Women are twice as likely as men to have RLS. PLMS causes the legs to twitch or jerk during sleep. It can happen as often as every 15 to 40 seconds and can continue all night long. PLMS can also lead to sleep deprivation. You might also feel unusual sensations like a tingling, crawling, or pulling sensation in your legs.
Movement may relieve these sensations. If you have mild RLS, symptoms may not occur every night. And you might attribute these movements to restlessness, nervousness, or stress. A more severe case of RLS is challenging to ignore.
It can complicate the simplest activities, like going to the movies. A long plane ride can also be difficult. People with RLS are likely to have trouble falling asleep or staying asleep because symptoms are worse at night. Daytime sleepiness, fatigue, and sleep deprivation can harm your physical and mental health. Symptoms usually affect both sides of the body, but some people have them on only one side. In mild cases, symptoms may come and go. RLS can also affect other parts of the body, including your arms and head.
For most people with RLS, symptoms worsen with age. People with RLS often use movement as a way to relieve symptoms. That might mean pacing the floor or tossing and turning in bed.
If you sleep with a partner, it may well be disturbing their sleep as well. More often than not, the cause of RLS is a mystery. There may be a genetic predisposition and an environmental trigger. More than 40 percent of people with RLS have some family history of the condition.
In fact, there are five gene variants associated with RLS. When it runs in the family, symptoms usually start before age There may be a connection between RLS and low levels of iron in the brain, even when blood tests show that your iron level is normal.
RLS may be linked to a disruption in the dopamine pathways in the brain. Some of the same medications are used to treat both conditions. Research on these and other theories is ongoing.
Other potential causes include medications to treat:. But RLS can actually be an offshoot of another health problem, like neuropathy, diabetes, or kidney failure. Learn more about the causes of restless leg syndrome ». There are certain things that may put you in a higher risk category for RLS. Having RLS can affect your overall health and quality of life. If you have RLS and chronic sleep deprivation, you may be a higher risk of:. A large part of the diagnosis will be based on your description of symptoms.
Your doctor will want to check for other neurological reasons for your symptoms. Be sure to provide information about any over-the-counter and prescription medications and supplements you take. And tell your doctor if you have any known chronic health conditions.
Blood tests will check for iron and other deficiencies or abnormalities. Home remedies, while unlikely to completely eliminate symptoms, may help reduce them. It may take some trial and error to find the remedies that are most helpful. When scheduling things that require prolonged sitting, such as a car or plane trip, try to arrange them for earlier in the day rather than later.
If you have an iron or other nutritional deficiency, ask your doctor or nutritionist how to improve your diet. Talk to your doctor before adding dietary supplements. Learn more about home remedies for restless leg syndrome ». Side effects may include mild lightheadedness and nausea.
These medications can become less effective over time. In some people, they can cause daytime sleepiness impulse control disorders, and worsening of RLS symptoms. Iron supplementation or medications are usually helpful but no single medication effectively manages RLS for all individuals.
Trials of different drugs may be necessary. In addition, medications taken regularly may lose their effect over time or even make the condition worse, making it necessary to change medications. Lifestyle changes.
Certain lifestyle changes and activities may provide some relief in persons with mild to moderate symptoms of RLS. These steps include avoiding or decreasing the use of alcohol and tobacco, changing or maintaining a regular sleep pattern, a program of moderate exercise, and massaging the legs, taking a warm bath, or using a heating pad or ice pack. There are new medical devices that have been cleared by the U.
Aerobic and leg-stretching exercises of moderate intensity also may provide some relief from mild symptoms. For individuals with low or low-normal blood tests called ferritin and transferrin saturation, a trial of iron supplements is recommended as the first treatment. Iron supplements are available over-the-counter. A common side effect is upset stomach, which may improve with use of a different type of iron supplement. Because iron is not well-absorbed into the body by the gut, it may cause constipation that can be treated with a stool softeners such as polyethylene glycol.
Others may require iron given through an IV line in order to boost the iron levels and relieve symptoms. Anti-seizure drugs. Anti-seizure drugs are becoming the first-line prescription drugs for those with RLS.
The FDA has approved gabapentin enacarbil for the treatment of moderate to severe RLS, This drug appears to be as effective as dopaminergic treatment discussed below and, at least to date, there have been no reports of problems with a progressive worsening of symptoms due to medication called augmentation.
Other anti-seizure drugs such as the standard form of gabapentin and pregabalin can decrease such sensory disturbances as creeping and crawling as well as nerve pain. Dizziness, fatigue, and sleepiness are among the possible side effects.
Recent studies have shown that pregabalin is as effective for RLS treatment as the dopaminergic drug pramipexole, suggesting this class of drug offers equivalent benefits. Dopaminergic agents. These drugs, which increase dopamine effect, are largely used to treat Parkinson's disease. They have been shown to reduce symptoms of RLS when they are taken at nighttime. These drugs are generally well tolerated but can cause nausea, dizziness, or other short-term side effects. Levodopa plus carbidopa may be effective when used intermittently, but not daily.
Although dopamine-related medications are effective in managing RLS symptoms, long-term use can lead to worsening of the symptoms in many individuals.
With chronic use, a person may begin to experience symptoms earlier in the evening or even earlier until the symptoms are present around the clock. Over time, the initial evening or bedtime dose can become less effective, the symptoms at night become more intense, and symptoms could begin to affect the arms or trunk. Fortunately, this apparent progression can be reversed by removing the person from all dopamine-related medications.
Another important adverse effect of dopamine medications that occurs in some people is the development of impulsive or obsessive behaviors such as obsessive gambling or shopping. Should they occur, these behaviors can be improved or reversed by stopping the medication. Drugs such as methadone, codeine, hydrocodone, or oxycodone are sometimes prescribed to treat individuals with more severe symptoms of RLS who did not respond well to other medications.
Side effects include constipation, dizziness, nausea, exacerbation of sleep apnea, and the risk of addiction; however, very low doses are often effective in controlling symptoms of RLS. These drugs can help individuals obtain a more restful sleep. However, even if taken only at bedtime they can sometimes cause daytime sleepiness, reduce energy, and affect concentration.
Benzodiazepines such as clonazepam and lorazepam are generally prescribed to treat anxiety, muscle spasms, and insomnia. Because these drugs also may induce or aggravate sleep apnea in some cases, they should not be used in people with this condition. These are last-line drugs due to their side effects. In the majority of cases, there's no obvious cause of restless legs syndrome. This is known as idiopathic or primary restless legs syndrome, and it can run in families. Some neurologists specialists in treating conditions that affect the nervous system believe the symptoms of restless legs syndrome may have something to do with how the body handles a chemical called dopamine.
Dopamine is involved in controlling muscle movement and may be responsible for the involuntary leg movements associated with restless legs syndrome. In some cases, restless legs syndrome is caused by an underlying health condition, such as iron deficiency anaemia or kidney failure. This is known as secondary restless legs syndrome.
There's also a link between restless legs syndrome and pregnancy. About 1 in 5 pregnant women will experience symptoms in the last 3 months of their pregnancy, although it's not clear exactly why this is.
In such cases, restless legs syndrome usually disappears after the woman has given birth. Find out more about the causes of restless legs syndrome. Mild cases of restless legs syndrome that are not linked to an underlying health condition may not require any treatment, other than making a few lifestyle changes.
If your symptoms are more severe, you may need medication to regulate the levels of dopamine and iron in your body.
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