Monday, February, 13, 2012

Restless Legs Syndrome and Related Disorders - Risk Factors

Table of Contents

  • Osteoarthritis (degenerative joint disease). About 72% of patients with RLS also have osteoarthritis, a common type of arthritis affecting mostly older adults.
  • Varicose veins. Varicose veins occur in 14% of patients with RLS.
  • Obesity
  • Diabetes -- people with type 2 diabetes may have higher rates of secondary RLS. Nerve pain (neuropathy) related to their diabetes cannot fully explain this increased rate in RLS.
  • Hypertension
  • Hypothyroidism (a condition in which the thyroid gland does not make enough hormones)
  • Fibromyalgia (chronic pain of unknown cause)
  • Rheumatoid arthritis
  • Emphysema (a lung disease usually caused by smoking)
  • Chronic alcoholism
  • Sleep apnea (pauses in breathing during sleep) and snoring
  • Chronic headaches
  • Brain or spinal injuries
  • Many muscle and nerve disorders; hereditary ataxia, a group of genetic diseases that affects the central nervous system and causes loss of motor control, is of particular interest. Researchers believe that hereditary ataxia may supply clues to the genetic causes of RLS.
Osteoarthritis
Osteoarthritis is a chronic disease of the joint cartilage and bone, once thought to result from "wear and tear" on a joint, although there are other causes such as trauma, and metabolic disorders. Joints appear swollen, are stiff and painful, and usually feel worse the more they are used throughout the day.
Hypothyroidism Click the icon to see an image of hypothyroidism.
Fibromyalgia Click the icon to see an image of fibromyalgia.
Rheumatoid arthritis Click the icon to see an image of rheumatoid arthritis.
Emphysema Click the icon to see an image of emphysema.

Environmental and Dietary Factors

Several environmental and dietary factors can worsen or provoke restless legs syndrome:

  • Iron deficiencies. People who are deficient in iron are at risk for restless legs syndrome, even if they do not have anemia
  • Folic acid or magnesium deficiencies
  • Smoking
  • Alcohol abuse
  • Caffeine (coffee drinking is specifically associated with PLMD)
  • Stress
  • Fatigue
  • Prolonged exposure to cold

Medications

Drugs that worsen or provoke RLS include:

  • Antidepressants
  • Antipsychotic drugs
  • Anti-nausea drugs
  • Calcium channel blockers (mostly used to treat high blood pressure)
  • Metoclopramide (used to treat various digestive diseases)
  • Antihistamines
  • Oral decongestants
  • Diuretics
  • Asthma drugs
  • Spinal anesthesia (anesthesia-induced restless legs syndrome typically disappears on its own within several months)

Risk Factors for Periodic Limb Movement Disorder

About 6% of the general population has PLMD. Among the elderly, the prevalence increases to 25 - 58%. Studies suggest that PLMD may be especially common in elderly women. As with RLS, numerous conditions are associated with PLMD. They include sleep apnea, spinal cord injuries, stroke, narcolepsy, and diseases that destroy nerves or the brain over time. Certain medications, including some antidepressants and anti-seizure medications, may also contribute to PLMD.


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Review Date: 10/15/2010
Reviewed By: Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)