Restless Legs Syndrome

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What is RLS?

Restless Legs Syndrome (RLS) is a poorly understood and frequently misdiagnosed group of disorders in which patients experience intense, unpleasant “sensations” or “symptoms” in their legs and compelling urges to move the legs in an effort to relieve these sensations. These vile sensations are the defining symptom of RLS. The sensations are difficult or impossible for patients to characterize, but are frequently described as Jimmy Legs, heebie-jeebies, antsy, etc. They are located deep inside the legs (usually between the knee and ankle), and are painful in about 30% of patients. They can occasionally be unilateral. There is a wide variation in severity. Some patients experiencing only occasional mild symptoms, while others struggle with disabling episodes on a nightly basis. Exercising or moving the legs temporarily relieves or diminishes the sensations - as long as the movement continues. When the movement stops, the cruel sensations quickly return. The unrelenting urge to move (in attempts to keep the dreaded sensations at bay) is what gives RLS its name.

The most vexing aspect of RLS is that lying down and trying to relax triggers the sensations; and the sensations prevent relaxation. Many sufferers experience severe symptoms during any period of inactivity and cannot enjoy sedentary activities such as watching television or a movie, attending church, going on long car or plane rides, etc. Symptoms of RLS are worse in the evening and generally diminish late in the night. Patients are usually asymptomatic by morning. The reason for this is unknown.

As RLS symptoms are strongest at bedtime, most patients have difficulty falling asleep and staying asleep. They often cannot get to sleep until they finally pass out from sheer exhaustion in the early morning hours. Patients with severe RLS experience nightly attacks that lead to the utter exhaustion and daytime fatigue of chronic sleep deprivation. Associated depression is common. The inability to concentrate, impaired memory, and lack of stamina can impact their job performance, their leisure activities, and their personal relationships. Unaffected spouses often have difficulty understanding how something invisible with such a silly name can be so debilitating.

RLS affects 5-15% of the American and European populations. Women are more likely to be affected. Age at onset is variable, and can be as young as infancy or early childhood. Approximately 2% of children and adolescents have symptoms of RLS. Sleep disturbance is significantly more common in children and adolescents with RLS, as are “growing pains.”[3] Incidence increases with age. Symptom severity increases in times of stress and as time goes by. The worst cases are generally seen in middle age or older patients. In certain cases, arm involvement can occur.[4]

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