Restless Legs Syndrome

Restless legs syndrome (RLS) is a sensory disorder causing an almost
irresistible urge to move the legs. The urge to move is usually due to
unpleasant feelings in the legs that occur when at rest. People with RLS use
words such as creeping, crawling, tingling, or burning to describe these
feelings. Moving the legs eases the feelings, but only for a while. The
unpleasant feelings may also occur in the arms.

Effects of RLS

RLS can make it hard to fall asleep and stay asleep. People with RLS often
don’t get enough sleep and may feel tired and sleepy during the day. This can
make it difficult to:

• Concentrate, making it harder to learn and remember things
• Work
• Carry out other usual daily activities
• Take part in family and social activities

Not getting enough sleep can also make you feel depressed or have mood
swings.

RLS can range from mild to severe, based on:

• How much discomfort you have in your legs and arms
• Whether you feel the need to move around
• How much relief you get from moving around
• How much sleep disturbance you have
• How tired or sleepy you are during the day
• How often you have symptoms
• How severe your symptoms are on most days
• How well you carry out daily activities
• How angry, depressed, sad, anxious, or irritable you feel

Types of RLS

There are two types of RLS:

• Primary RLS is the most common type of RLS. It is also
  
  called idiopathic RLS. “Primary” means the cause is not known. Primary RLS, once
  
  it starts, usually becomes a lifelong condition. Over time, symptoms tend to get
  
  worse and occur more often, especially if they began in childhood or early in
  
  adult life. In milder cases, there may be long periods of time with no symptoms,
  
  or symptoms may last only for a limited time.
• Secondary RLS is RLS that is caused by another disease or
  
  condition or, sometimes, from taking certain medicines. Symptoms usually go away
  
  when the disease or condition improves, or if the medicine is stopped.

Periodic Limb Movement Disorder

Most people with RLS also have a condition called periodic limb movement
disorder (PLMD). PLMD is a condition in which a person’s legs twitch or jerk
uncontrollably about every 10 to 60 seconds. This usually happens during sleep.
These movements cause repeated awakenings that disturb or reduce sleep. PLMD
usually affects the legs but can also affect the arms.

Outlook

RLS can be unpleasant and uncomfortable. However, there are some simple
self-care approaches and lifestyle changes that can help in mild cases. RLS
symptoms often improve with medical treatment. Research is ongoing to better
understand the causes of RLS and to develop better treatments.

What Causes Restless Legs Syndrome?

Primary RLS

In most cases of restless legs syndrome (RLS), no cause can be found. When no
cause can be found, the condition is called primary RLS. It is known, however,
that primary RLS tends to run in families. People whose parents have RLS are
more likely to develop the disorder. This suggests that there may be a genetic
link that increases the chance of getting RLS.

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Secondary RLS

Secondary RLS is RLS that is caused by another disease or condition, or as a
side effect of certain medications. Some of the diseases and conditions that can
cause RLS are:

• Iron deficiency (with or without anemia)
• Kidney failure
• Diabetes
• Parkinson’s disease
• Damage to the nerves in the hands or feet (peripheral neuropathy)
  
  (pe-RIF-e-ral noo-ROP-a-the)
• Rheumatoid arthritis (ROO-ma-toyd ar-THRI-tis)
• Pregnancy

RLS is common in pregnant women. It usually occurs during the last 3 months
of pregnancy and usually improves or disappears within a few weeks after
delivery. However, some women may continue to have symptoms after giving birth
or may develop RLS again later in life.

Some of the types of medicines that can cause RLS are:

• Antiseizure medicines
• Antinausea medicines
• Antidepressants
• Some cold and allergy medicines

RLS symptoms usually go away when the medicine is stopped.

Certain substances can trigger RLS symptoms or make them worse. These
substances include:

• Caffeine
• Alcohol
• Tobacco

Who Is At Risk for Restless Legs Syndrome?

Restless legs syndrome (RLS) may affect as many as 12 million people in the
United States.

Gender

RLS affects both men and women. The disorder occurs more often in women than
in men.

Age

The number of cases of RLS rises with age. Many people with RLS are diagnosed
in middle age. But in up to two out of every five cases, the symptoms of RLS
begin before age 20. People who develop RLS early in life usually have a family
history of the disorder.

Race/Ethnic Group

RLS can affect people of any race or ethnic group. The disorder is more
common in persons of northern European descent.

Pregnancy

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RLS is common in pregnant women. It usually occurs during the last 3 months
of pregnancy and usually improves or disappears within a few weeks after
delivery.

What Are the Signs and Symptoms of Restless Legs Syndrome?

Restless legs syndrome (RLS) has several major signs and symptoms:

• An almost irresistible urge to move the legs or arms when sitting or lying
  
  down
• An unpleasant feeling in the legs
• Difficulty falling asleep or staying asleep because of the unpleasant
  
  feelings in the legs or arms
• Daytime sleepiness, which results from a lack of restful sleep due to the
  
  repeated limb movements

Urge To Move

RLS gets its name from the urge to move the legs when sitting or lying down.
This urge is due to unpleasant feelings in the legs that are relieved by
movement. Typical movements are:

• Pacing and walking
• Jiggling the legs
• Stretching and flexing
• Tossing and turning
• Rubbing the legs

Unpleasant Feelings

The urge to move the legs usually is due to unpleasant feelings in the legs.
People with RLS describe these feelings as:

• Creeping
• Crawling
• Pulling
• Itching
• Tingling
• Burning
• Aching
• Painful
• Hard to describe

Children may describe RLS symptoms differently than adults.

The unpleasant feelings in RLS usually occur in the lower leg (calf). But the
feelings can occur at any place between the thigh and the ankle and also in the
arm. The feelings are worse:

• When lying down or sitting for a long period of time
• During the evening or night, more so than during the day

The unpleasant feelings also:

• Make it hard to fall asleep or stay asleep
• Are not as bad or go away when you move

Duration and Severity

RLS symptoms tend to get worse over time. They may begin in childhood and
develop slowly over several years. People with early symptoms are more likely to
have other family members with RLS than people who develop RLS later in
life.

Symptoms tend to worsen faster when RLS occurs later in life. RLS that occurs
later in life is also more likely to result from an underlying condition or
illness than RLS that occurs early in life.

People with mild symptoms may only notice them when they are still or awake
for a long time, such as on a long a