Restless Leg Syndrome

What is restless legs syndrome?

Restless legs syndrome, or “RLS,” is a condition that causes strange sensations in the legs. If you have RLS, you probably have the urge to move your legs at night. This can make it hard to get comfortable and fall asleep.

In some cases, RLS happens on its own and seems to run in families. In other cases, the condition seems to be linked to other medical problems. For instance, a condition called “iron deficiency anemia,” in which there is too little iron in the blood, seems to increase the risk of RLS. Other conditions that increase the risk of RLS include kidney disease, diabetes, and multiple sclerosis. Pregnancy seems to increase a person’s risk of developing RLS, too.

What are the symptoms of RLS?

People who have RLS get an uncomfortable urge to move their legs when they are resting. They describe the feeling as crawling, creeping, pulling, or itching. They say the feeling is deep in the legs (not on the skin), usually below the knees. These symptoms usually get worse as the day moves on, and they are worse at night. They can be especially bad when trying to stay still to read a book, watch TV, or fall asleep. It can be hard to do things that require sitting still for a long time. For example, symptoms can get worse if you take a long drive, fly in an airplane, or go to the theater.

People with RLS can make the feeling go away temporarily if they walk around or move their legs. Some people’s legs move on their own while they sleep.

In short, the symptoms:

• Happen when you are at rest
• Go away if you move your legs on purpose
• Are worst at night
• Sometimes include the legs moving on their own during sleep

Together, the symptoms of RLS can make it hard to get a good night’s sleep. People with RLS often also have insomnia. This means they have trouble falling or staying asleep, or they do not feel rested when they wake up.

Is there a test for RLS?

No. Your doctor or nurse should be able to tell if you have RLS by asking about your symptoms and doing an exam. They might do blood tests to see whether you have enough iron in your blood.

Your doctor or nurse might also do tests to check for other problems. For example, some people with RLS have another condition that affects their sleep, such as sleep apnea. People with sleep apnea stop breathing for short periods while they are asleep. If your doctor thinks you might have sleep apnea, they might recommend a “sleep study.”

What can I do on my own to feel better?

The table lists some things you can try:

For example, you can:

• Practice good “sleep hygiene” – This means following certain habits to improve your sleep. For example, avoid alcohol, especially near bedtime. Avoid looking at screens before bed.
• Do activities that keep your mind alert during the day, such as puzzles.
• Stay physically active – Any activities that involve moving your body are good for you. Even gentle forms of exercise, like walking or yoga, can help.
• Massage your legs – You can also have someone else massage them, if possible. Some people also feel better if they use “pneumatic compression devices.” These are special sleeves that fill with air and squeeze your legs.
• Apply heat to your legs – You can use a heating pad or take a hot bath or shower.
• Avoid taking medicines that can make RLS worse – These include antihistamines like diphenhydramine(sample brand name: Benadryl). Some over-the-counter sleep aids also contain diphenhydramine and can make RLS worse if you use them help with sleep. Some medicines used to treat depression and other mental health problems can make RLS worse. But talk to your doctor before stopping any of your medicines. They might recommend trying a different one instead.

How is RLS treated?

Some people with RLS do not need treatment because they have mild symptoms that don’t bother them much. If treatment is needed, there are several different medicines doctors can suggest. Examples include:

• Iron supplements
• Gabapentin(brand name: Neurontin)
• Pregabalin(brand name: Lyrica)
• Gabapentin enacarbil(brand name: Horizant)
• Pramipexole(brand name: Mirapex)
• Ropinirole(brand name: Requip)
• Rotigotine(brand name: Neupro)

In people with RLS who also have a severe form of kidney disease called kidney failure, the RLS might improve with dialysis treatment.

What if I am pregnant?

RLS is common during pregnancy. The main treatments usually involve taking iron supplements and trying the other tips that do not involve taking prescription medicines. This is because most of the medicines used to treat RLS are not proven to be safe to take during pregnancy. But if symptoms are severe, there might be some medicines your doctor can prescribe.

The symptoms of RLS can be difficult to live with. If you are struggling, talk with your doctor or nurse. Remember that RLS usually goes away or gets much better after you give birth.

When should I call the doctor?

Call your doctor or nurse for advice if your symptoms:

• Bother you, or get worse
• Prevent you from getting a good night’s sleep

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