Restless legs syndrome (RLS), also called Willis Ekbom disease causes uncomfortable feelings in the legs, such as itching, prickling, pulling, or crawling. These sensations create an overwhelming urge to move the legs.
People with RLS may walk, stretch, or shake their legs to achieve relief. Symptoms tend to be worse when inactive, including when relaxing or lying down. As a result, the symptoms of RLS often disrupt sleep.
RLS affects 5 to 10% of adults and 2 to 4% of children in the U.S. and it is found in women more often than men. People of all ages can develop RLS, but the most severe symptoms tend to occur in older adults.
The sensations associated with RLS are distinct from normal sensations experienced by those who don’t have the disorder. This makes them difficult to characterize. According to the International Classification of Sleep Disorders, the words and phrases most commonly used by RLS patients to describe the feelings are:
Learn more about RLS symptoms here.
The desire to move one’s legs makes falling asleep and staying asleep difficult for many people with RLS. A study found that 88% of individuals with RLS reported at least one sleep-related symptom. RLS symptoms often appear shortly after laying down at night and patients will kick, squirm, or massage their legs to lessen the sensation. Some people with RLS are compelled to get out of bed and pace or stretch.
As a result of the sleep disturbances associated with RLS, patients often experience fatigue and daytime sleepiness. Sleep deficiency is associated with depression, anxiety, heart disease, and obesity. RLS patients are at greater risk for these issues as well. Concerns about sleep are the main reason RLS patients seek medical care for their condition.
Most people who have RLS also have a condition called periodic limb movement disorder (PLMD). PLMD involves repetitive flexing or twitching of the limbs while asleep at night. It is different from RLS in that these movements are not accompanied by uncomfortable sensations and because they occur during sleep, patients are often not aware of them. However, PLMD-associated movements can cause a person to wake up and therefore can compound sleep issues in patients who also have RLS.
Although most people with RLS have PLMD, many with PLMD do not have RLS.
Sometimes, RLS is associated with other medical conditions, such as late-stage kidney disease, iron deficiency, neuropathy, multiple sclerosis, or Parkinson’s disease.
However, the cause of most RLS cases is unknown. RLS may have a genetic component. Between 40% and 90% of patients with RLS have at least one first-degree relative (parent, sibling, or child) with the condition. Researchers have identified some genetic changes that increase risk for RLS, but it is likely that more have yet to be discovered.
Sitting or resting are common triggers for RLS symptoms. Additionally, some substances can make symptoms worse. These include:
Incidentally, most of these substances when taken in excess or too close to bedtime can also adversely affect our sleep architecture.
The goals of treatment for RLS are to stabilize symptoms and improve sleep consistency. There are both non-medicinal approaches and drug treatments available to manage RLS.
The following approaches can reduce symptoms in patients with mild or moderate RLS and may be used in combination with medication in RLS patients who have severe symptoms.
Learn more about treating RLS here.