Restless leg syndrome Health Article

Definition

Restless leg syndrome is a sleep disorder characterized by leg discomfort during sleep, which is only relieved by frequent movements of the legs.

Alternative Names

Nocturnal myoclonus; RLS

Causes, incidence, and risk factors

Restless leg syndrome (RLS) occurs most often in middle-aged and older adults. It is worsened by stress. The cause is not known. RLS may occur more often in patients with peripheral neuropathy, chronic kidney disease, Parkinson's disease, pregnancy, iron deficiency, or the use of certain medications. A hereditary form also exists, and may be a factor when symptoms start at a younger age. The abnormal gene has yet to be identified.

Restless leg syndrome can result in a decreased quality of sleep (insomnia) with subsequent daytime sleepiness, anxiety or depression, and confusion or slowed thought processes from lack of sleep.

Symptoms

The disorder consists of sensations in the lower legs that make the person uncomfortable unless the legs are moved. The sensations usually occur shortly after going to bed but may also occur during the daytime.

The abnormal sensations occasionally occur in the upper leg, the feet, or the arms, in addition to the lower leg.

There is an irresistible urge to walk or move the legs to relieve the discomfort, resulting in periodic episodes of leg movements during early sleep stages. Symptoms, which may last for 1 hour or longer, can include:

• Abnormal sensation in the legs (occasionally, feet, thighs, arms)
  • Creeping sensations or discomfort (not pain, not cramps) relieved by movement of the legs
  • May occur during the day
  • Worse when lying down
• Irresistible urge to move the legs
• Persistent leg movements during sleep hours
• Sleeping difficulty

Note: Symptoms may be worse during stress or emotional upset.

Signs and tests

There is no specific examination for restless leg syndrome. No structural or other abnormalities are usually discovered unless peripheral nerve disease is also present. Blood tests (CBC and serum ferritin) may be done to rule out iron deficiency anemia, which rarely has been associated with restless leg syndrome.

Examination and testing may be used to rule out other disorders that may cause similar symptoms, especially disorders associated with ischemic claudication of the legs.