Some suffer from a strong urge to move their legs when lying down, which causes them trouble and difficulty sleeping. If you suffer from similar symptoms, you may have Restless Leg Syndrome, what are they, symptoms and causes, and then how is the treatment going?
What is Restless Leg Syndrome?
Restless legs syndrome – also called Willis-Ekbom disease – is a condition that causes an uncomfortable sensation in the legs and an irresistible urge to move them, as defined by US National Institute of Neurological Disorders and Stroke.
Symptoms most often occur in the late afternoon or evening and are often worse at night when a person is resting, such as when sitting or lying in bed.
It can also happen when someone is inactive and sitting for long periods of time (for example, while traveling on a plane or watching a movie). Since symptoms may worsen during the night, it may be difficult to fall asleep or go back to sleep after waking up. Moving the legs or walking usually relieves the symptoms of restless legs, but the symptoms often return after the movement stops.
Classification of restless legs syndrome
Restless legs syndrome is classified as a sleep disorder because the symptoms make it difficult to fall asleep, and it’s also classified as a movement disorder, especially since sufferers have to move their legs to relieve symptoms. . However, it is best described as a sensorineural disorder with symptoms originating in the brain itself.
Restless Leg Syndrome is one of many disorders that can cause fatigue and daytime sleepiness, which can seriously affect mood, concentration, work and school performance, and personal relationships.
Many people with Willis-Ekbom disease say they are often unable to concentrate, have poor memory, or fail to complete daily tasks. Untreated moderate to severe Restless Legs Syndrome can lead to a 20% decrease in productivity. Work can contribute to depression and anxiety.
Do men and women suffer in the same way?
Restless legs syndrome occurs in both men and women, although women are more likely to develop it than men.
Infection can begin at any age; Many severely affected people are middle-aged or older, and symptoms usually become more frequent and last longer with age.
Symptoms of Restless Leg Syndrome
- An irresistible urge to move.
- Uncomfortable sensation in the lower limbs.
- What the victim feels can be described as pain, tightness or itching.
- The nagging feeling often affects both sides.
Since moving the legs (or other affected body parts) relieves discomfort, people with Willis-Ekbom disease often keep their legs moving to reduce or prevent uncomfortable sensations. They can walk on the ground, constantly move their legs while sitting, and fidget. and turn over in bed. .
RLS symptoms worsen at night with a distinct symptom-free period in the early morning, allowing for more restful sleep at this time. Some people have trouble falling asleep and staying asleep. They may also notice worsening symptoms if their sleep is reduced by events or activities.
Symptoms of restless legs syndrome can vary from day to day, in severity and frequency, and from person to person. In moderately severe cases, symptoms only occur once or twice a week, but often result in a significant delay in falling asleep, with some disruption of daytime functions.
In severe cases of Willis-Ekbom disease, symptoms occur more than twice a week and lead to stressful interruptions to sleep and impaired daytime functions.
Causes of Willis-Ekbom disease
In most cases, the cause of restless legs syndrome is unknown. However, it has a genetic component and can be found in families where the onset of symptoms occurs before the age of 40.
Evidence suggests that low iron levels in the brain may also be responsible for the syndrome.
There’s also plenty of evidence that restless legs are linked to a malfunction in a part of the brain that controls movement called the basal ganglia, which uses the brain chemical dopamine.
Dopamine is needed for smooth, targeted muscle activity and movement. Disruption of these pathways often leads to involuntary movements. And people with Parkinson’s disease, another disorder of the dopamine pathways in the basal ganglia, have an increased risk of developing restless legs syndrome.
Restless legs syndrome may be associated or associated with any of the following conditions:
- Kidney disease and dialysis.
- Iron deficiency.
- Certain drugs that can make RLS symptoms worse, such as antinausea drugs (such as prochlorperazine or metoclopramide), antipsychotics (such as haloperidol or phenothiazine derivatives), antidepressants that increase serotonin (eg , fluoxetine, or sertraline), and some cold and allergy medicines that contain older antihistamines (eg, diphenhydramine).
- Consumption of nicotine and caffeine.
- Pregnancy, especially in the third trimester, and in most cases, symptoms usually resolve within 4 weeks of delivery.
- Sleep deprivation and other sleep disorders such as sleep apnea can also worsen or trigger symptoms in some people. Reducing or completely eliminating these factors can relieve symptoms.
Restless Leg Syndrome Treatment
Restless legs syndrome can be treated by taking care to relieve symptoms. Moving the affected limb may provide temporary relief. Sometimes symptoms can be controlled by finding and treating an associated medical condition, such as peripheral neuropathy, diabetes, or iron deficiency anemia.
Restless Leg Syndrome Treatment Options:
1- Change lifestyle
Certain lifestyle changes and activities may provide some relief for people with mild to moderate symptoms of restless leg syndrome.
- Avoid or reduce tobacco consumption.
- Regular sleep pattern.
- Do moderate exercise.
- Leg massage.
- Take a hot bath.
- Use a heating pad or an ice pack.
- New medical devices have been approved by the US Food and Drug Administration (FDA), including a foot bandage that compresses the bottom of the foot and a cushion that delivers vibrations to the back of the legs. Aerobic exercise and moderate-intensity leg stretching may provide some relief from mild symptoms.
For people with low blood measurements, called ferritin and transferrin saturation, it is recommended to try iron supplementation as a first treatment. Iron supplements are available without a prescription.
3- Anticonvulsant drugs
Anti-epileptic drugs have become a first-line prescription for people with restless legs syndrome. Gabapentin Enacarbil has been approved by the United States Food and Drug Administration for the treatment of moderate to severe restless legs syndrome, and it appears to be as effective as dopamine therapy.
4- Dopaminergic agents
These drugs, which increase the effect of dopamine, are widely used in the treatment of Parkinson’s disease. It has been shown to reduce the symptoms of restless leg syndrome when taken at night.
The United States Food and Drug Administration has approved ropinirole, pramipexole, and rotigotine for the treatment of moderate to severe RLS. These medications are generally well tolerated but may cause nausea, dizziness, or other short-term side effects.
Although dopamine-related medications are effective in managing the symptoms of restless legs syndrome, long-term use can exacerbate symptoms in many people. With chronic use, a person may begin to experience symptoms in the early evening or even earlier. Until the symptoms appear around the clock.
Over time, the initial evening or bedtime dose may become less effective, nighttime symptoms may worsen, and symptoms may begin to affect the arms or torso.
Fortunately, this apparent progression can be reversed if the person withdraws all dopamine-related medications.
Sometimes medications such as methadone, codeine, hydrocodone, or oxycodone are prescribed to treat people with more severe symptoms of restless legs syndrome who have not responded well to other medications. Side effects include constipation, dizziness, nausea, worsening sleep apnea, and risk of addiction. However, very low doses are often effective in controlling the symptoms of restless legs syndrome.
These drugs can help people get more restful sleep. However, even if only taken at bedtime, they can sometimes cause daytime drowsiness, lower energy, and affect concentration. Benzodiazepines such as clonazepam and lorazepam are usually prescribed to treat anxiety, muscle spasms, and insomnia.
Since these drugs can also cause or worsen sleep apnea in some cases, they should not be used in people with this condition.