Approximately seven to 10% of Americans have restless legs syndrome (RLS) – also known as Willis-Ekbom disease – according to the National Institute of Neurological Disorders and Stroke (NINDS).
RLS is characterized by an overwhelming sensation to constantly move the legs and is worse at night, which causes those with RLS to lose sleep, develop a mental fog and feel fatigued. NINDS reports that untreated moderate to severe RLS can lead to nearly a 20% decrease in work productivity and can contribute to depression and anxiety.
“Restless legs syndrome can be described as many different things by different individuals,” says Chee Yoon Bauer, MD, pediatric sleep medicine specialist with Oklahoma Children’s Hospital – OU Health. “People say their legs have discomfort, pain, cramps, etc., but it is diagnosed when the person’s symptoms meet a specific set of criteria. [RLS] is an uncomfortable feeling caused by an urge to move the legs, rather than actual pain or cramps that may stem from other causes.”
When a person keeps their legs in motion, the ‘urge’ gets better, but quickly returns when they keep their legs still. This overwhelming feeling of restlessness occurs more frequently during the evening and night but can also happen when a person is sitting for a long period of time, such as during travel or when watching a movie.
“Also, despite the name of the condition, sometimes arms and other parts of the body can also be affected,” says Bauer, adding that a sleep study is not needed to diagnose RLS.
According to NINDS, more than 80% of RLS patients also experience periodic limb movement of sleep (PLMS) – a condition where the legs, and sometimes the arms, involuntarily twitch or jerk often, every 15 to 40 seconds, throughout the night. However, while many people with RLS develop PLMS, most individuals with PLMS do not experience RLS.
Bauer says RLS is more common in older adults, but can afflict younger people with a family history. For individuals with that family history, symptoms may begin to appear in their twenties or thirties.
“For adults, prevalence is twice as high in women than in men, but in children, girls and boys seem to be equally affected,” she says. “Some other conditions that may increase your risk of having RLS include iron deficiency, pregnancy and chronic renal failure. Some medications like antidepressants can also cause you to have RLS.”
When treating RLS, Bauer says that typically the first thing to do is to optimize the body’s iron storage.
“This is done with iron supplementation to increase the ferritin above a certain level,” she says. “If you continue to have RLS symptoms despite adequate iron storage, then medications would be indicated. For adults, we often start with a medication called ropinirole. For children, we would trial a medication called gabapentin.”
While there is no cure for RLS, there are many treatments available that can ease symptoms. In addition, some individuals may have periods of remission and go without symptoms for days, weeks, months or years.