Do You Have Restless Legs?

IT’S nighttime. You are comfortable and relaxed in your bed. Then it begins—that crawling feeling in your legs. You cannot ignore it. The only way to find relief is to get up and move around. Walking helps, but when you lie down again, the sensation returns. You want to sleep, but you cannot. If this sounds like something you experience, you are not alone. For example, perhaps as much as 15 percent of the U.S. population live with this condition.

Though many doctors today fail to diagnose or properly treat this disorder, it is not new. In 1685 a doctor wrote of those who after going to bed feel “so great a Restlessness” in their arms and legs that they “are no more able to sleep, than if they were in a Place of the greatest Torture.”

Part of the problem in recognizing this disorder is that there is no laboratory test that can determine if a person has it. It is identified by the symptoms it produces. A knowledgeable doctor may ask: ‘Do you feel the crawling sensation in one leg or both? Do you ever feel it in your arms? Does the discomfort go away if you get up and walk, take a bath, or massage your legs? Does the unpleasant sensation sometimes occur if you have to sit for a long period, such as in a car or an airplane? Does it bother you most at night? Do any of your family members experience the same problem? Does your mate say that you sometimes jerk your legs when you are asleep?’ If your answer to some of these questions is yes, the doctor may conclude that you have restless legs syndrome (RLS).

Those Who Have It

For some, RLS is a mild disorder with occasional symptoms. For others, it is much more serious, causing chronic insomnia resulting in daytime fatigue that interferes significantly with everyday life. Said one victim: “I feel as if worms are creeping and crawling in my legs. I need to wiggle my legs to make the feelings go away.”

 RLS affects both sexes and is most common and more severe in older people. Most often it is diagnosed in people in their 50’s, though often the symptoms appear decades earlier. Sometimes symptoms can be traced back to childhood. Often, though, RLS goes unrecognized in children. Because they can’t sit still or are constantly fidgeting, young people with RLS are frequently labeled as “hyperactive.”

Though experts recognize RLS to be a neurological disorder, its cause is difficult to pinpoint. In most of those who have it, the cause is unknown. RLS has, however, been linked to certain factors. For example, RLS runs in families, passing genetically from parents to their children. Some pregnant women experience RLS symptoms, especially during the last months of pregnancy. After delivery, the disorder usually disappears. Sometimes medical disorders, such as low iron levels or a lack of certain vitamins, trigger RLS discomfort. Chronic disease may also cause RLS symptoms—particularly kidney failure, diabetes, rheumatoid arthritis, and peripheral neuropathy, damage to the nerves in the hands and the feet.

The Search for Relief

Sadly, there is no cure for RLS, and the symptoms often worsen over the years. However, the good news is that RLS can be treated effectively, often without drugs. There is no one solution; what works for one person may not work for another. Those who have it need to find what habits, activities, or medications either worsen the symptoms or improve them.

A first step in treatment is to decide if there is some correctable medical condition that is causing RLS symptoms. For those who have an iron or vitamin deficiency, supplementing the diet with iron or vitamin B₁₂ may be all that is needed to relieve RLS symptoms. However, taking too many vitamins and minerals can endanger one’s health. Thus, a health-care provider should be involved in deciding whether a person should have iron or vitamin supplements.

In some people caffeine aggravates RLS symptoms. Coffee, tea, chocolate, and many soft drinks contain caffeine. Cutting back on caffeine or cutting it out may help to improve or eliminate RLS symptoms. Alcohol consumption too usually increases the span or intensity of symptoms. By reducing alcohol in the diet or eliminating it, some find relief.

Living With RLS

If you have RLS, life-style changes may help you. Since fatigue and drowsiness often make symptoms worse, a consistent sleep routine can be a real help. If possible, it’s best to have a sleeping environment that is quiet, cool, and comfortable. Going to bed at the same time every evening and waking up at the same time every morning also help.

A regular exercise program will help you get a good night’s sleep. However, vigorous exercise within the six hours before you go to bed may have the opposite effect. Some with RLS find that moderate exercise immediately before bedtime helps them sleep. Experiment with various exercises to discover what is best for you.

Don’t fight the urge to move. If you try to suppress movement, the symptoms usually worsen. Often the best solution is to get out of bed and move about. Some find a measure of relief in walking, stretching, bathing in hot or cold water, or massaging their legs. If you have to sit for a long time, such as when traveling, it may help if you keep your mind actively engaged in reading.

What about medication? The Restless Legs Syndrome Foundation, located in Raleigh, North Carolina, U.S.A., says that “the institution of pharmacologic [drug] therapy may become necessary.” Since there is no one medication that is effective for all who suffer from RLS, your health-care provider may need to find the one that works best for you. Some find that a combination of medications is most effective. Sometimes a medication that works for a while loses its effectiveness. Since taking drugs and especially combinations of drugs carries health risks, it is important to work closely with your health-care provider to determine what works best for you.