Restless leg syndrome: Do you have it?

Restless_leg_Dec_1_2015_blogRestless leg syndrome (RLS) is an uncomfortable sensation that gives a person the urge to move their legs. This sensation has been described in many ways; sometimes it can feel like a pain, a tingling or a “creepy-crawling” sensation. It is important to know that RLS happens when a person is awake, not asleep, although many people with RLS may move their legs while asleep. And it gets worse or occurs predominantly at night.

About 14% of people in the U.S. have restless leg. Some people feel that it is difficult to explain to their doctor and may not seek treatment. It is, however, a real sleep disorder that has consequences when it interferes with a person’s quality of life.

With RLS, everyday activities such as sitting down to watch TV in the evening or riding in a car or plane can be difficult. 

The good news is that restless leg syndrome is treatable.

Diagnosing and treating restless leg

Only a physician or sleep medicine specialist can diagnose and treat restless leg.

Iron and RLS

The first step is to get an iron study that looks specifically at a protein called ferritin. A ferritin level of 50 or less has been associated with RLS. There are some medications that can cause or worsen RLS. Talk to your doctor about the medications you are taking if you have RLS.

If your ferritin level is low, you can be treated with iron. It can take a long time for iron to normalize in your system.

If you truly have RLS, there are additional behavioral modifications and medications you can try.

Behavioral modifications for RLS

RLS is often improved by movements such as walking or stretching. Regular exercise can help. Limiting your caffeine or alcohol is helpful. Most people should not drink caffeine for 8 hours before bed. If you have RLS, you may need to extend that time, especially if your RLS is sensitive to caffeine.

You also could try using a heating or cold pad on your legs or even alternating between ice and heating pad.

Some people report that engaging in mentally stimulating activities is a big help.

Medications for RLS

There are several medications for treating RLS. The two primary ones are dopamine agonist (one example is known by its brand name Pramipexole) or gabapentin (marketed under the name Neurontin). They are both FDA-approved for the treatment of RLS.

Many medications for RLS can be taken on an as-needed basis. This is especially good if you don’t have RLS every night.

Who is prone to RLS?

People who have low iron, such as women with heavy menstrual periods or who are pregnant, especially during the second or third trimester, often have RLS. People with peripheral neuropathy, kidney failure, multiple sclerosis or a family history of RLS are at increased risk for the condition.

The bottom line

Typically, about 2-3% of people with RLS think it is severe enough to seek treatment. The decision to treat it is really up to you. If it bothers you enough that it’s either making it hard to fall asleep or giving you poor quality sleep, then it’s time to see a physician.

In addition, if your legs move when you sleep, that is not restless leg syndrome. It may be a condition called periodic limb movements.

Next steps

Hershner_80Shelley D. Hershner, M.D., is Assistant Professor of Neurology and Director of the Collegiate Sleep Disorders Clinic. Dr. Hershner is interested in disordered sleep in college students and how sleep impacts academic performance.




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