The restless legs syndrome is a common condition that can make it hard to sleep, it is a condition of the nervous system in which you want to move the legs to relieve the unpleasant sensations. There is a lot you can do that can be helpful.
What is restless leg syndrome?
Also called Willis-Ekbom disease, it causes unpleasant or uncomfortable sensations in the legs and an irresistible urge to move them, symptoms commonly occur in the late afternoon or evening and are most severe at night when a person is resting. such as sitting or lying in bed can also occur when someone is inactive and sits for long periods of time (for example, when taking a plane or watching a movie).
Since symptoms can increase in severity during the night, it can be difficult to fall asleep or go back to sleep after waking up, moving the legs or walking generally relieves discomfort, but the sensations recur once the movement stops. It is classified as a sleep disorder as symptoms are triggered by resting and trying to sleep, and as a movement disorder, as people are forced to move their legs to relieve symptoms. However, it is best characterized as a sensory neurological disorder with symptoms that arise from the brain itself.
It is one of several disorders that can cause exhaustion and daytime sleepiness, which can strongly affect mood, concentration, work and school performance, and personal relationships. Many people report that they are unable to concentrate, have memory problems, or are unable to perform daily tasks. Untreated moderate to severe restless leg syndrome can lead to about a 20 percent decrease in work productivity and can contribute to depression and anxiety , it can also make traveling difficult.
It occurs in both men and women, although women are more likely to have it than men, it can start at any age. Many people who are severely affected are middle-aged or older, and symptoms generally become more frequent and last longer with age.
More than 80 percent of people with this condition also experience periodic limb movements during sleep, which is characterized by involuntary contractions of the leg (and sometimes the arm) or jerky movements during sleep that typically occur every 15 to 40 seconds, sometimes overnight.
Fortunately, most cases can be treated with non-drug therapies and, if necessary, with medications.
What are the symptoms of restless legs?
Because there is no test that can be performed to diagnose this syndrome, a doctor has to diagnose it by listening to descriptions of symptoms from patients. To confirm a diagnosis, the following symptoms must be present:
- An urge or desire to move the legs, usually accompanied by uncomfortable sensations such as numbness, tingling, tingling, stinging, burning, cramping, or pain.
- The urge to move or uncomfortable sensations begin or worsen during periods of rest or inactivity, such as when sitting in front of the television or when traveling by car or plane.
- The urge to move or uncomfortable sensations are partially or fully relieved by activities such as stretching, walking, or exercising the affected muscles.
- The need to move or uncomfortable sensations are worse or occur only at night.
- The urge to move or the uncomfortable sensations are not solely due to another medical or behavioral problem (muscle aches, leg cramps, arthritis, habitual tapping of the foot).
Your doctor may ask you to talk about your family health history, including family members who may have the syndrome. In 50% of patients, the disorder is presumed to be genetic, the chance of developing it increases three to six times when an immediate family member has the disorder. Furthermore, these patients tend to develop symptoms earlier in life (before age 45) than those without the genetic link.
Other medical problems that can contribute to development include iron deficiency, Parkinson’s disease, kidney disease, diabetes, rheumatoid arthritis, and peripheral neuropathy (a disease of the nervous system that affects the nerves in the extremities). Pregnant women notice symptoms after 20 weeks’ gestation, and dialysis patients are especially susceptible to developing it and patients taking antidepressants, sedative antihistamines, or anti-nausea medications as well.
Your doctor will also ask if you have trouble staying awake during the day or if you have insomnia (trouble falling asleep), as well as daytime sleepiness, irritability, and poor concentration caused by a restless night’s sleep. In addition, he will perform a complete physical and neurological examination to detect nerve damage or blood vessel problems and may order a series of blood tests to rule out associated medical conditions.
Causes of restless legs syndrome
It is due to an iron deficiency (low total body iron status) and this represents 20% of cases. A study published in 2007 indicated that the characteristics of the syndrome were observed in 34% of people with iron deficiency compared to 6% of controls.
Other associated conditions include varicose veins or venous reflux, folate deficiency, magnesium deficiency, fibromyalgia, sleep apnea , uremia, diabetes, thyroid disease, peripheral neuropathy, Parkinson’s disease, and certain autoimmune diseases such as Sjögren’s syndrome, celiac disease, and rheumatoid arthritis. It can also get worse during pregnancy.
Attention deficit hyperactivity disorder
An association has been observed between attention deficit hyperactivity disorder and restless legs syndrome or periodic limb movement disorder, both conditions appear to have links with dysfunctions related to the neurotransmitter dopamine, and common medications for both conditions, among other systems, they affect dopamine levels in the brain.
- Certain medications can cause or worsen this type of syndrome or cause it secondarily, including:
- Certain antiemetics (antidopaminergics).
- Certain antihistamines (especially first-generation sedating H1 antihistamines, often in over-the-counter cold medications).
- Many antidepressants.
- Antipsychotics and certain anticonvulsants.
- A rebound effect of sedative-hypnotic drugs, such as benzodiazepine withdrawal syndrome, when discontinuing benzodiazepine tranquilizers or sleeping pills.
Alcohol withdrawal can also cause restless leg syndrome and other movement disorders such as akathisia and parkinsonism generally associated with antipsychotics. Opioid withdrawal is associated with the cause and worsening.
The cause versus effect of certain conditions and behaviors seen in some patients (eg, excess weight, lack of exercise, depression, or other mental illnesses) is not well established. Loss of sleep due to the syndrome could cause the conditions.
More than 60% of cases are familial and inherited in an autosomal dominant fashion with variable penetrance. Research and brain autopsies have implicated both the dopaminergic system and a deficiency of iron in the substantia nigra. Iron is well understood as an essential co-factor for the formation of L-dopa, the precursor to dopamine.
