Restless Legs Syndrome (RLS): Causes, Symptoms & More

Restless Legs Syndrome

What is restless legs syndrome?

Restless legs syndrome (RLS) is a neurological condition. Willis-Ekbom disease or RLS/WED, is another name for RLS.

RLS produces uncomfortable leg feelings as well as a strong desire to move them. Most people’s urges are stronger while they’re calm or trying to sleep.

For those with RLS, the most severe problem is that it disrupts sleep, producing daytime drowsiness and tiredness. If not treated, RLS and sleep loss can lead to other health issues, including depression.

According to the National Institute of Neurological Disorders and Stroke, RLS affects around 10% of Americans. It can strike at any age, although it is most common in middle age or later. RLS affects twice as many women as it does males.

A similar disorder known as periodic limb movement of sleep affects at least 80% of patients with RLS (PLMS). During sleep, PLMS causes the legs to twitch or jerk. It might occur as frequently as every 15 to 40 seconds and can last all night. Sleep deprivation is another side effect of PLMS.

Although there is no cure for RLS, medicines can help control symptoms.

Read: Central Sleep Apnea

Restless legs syndrome symptoms

The overwhelming need to move your legs, especially while you’re sitting quietly or laying in bed, is the most common symptom of RLS. You may also have strange feelings in your legs, such as tingling, crawling or tugging. These feelings may be relieved by moving about.

If you have moderate RLS, you may not have symptoms every night. These motions might be attributed to restlessness, anxiety or stress.

It’s difficult to overlook a more severe case of RLS. It may make more difficult even the most basic activities, such as going to the movies. A long airline journey may be exhausting.

Because symptoms are greater at night, people with RLS are more likely to have difficulties sleeping or staying asleep. Sleepiness, tiredness and sleep deprivation throughout the day can be harmful to your physical and mental health.

RLS symptoms generally affect both different parts of the body. However, they might affect only one side in certain persons. Restless legs syndrome symptoms may occur and go in mild instances. RLS can also impact other body parts, such as your limbs and head. The majority of persons with RLS experience worsening symptoms as they become older.

RLS sufferers frequently utilize movement to alleviate their symptoms. This might include tossing or pacing the floor and turning in bed. If you share a bed with someone, it’s possible that you’re disrupting their sleep too.

Read: Obstructive Sleep Apnea

What causes restless legs syndrome?

Most of the time, the restless legs syndrome causes are unknown. There might be a hereditary tendency as well as a trigger in the environment.

More than 40% of persons who have RLS have a family history of the disorder. In reality, RLS is linked to five different gene variations. Symptoms generally appear before the age of 40 when it runs in the family.

Even if your iron levels are normal, there may be a link between RLS and low amounts of iron in the brain.

RLS might be caused by a disturbance in the brain’s dopamine pathways. Dopamine is also linked to Parkinson’s disease. That might explain why so many patients with Parkinson’s disease also suffer from RLS. Both diseases are treated with some of the same medicines. These and other hypotheses are still being researched.

Certain drugs, such as coffee or alcohol, may cause or exacerbate symptoms. Medications used to address the following conditions might also be a factor:

RLS without an underlying cause is known as primary RLS. RLS, on the other hand, might be a symptom of another illness, such as neuropathy, diabetes or renal failure. If this is the case, addressing the underlying problem may be enough to alleviate RLS symptoms.

Read: Psychophysiological Insomnia

Risk factors for restless legs syndrome

Certain factors may put you at an increased risk for RLS. However, it’s unclear if any of these causes are responsible for RLS.

Here are a few examples:

  • Gender: RLS is twice as common in women as it is in males.
  • Age: RLS may strike anybody at any age, although it is more frequent and more severe after middle age.
  • Family history: If someone in your family has RLS, you’re more likely to have it.
  • Pregnancy: RLS affects some women during pregnancy, especially in the third trimester. This generally goes away after a few weeks.
  • Chronic diseases: RLS can be caused by a lot of conditions, including peripheral neuropathy, diabetes and renal failure. RLS symptoms are frequently relieved by treating the disease.
  • Medications: RLS symptoms may be triggered or worsened by antinausea, antipsychotic, antidepressant and antihistamine drugs.
  • Ethnicity: RLS can affect anybody, although it is more frequent among persons of Northern European ancestry.

RLS can have a negative impact on your entire health and enjoyment of life. If you have RLS and sleep deprivation, you will be more susceptible to:

  • Heart disease
  • Stroke
  • Diabetes
  • Kidney disease
  • Depression
  • Early death

Read: Chronic Insomnia Disorder

RLS Diagnosis

RLS cannot be confirmed or ruled out by a single test. Your symptoms will be used to make a major portion of the diagnosis.

