Restless Legs Syndrome (RLS)

What is restless legs syndrome (RLS)?

Restless legs syndrome (RLS), also called Willis-Ekbom disease, is a neurological sleep disorder that causes an uncomfortable urge to move your legs. Many people describe a crawling, tingling, itching, pulling or burning feeling deep in the legs, especially at night. 

Symptoms usually start or get worse when you are resting - such as sitting, lying down or trying to fall asleep. Moving your legs, walking or stretching may bring temporary relief, but the sensations often return when you stop. 

Who gets restless legs syndrome?

RLS is common and can affect anyone. However, it’s more likely to develop in:

• Women
• People who are white
• Adults over age 40

Children can also have RLS, especially if there’s a family history. In kids, it’s sometimes mistaken for growing pains or attention-deficit/hyperactivity disorder (ADHD).

RLS symptoms can be:

• Mild (occasional discomfort)
• Moderate (a few times a week)
• Severe (multiple times a week or nightly)

Severe RLS can disrupt your sleep, daily routine and quality of life.

What causes restless legs syndrome?

RLS can be linked to several underlying factors:

Genetics

RLS often runs in families, though researchers are still studying how the genetic component works.

Dopamine imbalance

Dopamine is a brain chemical that helps control movement. If your dopamine levels are off, or if your brain has trouble processing dopamine signals, you may develop RLS. Medications that regulate dopamine may help.

Low iron levels

Iron is essential for dopamine production. Conditions like anemia or chronic kidney disease can lead to iron deficiency and increase your risk for RLS.

Other medical conditions

Health issues that may contribute to or worsen RLS include:

• Peripheral neuropathy (nerve damage)
• Kidney failure
• Spinal cord disorders
• Sleep apnea
• Substance use disorder
• Parkinson’s disease
• Periodic limb movement disorder (involuntary leg movements during sleep)

Pregnancy

Some people experience RLS during pregnancy, especially in the third trimester. These symptoms usually go away after giving birth.

What can make restless legs syndrome worse? 

Certain factors may trigger or worsen symptoms, including: 

• Lack of sleep 
• Stress 
• Caffeine 
• Alcohol 
• Some medications, including certain antihistamines and antidepressants 
• Long periods of inactivity 

Reducing triggers and improving sleep habits can help manage symptoms. 

Primary vs. secondary restless legs syndrome 

Some people have primary RLS, meaning it develops on its own and often runs in families. 

Others have secondary RLS, which is linked to another condition such as iron deficiency, kidney disease or pregnancy. Treating the underlying condition may improve symptoms. 

Your provider may check your iron levels with a blood test, even if you don’t have anemia.

What are the symptoms of restless legs syndrome?

RLS symptoms can be difficult to describe but often include: 

• Crawling or creeping sensations under the skin 
• Tingling or “pins and needles” 
• Burning, aching or throbbing 
• Pulling, tugging or jerking feelings 
• A strong urge to move the legs 

Symptoms typically: 

• Start or worsen during rest 
• Are more noticeable in the evening or at night 
• Improve with movement 
• Return once movement stops 

RLS can also: 

• Make it hard to fall asleep or stay asleep 
• Disrupt naps or daytime rest 
• Be triggered by long periods of sitting, such as travel 

Over time, poor sleep may lead to daytime fatigue, mood changes, trouble concentrating and reduced performance at work or school.   

When should you see a doctor for restless legs syndrome? 

Talk to a health care provider if: 

• You have ongoing leg sensations that happen during rest 
• Symptoms interfere with your sleep 
• You feel tired, irritable or unfocused during the day 
• Symptoms are getting worse over time 
• Self-care measures are not helping 

Getting evaluated can help rule out underlying conditions such as iron deficiency or sleep disorders. 

Frequently asked questions about restless legs syndrome 

Is restless legs syndrome serious? 

RLS is not life-threatening, but it can significantly affect sleep and quality of life. 

Does restless legs syndrome go away? 

Some people experience improvement over time. Others may need ongoing management. 

Is RLS hereditary? 

Yes. Many people with early-onset RLS have a family history. 

Can children have restless legs syndrome? 

Yes. RLS can affect children and is sometimes mistaken for growing pains or ADHD.

Find relief from restless legs syndrome

If restless legs are keeping you awake or affecting your daily life, our sleep medicine and neurology specialists can help. We’ll review your symptoms, check for underlying causes and recommend treatment options tailored to you.

Treatment may include lifestyle changes, iron therapy if needed, medications or a sleep study in some cases.

Learn more about diagnosing and treating restless legs syndrome or schedule an appointment to get started.