Restless Leg Syndrome

Restless leg syndrome is a common disorder resulting in an urge to move the legs at bedtime and sometimes during the day while resting. Restless legs can result in severe insomnia and daytime fatigue and sleepiness.

In cases where the symptoms are prominent during the daytime, it may be difficult to sit for even short periods of time at work or during social activities.

Symptoms

Restless leg syndrome has four key symptoms:

  1. An urge to move the legs and sometimes arms, which can be irresistible when severe. This urge is usually associated with an abnormal sensation such as a creep crawly feeling, an ache, or a discomfort that may be very difficult to put into words,
  2. Excessive movement of the legs when at rest,
  3. Aggravation of the discomfort during rest and at least temporary relief by movement,
  4. A circadian rhythm of severity with symptoms being worse at the usual bedtime.

In addition to the symptoms experienced when awake, an individual with restless legs syndrome usually experiences periodic limb movements during sleep.

Often associated with sleep fragmentation is the rhythmic twitching of the legs that occurs every 20-40 seconds with restless leg syndrome. Although the person afflicted may be unaware of these movements, it is still very disruptive to his or her sleep patterns. In many situations, the sleep of a spouse can also suffer from these movements.

Diagnosis

Restless legs is a clinical diagnosis. A history and physical examination will be performed at the time of the initial office visit to confirm the diagnosis and rule out secondary causes of similar symptoms, such as spinal cord or peripheral nerve damage. Blood may be drawn to test for conditions that may aggravate restless legs such as an iron deficiency.

An all-night polysomnogram may be performed if the sleep center physician feels it is indicated, but it is not a routine part of an initial evaluation for restless legs syndrome.

Treatment

After a patient receives a thorough examination, the sleep center physician will determine a comprehensive treatment plan.

Some patients can be managed without medications by reducing aggravating factors such as caffeine consumption, and hot baths or massage at bedtime.

Many patients require medications to control the symptoms. There are several effective medications and the sleep center physician can make recommendations at the time of the visit.