There is also some evidence that periodic limb movements in sleep are associated. The presence of a positive family history suggests that there may be a genetic implication in the etiology of restless legs syndrome.
What are the sleeping habits to have? – Treatments.
Having good sleep habits is advisable for anyone, but perhaps especially for people who have trouble sleeping, such as people with restless legs syndrome.
While better sleep may not resolve your symptoms of the condition, it may help you compensate for the loss of sleep that you experience with your condition. Try the following tips to make your sleep as relaxing and restorative as possible.
- Go to sleep and wake up at the same time every day.
- Keep your sleeping area cool, quiet, and dark.
- Keep distractions, such as the television and the telephone, to a minimum in your bedroom.
- Avoid electronic displays for two to three hours before going to sleep, as the blue light from these displays can disrupt your circadian rhythm, helping you maintain a natural sleep cycle.
Iron and vitamin supplements
Iron deficiency is believed to be one of the main causes, several studies have shown that iron supplements can help alleviate symptoms. A simple blood test can check for iron deficiency, so if you think this could be a problem for you, talk to your doctor.
If the iron deficiency test is positive, your doctor may recommend oral supplements, which you can find at your local pharmacy. In some cases, intravenous iron may be necessary. Additionally, vitamin D deficiency could be linked – a 2014 study found that vitamin D supplements reduce symptoms in people who suffer from it. And for people on hemodialysis, vitamin C and E supplements can help relieve symptoms.
Exercise can help you feel better, the National Institutes of Health indicates that moderate exercise can help relieve mild symptoms.
A 2006 study of 23 people with the problem found that aerobic exercise and lower body resistance training, performed three times a week for 12 weeks, significantly decreased symptoms.
Other studies have also found exercise to be very effective, especially in people with end-stage kidney disease.
Considering these studies, in addition to others showing that activity can help improve sleep, exercise seems like a natural fit for people with restless leg syndrome.
One recommendation: exercise in moderation, don’t work to the point of aches and pains, as this could make your symptoms worse.
Yoga and stretching
Like other types of exercises, yoga and stretching exercises have been shown to have benefits for people with syndrome like this type.
It’s not entirely clear to researchers why yoga and stretching work, and more research would be beneficial. But given these results, you may want to add some calf and upper leg stretches to your daily exercise routine.
Massaging the leg muscles could help relieve symptoms, many health organizations, such as the National Institutes of Health and the National Sleep Foundation, suggest it as a home treatment.
Although there isn’t much other research supporting massage as a treatment, a 2007 case study illustrated its benefits. As an added bonus, massage can aid relaxation, which may help improve your sleep.
A foot bandage has been shown to help relieve symptoms, as it puts pressure on certain points on the bottom of the foot, the pressure sends messages to your brain, which responds by telling the affected muscles to relax, this helps relieve your symptoms.
A 2013 study of 30 people who wore the foot wrap for eight weeks found significant improvements in symptoms and quality of sleep.
If you have ever spent the night in the hospital, you may have had pneumatic compression. This treatment uses a “sleeve” that covers your leg and inflates and deflates, gently squeezing and releasing the limb.
In the hospital, a pneumatic compression device is generally used to improve circulation and prevent blood clots, improved circulation may also be the reason that pneumatic compression has been shown to help relieve symptoms of restless legs syndrome. .
Some researchers believe that the cause is the low oxygen concentration in the limbs, they think that the body responds to this problem by increasing circulation through muscle contractions that occur when the person moves the limb. Whatever the reason, some research has shown that pneumatic compression can help relieve symptoms.
Some of these are rented and others can be purchased over the counter or with a prescription. Insurance coverage may be easier to purchase for people who cannot tolerate medications.
A vibrating pad called a relaxis pad may not relieve symptoms, but it may help you sleep better. You use the vibrating pad while you are resting or sleeping, place it on the affected area and adjust it to the desired vibration intensity. The pad vibrates for 30 minutes and then turns itself off.
The idea behind the platform is that the vibrations provide ‘counter-stimulation’, that is, they cancel out uncomfortable sensations, so vibrations are felt rather than symptoms. There is not much research available and it has not been shown to relieve symptoms, however it has been shown to improve sleep.
Hot and cold treatments
While there isn’t much research to support the use of heat and cold to alleviate symptoms, many health care organizations recommend it. These organizations suggest taking a hot or cold bath before bed or applying hot or cold compresses to your legs.
Some people’s symptoms are aggravated by cold, while others have heat problems, this could explain the benefits of these hot or cold treatments.
Repetitive transcranial magnetic stimulation
A non-invasive procedure generally used to treat depression may be helpful in relieving symptoms. So far, studies have been limited and more research is needed, but the results are promising. Repetitive transcranial magnetic stimulation sends magnetic impulses to certain areas of the brain.
It is not entirely clear why it might help relieve symptoms, one theory is that the impulses increase the release of dopamine in the brain. Another suggests that it might help calm hyperarousal in the parts of the brain that are associated with it.
Transcutaneous electrical nerve stimulation
With transcutaneous electrical nerve stimulation, a device sends small electrical currents to parts of your body to help relieve pain. There isn’t much research on its use to treat it in restless legs syndrome, but it might work. The idea is that, like the vibrating pad, it uses counterstimulation.
Hello, how are you? My name is Georgia Tarrant, and I am a clinical psychologist. In everyday life, professional obligations seem to predominate over our personal life. It's as if work takes up more and more of the time we'd love to devote to our love life, our family, or even a moment of leisure.