/mds.22254/full
  • https://www.rls.org/file/pregnancy-for-hcp.pdf
  • https://rls-uk.org/what-is-rls/