It’s not a very common thing, but it does happen.
You’re fast asleep in the dead of night, comfortable as you can be, and suddenly your leg starts waking up. And it is not quite the usual pins-and-needles sensation of having your leg wake up from falling asleep, but something similar that is hard to describe. It’s like you can’t help but want to move the leg, and it’s generally uncomfortable.
The strangest part is, there seems to be no reason for your leg to have fallen asleep in the first place. But beyond simply bizarre, the worst part is that it won’t seem to go away. This is a condition aptly known as restless leg syndrome.
WHAT IS IT?
Restless leg syndrome (also known as Willis-Ekbom disease) is categorized as a sleep disorder because it typically occurs during hours when sleep is expected — and because it tends to disrupt sleep.
Some studies even indicate that it is triggered by rest or an attempt to sleep. It’s technically also categorized as a movement disorder given that relief is temporarily found in moving around. Ultimately, however, its best characterization is as a neurological sensory disorder, as the symptoms tend to be produced by the brain.
WHAT CAUSES IT?
According to WebMD, the cause of primary restless leg syndrome is unknown. However, studies suggest that there is a genetic component to it, those specific gene variants are associated with it, and that RLS can typically be located in families that have an onset age below 40. Interestingly, some studies link RLS with low iron levels in the brain.
More revealingly, some studies appear to link RLS with some other conditions.
Possibly a dysfunction in the basal ganglia, a brain section that controls movement — maybe a disruption in the pathways carrying dopamine, which is needed for the body to produce smooth muscle activity. The disruption of the pathways may be what causes the involuntary, jerky movements.
Some are possible causes of RLS but not conclusive:
- sleep apnea, or similar conditions
- pregnancy, particularly in the final trimester
- renal disease, particularly end-stage, and hemodialysis
- iron deficiency, as noted above
- intake of alcohol, coffee, and nicotine
- the use of certain medications, which may actually aggravate symptoms of RLS. These include antidepressants that increase the body’s levels of serotonin (sertraline or fluoxetine) and anti-nausea medicines (metoclopramide, or prochlorperazine)
- nerve damage, or neuropathy
HOW IS IT DIAGNOSED?
There is actually no test for RLS, which means a doctor typically evaluates a patient based on observed symptoms. Doctors usually look for five vital signs:
- A powerful, sometimes overwhelming urge to move the legs, often associated with uncomfortable sensations.
- The symptoms either starting or getting worse during periods of rest or otherwise being inactive.
- The urge to move starting or aggravating in the evening or at night.
- The urge being diminished or relieved, wholly or in part, by movement.
- The absence of a medical condition causing any of the above.
The doctor may ask for additional information, such as detailed descriptions of the symptoms and the times of day when they manifest. Some information about your medical and family history may be of help in contextualizing the findings and formulating an overall diagnosis as well. In some cases, laboratory tests may be recommended first if only to rule out other possible causes such as iron deficiency anemia or kidney failure.
In other cases, a sleep study may be advised to identify other possible reasons that may be disrupting sleep, such as sleep apnea. It’s essential to provide and gather as much information as possible.
WHAT IS THE TREATMENT?
The immediate “treatment,” if you can call it like that, is to move about a bit. Sadly, the relief from this is just temporary. There may be more lasting approaches to try and control RLS symptoms, but there is no cure.
Nevertheless, the good news is that RLS does not immediately indicate the possibility of more concerning neurological diseases like Parkinson’s. Even better, while RLS may never completely go away, some individuals have reported periods of remission — symptoms going away for days, months, or even years.
While not to a certain extent, RLS may be treated in some ways, such as by identifying the associated medical condition that may be contributing to it, whether iron deficiency anemia, diabetes, or peripheral neuropathy.
There are many options for treatment.
- Iron supplementation medication. Note that while this helps address the associated deficiency in iron, there is no single medication that uniformly effectively manages RLS for everyone. Furthermore, it may be possible that regularly-taken medicines may slowly lose their effect over time, which would necessitate a change in medication.
- Lifestyle changes are one approach to take. Where lifestyle choices and factors may be found to contribute to RLS, they may be phased out or outright done away with. These changes may include avoiding alcohol, coffee, and nicotine, or perhaps adopting a regular sleep pattern.
One may also look into taking a moderate exercise program (probably one favoring moderately intense aerobic or leg-stretching exercises), as well as a regimen of massaging the legs or using hot or cold packs. Some new devices have been cleared for use, including a vibrating pad that helps soothe the back of the legs, and copper-lined compression socks as well.
3. Taking dopaminergic agents. These medications typically seek to increase the effect of dopamine on the body, which would enable better control of movement and reduced erratic, jerky, and involuntary movements such as those associated with RLS.
NOTE: Your doctor will almost certainly warn of the risk that chronic use may lead to worsening of the symptoms. This doesn’t happen for everyone, but some individuals have reported experiencing symptoms earlier in the day, or the restlessness beginning to affect the trunk or even the arms. The good news is that dropping the dopaminergic medication reverses this progression.
4. Compression Treatment. Wear compression socks. They help in the blood circulation. Wearing compression socks, preferably cotton compression socks that tend to be more comfortable and better tolerated at night can actually be the relief that you are looking for. Compression socks with progressive stretch technology are highly recommended for maximum comfort. To know more about cotton compression socks, click here.
You can’t get rid of RLS but you can manage it with the suggestions above. If you are experiencing the early signs of RLS you should consult your doctor immediately. Manage it by taking care of your health. Take care of your legs!