At Home Sleep Test

Overview

Restless legs syndrome (RLS) is a condition that causes an uncontrollable urge to move the legs, usually because of an uncomfortable sensation. It typically happens in the evening or nighttime hours when you're sitting or lying down. Moving eases the unpleasant feeling temporarily.

Restless legs syndrome, also known as Willis-Ekbom disease, can begin at any age and generally worsens as you age. It can disrupt sleep, which interferes with daily activities.

Simple self-care steps and lifestyle changes may help relieve symptoms. Medications also help many people with RLS.

Symptoms

The chief symptom is an urge to move the legs. Common accompanying characteristics of RLS include:

Sensations that begin while resting. The sensation typically begins after you've been lying down or sitting for an extended time, such as in a car, airplane or movie theater.
Relief with movement. The sensation of RLS lessens with movement, such as stretching, jiggling the legs, pacing or walking.
Worsening of symptoms in the evening. Symptoms occur mainly at night.
Nighttime leg twitching. RLS may be associated with another, more common condition called periodic limb movement of sleep, which causes the legs to twitch and kick, possibly throughout the night, while you sleep.

People typically describe RLS symptoms as compelling, unpleasant sensations in the legs or feet. They usually happen on both sides of the body. Less commonly, the sensations affect the arms.

The sensations, which generally occur within the limb rather than on the skin, are described as:

Crawling
Creeping
Pulling
Throbbing
Aching
Itching
Electric

Sometimes the sensations are difficult to explain. People with RLS usually don't describe the condition as a muscle cramp or numbness. They do, however, consistently describe the desire to move the legs.

It's common for symptoms to fluctuate in severity. Sometimes, symptoms disappear for periods of time, then come back.

Risk Factors

RLS can develop at any age, even during childhood. The condition is more common with increasing age and more common in women than in men.

RLS usually isn't related to a serious underlying medical problem. However, it sometimes accompanies other conditions, such as:

Peripheral neuropathy. This damage to the nerves in the hands and feet is sometimes due to chronic diseases such as diabetes and alcoholism.
Iron deficiency. Even without anaemia, iron deficiency can cause or worsen RLS. If you have a history of bleeding from the stomach or bowels, experience heavy menstrual periods, or repeatedly donate blood, you may have iron deficiency.
Kidney failure. If you have kidney failure, you may also have iron deficiency, often with anaemia. When kidneys don't function properly, iron stores in the blood can decrease. This and other changes in body chemistry may cause or worsen RLS.
Spinal cord conditions. Lesions on the spinal cord as a result of damage or injury have been linked to RLS. Having had anaesthesia to the spinal cord, such as a spinal block, also increases the risk of developing RLS.
Parkinson's disease. People who have Parkinson's disease and take certain medications called dopaminergic agonists have an increased risk of developing RLS.

Treatment Options

Sometimes, treating an underlying condition, such as iron deficiency, greatly relieves symptoms of RLS. Correcting an iron deficiency may involve receiving iron supplementation orally or intravenously. However, take iron supplements only with medical supervision and after your provider has checked your blood-iron level.

If you have RLS without an associated condition, treatment focuses on lifestyle changes. If those aren't effective, your provider might prescribe medications.

Medications

Several prescription medications, most of which were developed to treat other diseases, are available to reduce the restlessness in the legs. These include:

Medications that increase dopamine in the brain. These medications affect levels of the chemical messenger dopamine in the brain. Rotigotine (Neupro) and pramipexole (Mirapex) are approved by the Food and Drug Administration for the treatment of moderate to severe RLS.
Short-term side effects of these medications are usually mild and include nausea, light-headedness and fatigue. However, they can also cause impulse control disorders, such as compulsive gambling, and daytime sleepiness.
Drugs affecting calcium channels. Certain medications, such as gabapentin (Neurontin, Gralise), gabapentin enacarbil (Horizant) and pregabalin (Lyrica), work for some people with RLS.
Muscle relaxants and sleep medications. These drugs help you sleep better at night, but they don't eliminate the leg sensations, and they may cause daytime drowsiness. These medications are generally only used if no other treatment provides relief.
Opioids. Narcotic medications are used mainly to relieve severe symptoms, but they may be addicting if used in high doses. Some examples include tramadol (Ultram, ConZip), codeine, oxycodone (Oxycontin, Roxicodone, others) and hydrocodone (Hysingla ER).

It may take several trials for you and your doctor to find the right medication or combination of medications that work best for you.

Caution about medications

Sometimes dopamine medications that have worked for a while to relieve your RLS become ineffective, or you notice your symptoms returning earlier in the day or involving your arms. This is called augmentation. Your provider may substitute another medication to combat the problem.

Most drugs prescribed to treat RLS aren't recommended during pregnancy. Instead, your provider may recommend self-care techniques to relieve symptoms. However, if the sensations are particularly bothersome during your last trimester, your provider may approve the use of certain drugs.

Some medications may worsen symptoms of RLS. These include some antidepressants, some antipsychotic medications, some anti-nausea drugs, and some cold and allergy medications. Your provider may recommend that you avoid these drugs, if possible. However, if you need to take these medications, talk to your provider about adding drugs to help manage your RLS.

Lifestyle and home remedies

Making simple lifestyle changes can help alleviate symptoms of RLS:

Try baths and massages. Soaking in a warm bath and massaging the legs can relax the muscles.
Apply warm or cool packs. Use of heat or cold, or alternating use of the two, may lessen the limb sensations.
Establish good sleep hygiene. Fatigue tends to worsen symptoms of RLS, so it's important that you practice good sleep hygiene. Ideally, have a cool, quiet, comfortable sleeping environment; go to bed and rise at the same time daily; and get at least seven hours of sleep nightly.
Exercise. Getting moderate, regular exercise may relieve symptoms of RLS, but overdoing it or working out too late in the day may intensify symptoms.
Avoid caffeine. Sometimes cutting back on caffeine may help restless legs. Try to avoid caffeine-containing products, including chocolate, coffee, tea and soft drinks, for a few weeks to see if this helps.
Consider using a foot wrap or a vibrating pad. A foot wrap specially designed for people with RLS puts pressure under the foot and may help relieve your symptoms. You may also find relief using a pad that vibrates on the back of the legs.

Restless Leg Syndrome