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Restless Legs Syndrome Factsheet

 

What is Restless Legs Syndrome?

Restless Legs Syndrome (RLS) is a neurological disorder characterised as an overwhelming, irresistible urge to move the legs.1

How is it caused?

The exact causes of RLS are yet to be identified. It has been suggested that factors which trigger the disease could stem from the level of dopamine in the brain.2 Low levels of dopamine are known to disrupt the nerve signals sent from the brain to the legs causing uncontrolled movement and the unpleasant tingling feeling associated with it.2

Other causal factors for RLS may be the result of an underlying health condition such as:

  • Anaemia – low levels of iron are known to lead to reduced levels of dopamine2
  • Chronic diseases – RLS may be secondary to or exacerbated by diabetes, rheumatoid arthritis, renal failure, Parkinson’s disease or an underactive thyroid gland2
  • Pregnancy – RLS is known to occur in the last trimester (week 27 to birth) but in most cases symptoms disappear within four weeks after giving birth2

How common is it?

1 in 10 people will develop RLS at some point in their lives. It affects women more than men and can occur at any point in life.3

What are the symptoms?

The symptoms of RLS will vary according to each individual but they have the tendency to occur in the evening when dopamine levels drop due to decreased activity. Some of the most common descriptions for symptoms include:3

  • electric feeling
  • a crawling sensation
  • feeling like water running down the leg
  • deep pain in the leg

Symptoms are unpleasant for patients particularly in those who suffer from them regularly which can be daily. 3 in f 4 people living with RLS also suffer from periodic limb movements of sleep (PLMS) involving twitchy or jerky leg movements at night.3

How is RLS diagnosed?

Not one single pathway exists in diagnosing RLS. Assessments to facilitate diagnosis will be based on the patient’s symptoms and whether there is any family history of the disorder. A clinical diagnosis of RLS can be made if patients complain of four key symptoms classified by the International Restless Legs Syndrome Study Group (IRLSSG).1

These include:1

  • Urge to move the legs or other body parts usually accompanied or caused by unpleasant sensations
  • Urge to move or unpleasant sensations begin or worsen during rest or inactivity
  • Urge to move or unpleasant sensations are partially or totally relieved by movement
  • Urge to move or unpleasant sensations are worse in the evening or at night or occur only in the evening or at night

Blood tests may also be conducted to rule out any other diseases such as anaemia, renal failure and diabetes. Sleep tests such as polysomnography which measure breathing and heart rate and brain waves, may be recommended to test in particular for PLMS.2

Is RLS treatable?

Certain lifestyle changes can help treat mild forms of RLS.2 The below life style changes have been suggested to help manage symptoms:4

  • Avoiding stimulants (e.g. caffeine, tobacco and alcohol)
  • Not smoking

Taking moderate, daily exercise

  • Establishing a regular sleeping pattern
  • Avoiding medicines that trigger the symptoms of RLS or make them worse

There is no cure for RLS but dopaminergic agents, (drugs that increase dopamine) are licensed in reducing symptoms. 4

How does RLS affect daily life?

RLS is a chronic disorder and can be very disruptive impacting on the individual’s daily life. It is known for symptoms to worsen with age however the decline is more associated in those whose RLS has been triggered by an associated medical condition.4

It is known that RLS can be particularly disruptive on sleep.5 This can in-turn lead to performance-related affects the following day including daytime sleepiness and can impair cognitive function.5 Studies conducted in this disorder highlight that approximately 30% of people with RLS are unable to work a full day compared to around 4% of the general population.6


References

1. Garcia-Borreguero et al. Algorithms for the diagnosis and treatment of restless legs syndrome in primary care (EURLSSG Guidelines).BMC Neurology 2011, 11-28.

2. NHS Choices http://www.nhs.uk/Conditions/Restless-leg-syndrome/Pages/Symptoms.aspx (accessed June 2012)

3. www.patient.co.uk/health/Restless-Legs-Syndrome.htm (accessed August 2012)

4. NINDS. Restless Legs Syndrome Fact Sheet http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm (accessed June 2012)

5. Allen RP et al. REST Study. Arch Intern Med 2005; 165, 1286 – 1292

6. Chaudhuri et al. Restless legs Syndrome Handbook. Oxford University Press, 2009.

Oct 2012 - UK/12NE0079