All of the following has to be present to diagnose RLS:

  • A strong desire to move, often accompanied by strange feelings
  • Symptoms are worse at night and are moderate or non-existent in the morning.
  • When you try to relax or sleep, sensory symptoms are activated.
  • When you move, your sensory symptoms improve.

Even if all of the requirements are satisfied, you will almost certainly require a physical examination. Your doctor will want to rule out any other neurological issues that might be causing your symptoms.

Make sure to tell them about any over-the-counter or prescription drugs, as well as any supplements you’re taking. Also, let your doctor know if you have any recognized chronic illnesses.

Blood testing will look for iron deficiency and other abnormalities. You may be sent to a sleep expert, neurologist, or other specialists if there are any signs that something other than RLS is causing your symptoms.

Children who are unable to explain their symptoms may find it more difficult to be diagnosed with RLS.

Read: Dyssomnia

Treatment of RLS

Home remedies for restless legs syndrome

While home treatments are unlikely to entirely remove symptoms, they may help in their reduction. It may take a little practice to identify the most effective treatments.

Here are a few ideas to get you started:

  • Caffeine, alcohol and cigarettes should be consumed in moderation or not at all.
  • Maintain a consistent sleep routine by going to bed and waking up at the same time each week.
  • Every day, do some exercise by walking or swimming.
  • In the evening, massage or stretch your leg muscles.
  • Before going to bed, take a hot bath.
  • When you’re experiencing symptoms, use a heating pad or an ice pack.
  • Yoga or meditation are good options.

When planning activities that involve long periods of sitting, such as a plane trip or a car, try to schedule them earlier in the day rather than later.

Ask your doctor or a nutritionist how to modify your diet if you really have an iron or other nutritional deficit. Before using any dietary supplements, consult your doctor. Certain supplements might be dangerous if you are not lacking in them.

Even if you use medicine to treat RLS, these choices may be beneficial.

Related: Tips to Stop Restless Legs Syndrome

Medications for restless legs syndrome

RLS is not curable, although medication can help control symptoms. The following are some possibilities:

  • Drugs that boost dopamine levels (dopaminergic agents)
  • These drugs work by reducing the amount of movement in your legs.

Among the drugs in this category are:

  • Pramipexole (Mirapex)
  • Ropinirole (Requip)
  • Rotigotine (Neupro)

Mild lightheadedness and nausea are possible side effects. Over time, these medicines may become less effective. They can induce daytime drowsiness, impulse control problems, and a worsening of RLS symptoms in some persons.

Read: Sleep Terrors

Sleep aids and muscle relaxants (benzodiazepines)

These drugs won’t cure your problems, but they will help you relax and sleep well.

Among the drugs in this category are:

  • Clonazepam (Klonopin)
  • Eszopiclone (Lunesta)
  • Temazepam (Restoril)
  • Zaleplon (Sonata)
  • Zolpidem (Ambien)

Daytime drowsiness is one of the side effects.

Narcotics (opioids)

These medicines can help you relax and reduce discomfort and odd sensations.

Among the drugs in this category are:

  • Codeine
  • Oxycodone (Oxycontin)
  • Combined acetaminophen (Norco) and hydrocodone
  • Combined acetaminophen (Roxicet, Percocet) and oxycodone

Dizziness and nausea are two possible side effects. If you have sleep apnea, you should avoid using these items. These drugs are extremely strong and addictive.

Read: Circadian Rhythm Sleep Disorder


These medicines aid in the reduction of sensory disturbances:

  • Gabapentin (Neurontin)
  • Gabapentin enacarbil (Horizant)
  • Pregabalin (Lyrica)

Dizziness and tiredness are two possible side effects.

It might take several tries to find the right medicine. As your symptoms vary, your doctor will alter the medicine and dose.

Restless leg syndrome in kids

RLS can cause children to have the same tingling and tugging feelings in their legs as adults. However, they may have a difficult time expressing it. They could describe it as a “creepy-crawly” sensation.

RLS patients experience an excessive need to move their legs. They’re more prone to develop symptoms during the day than grownups.

RLS can disrupt sleep, which can have a negative impact on many aspects of life. RLS can make a kid appear inattentive, impatient or fidgety. They might be described as obnoxious or hyperactive. RLS can be diagnosed and treated to aid with these issues and enhance school performance.

Adult criteria must be met to diagnose RLS in kids under the age of 12:

  • A strong desire to move, often accompanied by odd feelings
  • At night, the symptoms get worse
  • When you try to relax or sleep, symptoms appear
  • When you move, your symptoms improve

In addition, the kid must be able to verbally explain the leg feelings.

Two of these have to be true otherwise:

  • There is a sleep disruption that is clinically diagnosed as being related to aging.
  • RLS was inherited from a biological parent or sibling.
  • A sleep study reveals a five-or-more-per-hour-of-sleep periodic limb movement index.

