Restless Legs Syndrome (RLS) is a sleep-related movement disorder. Those with RLS usually report a strong urge to move their legs, often accompanied by an unpleasant feeling that has been described as creeping, crawling, pulling, itching, tingling, burning, aching, or even electric shocks.
The urge to move the legs usually happens during periods of rest or inactivity — and this can make it harder to fall asleep and lead to higher levels of daytime sleepiness.
There are four key signs of RLS that need to be present for diagnosis. These are:
- A strong urge to move the legs along with uncomfortable sensations
- The urge to move the legs worsens during periods of rest or inactivity
- Temporary relief comes from moving around
- Symptoms get worse at night
If you think you may have RLS, there is a simple test you can try at home. All you need to do is sit in a chair for 20 minutes and try not to move your legs. This will be very hard to do if you have RLS.
How RLS affects sleep
The most common sleep problem reported by those with RLS is difficulty falling asleep. Fragmented sleep is also common among those with RLS. Sleep is often fragmented with short bursts of sleep followed by an awakening along with a leg movement. This tends to be more of a problem in the early hours of the morning.
What causes RLS?
We don’t know for sure. However, a number of medical problems do increase the likelihood of RLS. Diabetes, for example, is linked to RLS — perhaps due to nerve damage in the feet. Other medical issues associated with RLS include:
- Joint replacements
- Bone fractures
- Kidney disease
Certain medications such as Selective Serotonin Reuptake Inhibitors (SSRIs) may also cause or worsen RLS symptoms.
Smoking and obesity have been linked to RLS and studies have also found RLS to be more common in those with reduced iron levels, such as pregnant women and individuals with anemia.
How to treat RLS
In the past, those with RLS were treated with medications intended to reduce nighttime awakenings — but this didn’t address the overwhelming urge to move the legs.
At the time of writing this article, newer medications known as dopamine agonists (such as pramipexole and ropinirole) and alpha-2-delta drugs such as gabapentin are considered to be the best treatment options for RLS.
Since RLS is linked to low iron levels, iron supplements may also help.
For those looking for treatment options that don’t involve drugs or supplements, a clinical review published in Sleep Medicine Reviews in 2018 found the following complementary and alternative therapies for RLS can help reduce the severity of symptoms:
- Exercise training
- Transcutaneous spinal direct current stimulation
- Pneumatic compression devices
- Near infra-red light treatment to the lower legs
- Repetitive transcranial magnetic stimulation
Walking, stretching, taking a hot or cold bath, massaging, and using heat or ice packs can also help reduce symptom severity. If you know you will be traveling on an airplane or sitting in a movie theater, choose an aisle seat or a spot with more leg room so you can move your legs if necessary.
Finally, try to observe good sleep hygiene to help minimize the sleep disturbances associated with RLS. Relaxation techniques can also reduce sleep-related worries and help set the stage for sleep.