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Types of Sleeping Disorders
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Sleeping Problems (Home) > Types of Sleeping Disorders > Restless Legs Syndrome
Restless Legs Syndrome (RLS): Information, Symptoms and Causes
Restless Legs Syndrome (RLS) (also called Wittmaack-Ekbom's Syndrome, which is not to be confused with Ekbom's Syndrome) is a neurological sleep disorder that involves an irresistible and uncontrollable urge to move in order to stop uncomfortable, painful, or odd sensations in the body, most commonly in the legs. Moving the affected body part eliminates the sensation, providing temporary relief. However, the sensations and urge to move may return immediately after ceasing movement, or at a later time. RLS can start at any age, including early childhood, and is a progressive disease (it gets worse with age) for a certain percentage of sufferers.RLS is a poorly understood disorder and often misdiagnosed disorder.
There are two types of Restless Legs Syndrome (RLS)
- Primary RLS
- Secondary RLS
Primary RLS has a slow onset that starts before the age of 40 or 45, but it can occur much earlier, and even develop is rare cases as early as the first year of life. The symptoms of Primary RLS may disappear for months or even years at a time, but they always return. Primary RLS is usually progressive and gets worse as the person ages.
Secondary RLS often has a sudden onset and the symptoms may occur daily from the very start. Secondary RLS usually occurs after the age of 40, however it can occur earlier in life. Secondary RLS is often associated or linked with specific medical conditions and the use of certain drugs.
Often RLS sufferers think they are the only ones to be afflicted by this peculiar condition, and are often relieved when they find out that they are not alone, and that many others also suffer from it. The severity and frequency of the disorder can vary tremendously. Many people only experience symptoms when they try to sleep, while other experience symptoms during the day. It is common for RLS sufferers to experience symptoms on long car rides or during long periods of inactivity, such as when watching television or a movie, attending a musical or theatrical performance, and so on.
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Random Sleeping Tip |
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Symptoms
The International Restless Legs Syndrome Study Group (IRLSSG) has identified the following four criteria which must be present for an RLS diagnosis:
- An urge to move, usually due to uncomfortable sensations that occur primarily in the legs. The sensations are unusual and unlike other common sensation, and people with RLS have a hard time describing them. People use words such as: uncomfortable, electrical, creeping, painful, itching, pulling, creepy-crawly, and many other adjectives. The sensation and the urge can occur in any body part but is most common in the legs, followed by the arms. Some people have little or no sensation, yet still have a strong urge to move.
- Motor restlessness, expressed as activity, that relieves the urge to move. Movement, such as walking, stretching, yoga, cycling, and other physical activity, may help bring immediate relief for the symptoms, although often this relief is only temporary. Sometimes a specific type of movement will help one person more than another.
- Worsening of symptoms by relaxation. Any type of inactivity, such as sitting, lying down, reading a book, watching TV, and so on, can trigger the sensations and the urge to move. However, this depends on several factors, such as the severity of the person's RLS, the degree of restfulness, the duration of the inactivity, the time of day, and so on.
- Variability over the course of the day-night cycle, with symptoms worse in the evening and early in the night. While some people only experience RLS at bedtime, others may experience the symptoms of RLS at all times of the day and night. However, almost all RLS sufferers notice that their symptoms are worst in the evening and the least noticeable during the early to mid morning.
Causes
No one has discovered the exact cause(s) of Primary RLS at this time. However, there does seem to be a genetic link, with a high incidence of familial cases.
Also, various research and brain autopsies have implicated both the dopaminergic system and iron deficiency in the substantia nigra as possible causes for RLS. Iron is involved in the formation of dopamine.
In addition, both Primary RLS and Secondary RLS can be aggravated by injuries and almost any kind of surgery, especially back surgery and back injury.
Secondary RLS is also associated or linked with specific medical conditions and the use of certain medications and drugs, as follows:
- Medical Conditions: include: pregnancy, iron deficiency, folate deficiency, uremia, diabetes, thyroid problems, peripheral neuropathy, and certain auto-immune disorders, such as Sjogren's Disease, Celiac Disease, and Rheumatoid Arthritis. Treatment of the underlying medical condition(s) usually eliminates the Secondary RLS.
- Medications: Various medications may worsen RLS in those who already have it, or cause it secondarily. These medications include: anti-nausea drugs, certain antihistamines (which are often contained in over-the-counter cold medications), drugs used to treat depression (both older tricyclics and newer SSRIs), antipsychotic drugs, and certain medications used to control seizures.
Ethnic factors (such as race and diet) may also play a role in the occurrence and causes of RLS. For example, approximately 10% of adults in North America and Europe experience RLS, while, according to the National Sleep Foundation, the condition has a lower prevalence in India, Japan and Singapore.
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