Better Me

I Can’t Sleep. Is This Restless Legs Syndrome?

It’s the middle of the night, you’re exhausted, but your legs won’t stop moving. We’ve all felt something like this after a long day of hiking or after forgetting to apply sunscreen to your legs. But for some, this is a nightly routine leading to daytime sleepiness and mental fatigue. If you are frequently feeling the irresistible urge to move your legs while you try to fall asleep, you may be experiencing restless legs syndrome (RLS), also known as the medical condition called Willis-Ekbom disease.

To help answer questions about this often mysterious condition, we spoke with Joyce Lee-Iannotti, MD, a neurologist and sleep specialist with Banner Brain & Spine.

What does restless legs syndrome feel like?

“Restless legs syndrome feels a little different for every person,” said Dr. Lee-Iannotti. “But most describe a tingling or the uncomfortable sensation in the legs of ants crawling on them. For some it can feel like pins and needles. In some cases, the feeling may progress beyond simple sensations to be painful.”

Dr. Lee-Iannotti commented that as much as 10% of the U.S. could be suffering from RLS, however the condition is sometimes misdiagnosed. A condition called periodic limb movement disorder has similar symptoms and can also occur alongside RLS. Even more often, patients never bring the issues to their doctor’s attention. RLS tends to develop slowly, over decades. However, if left untreated the symptoms can become severe. In advanced cases, nights become extremely stressful and symptoms can persist throughout the day, spreading from the legs to other extremities.

How is RLS diagnosed?

Dr. Lee-Iannotti mentioned “the first thing we do is rule out any other causes for the discomfort. In some cases, the sensations may be associated with leg cramps, arthritis or neuropathy.” There are subtle details to pay attention to when diagnosing RLS. The four basic criteria for diagnosis of RLS include the following:

  • Symptoms include an overwhelming urge to move your legs, associated with a discomfort or unusual feeling
  • Symptoms usually worsen at rest
  • Discomfort typically goes away, either partially or totally, with movement
  • The urge starts or gets worse in the evening

Depending on your situation, your physician may recommend participation in a sleep study. During these studies, you will be given a private room with a comfortable bed and everything you need to rest. These studies can reveal a lot about your sleep that you’ve never noticed. Dr. Lee-Iannotti is an expert in creating a welcoming, relaxing environment where you can sleep naturally without the pressure of feeling “watched.”

What causes RLS?

The cause of restless legs syndrome is often unknown, but there are a few easily remedied causes to look for right away. Dr. Lee-Iannotti said that people with an iron deficiency, pregnant women and sometimes vegans, are more likely to complain about RLS symptoms. “Anti-depressants or allergy medication can also worsen the symptoms of RLS,” added Dr. Lee-Iannotti. “Smoking, excessive alcohol use and heavy caffeine consumption will also make living with RLS much more difficult."

How is it treated?

“People with RLS have many options,” said Dr. Lee-Iannotti. “There are pharmacological and non-pharmacological methods of treatment, depending on the severity of the symptoms. If mild, simple changes in lifestyle including increased exercise, improving sleep hygiene and avoiding caffeine, tobacco, and alcohol may be solutions. If moderate or severe, medications including dopaminergic drugs can be used to help relieve symptoms, discomfort and improve sleep.

Overall, the prognosis with proper treatment of RLS is good. Any condition that robs you of healthy sleep will lead to further complications. A tired brain is more likely to experience depression, anxiety and poor workplace performance. With time, these effects can damage your internal organs and physical health. Visit your doctor immediately to recover your ability to rest. In fact, restoring healthy sleep habits is key in reducing the symptoms of RLS.

Could RLS be linked to anything else?

Restless legs syndrome is considered both a movement and sleep disorder. But at its root, it is a neurological disorder, with symptoms originating in the brain. Dr. Lee-Iannotti stated, “we have found RLS to be related to low production of dopamine, a powerful chemical affecting motor skills and many other functions of your brain. This gives us reason to believe that RLS may be linked to Parkinson’s disease, a degenerative condition that can cause tremors and other motor impairments.”

Get some rest

“Restless legs syndrome is real,” assured Dr. Lee-Iannotti. “There are few things more important to your health and quality of life than getting adequate rest. Speak with your primary care physician and ask them if a sleep medicine consultation or a sleep study is appropriate for you. The symptoms that people with restless leg syndrome are experiencing are easily treatable in almost every case. You don’t have to feel this way forever.”

Other useful articles:

Sleep Neurosciences Brain and Spine