Any nutritional deficits must be remedied. Caffeine should be avoided by children with RLS, and appropriate nighttime routines should be developed.

Medications such as dopamine agonists, benzodiazepines and anticonvulsants may be administered if necessary.

Read: Depression in Children

RLS in pregnancy

RLS symptoms may appear for the first time during pregnancy, often in the third trimester. According to research, pregnant women may have a two to three times increased risk of RLS.

The reasons behind this aren’t entirely clear. Vitamin and mineral shortages, hormonal shifts and nerve compression are all factors.

Leg pains and insomnia are common side effects of pregnancy. It might be difficult to tell the difference between these symptoms and RLS. Consult your doctor if you’re pregnant and experiencing RLS symptoms. It’s possible that you’ll need to be checked for iron or other deficiencies.

You can also try any of the following home-care methods:

  • Sitting motionless for lengthy periods of time is not recommended, especially in the evening.
  • Even if it’s only a short walk in the afternoon, try to get some exercise every day.
  • Before going to bed, give your legs a massage or do some leg stretching exercises.
  • When your legs are troubling you, try applying heat or cold to them.
  • Maintain a consistent sleep pattern.
  • Antihistamines, caffeine, smoking and alcohol should all be avoided.
  • Ensure that your diet or prenatal vitamins provide you with all of the nutrients you require.
  • Some of the drugs used to treat RLS aren’t safe to take while pregnant.

RLS in pregnancy generally subsides after a few weeks before giving birth. If it doesn’t work, talk to your doctor about other options. If you’re breastfeeding, be careful to mention that.

Read: Depression During Pregnancy

Restless legs syndrome and sleep

It can be uncomfortable or painful to feel strange sensations in your legs. There is a high probability that you will not get to sleep or stay asleep due to those symptoms.

It is harmful to your health and well-being to be sleep deprived and fatigued.

You can also improve your chances of restful sleep by working with your doctor to find relief:

  • Make sure your mattress and pillows are in good condition. They may need to be replaced if they are old and lumpy. Additionally, purchasing comfortable sheets, blankets, and pajamas is a good investment.
  • Keep outside light out of windows with drapes or shades.
  • Do not place any digital devices near your bed, including clocks.
  • Remove bedroom clutter.
  • Stay cool in your bedroom to avoid overheating.
  • Organize your sleep schedule. Whether it’s on weekends or not, try to get up and go to bed at the same time every morning. It will support the natural rhythm of sleep.
  • It is recommended that you stop using electronic devices one hour before you go to sleep.
  • Spend some time massaging your legs before bedtime or taking a hot bath.
  • Put a pillow between your legs while you sleep. The treatment might prevent nerve compression and the onset of symptoms.

Facts and statistics about restless leg syndrome

According to the National Institute of Neurological Disorders and Stroke, RLS affects around 10% of Americans. One million school-aged children are included in this figure.

RLS affects 35% of persons before they reach the age of 20. By the age of ten, one out of every ten children had symptoms. With age, symptoms tend to worsen.

The rate of occurrence is twice as high in women as it is in males. Pregnant women may face a two- to three times increase in risk compared to the general population.

Northern Europeans are more likely to have it than persons of other ethnicities.

Antihistamines, antinausea, antidepressants and antipsychotic drugs can all cause or exacerbate RLS symptoms.

RLS is associated with a problem known as periodic limb movement of sleep, which affects around 80% of people (PLMS). During sleep, PLMS causes involuntary limb twitching or jerking every 15 to 40 seconds. The majority of persons who have PLMS do not have RLS.

RLS is caused by a variety of factors that aren’t always evident. However, more than 40% of persons with RLS have a familial history of the disorder. Symptoms generally appear before the age of 40 when it runs in the family.

RLS is linked to five different gene variations. About 75% of persons with RLS have a variation in the BTBD9 gene that is linked to an increased risk of RLS. It’s also found in around 65% of persons who don’t have RLS.

RLS has no known treatment. Medications and lifestyle changes, on the other hand, can help control symptoms.


The symptoms of RLS can range from barely bothersome to incapacitating, although they do not lead to other serious conditions. Sleeping is difficult for many people with RLS.

It is possible to experience depression as a result of severe RLS, which can significantly impair life quality. Those who suffer from insomnia may feel drowsy during the day, but those who suffer from RLS may find it impossible to nap.

Prognosis of restless legs syndrome

There is no cure for restless legs syndrome, but it can get worse as you age. However, some people have remissions that last from a few days to a few years.

Make sure your doctor knows how you’re doing. They may recommend changing your lifestyle or prescribing medication if you begin to feel worse.

You may find it helpful to talk to someone who understands what you’re experiencing, such as a family member with RLS or someone from a support group.

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