Can't sleep; can't rest...
What is the Restless Legs Syndrome / Willis-Ekbom Disease (RLS/WED)?
Restless legs syndrome is a common condition characterised by 4 main symptoms:
1. A need to move the legs, usually accompanied or caused by uncomfortable, unpleasant sensations in the legs. Sometimes the need to move is present without the uncomfortable sensations and sometimes the arms or other body parts are involved in addition to the legs.
2. The need to move and unpleasant sensations are exclusively present or worsen during periods of rest or inactivity such as lying or sitting.
3. The need to move and unpleasant sensations are partially or totally relieved by movement such as walking or stretching at least as long as the activity continues.
4. The need to move and unpleasant sensations are generally worse or exclusively occur in the evening or night.
How common is RLS?
Whilst most people will have experienced these symptoms at some stage in their life, such as during pregnancy, restless legs becomes a problem when symptoms occur most days and result in difficulty getting to sleep or sleep disturbance. This occurs in around 5% of the population, and when symptoms are this frequent and disturb sleep, people should seek help, as effective treatments are available for this disabling condition.
How do you assess RLS?
Assessment of patients with restless legs symptoms requires a careful clinical evaluation, completing an RLS Rating Scale, ensuring iron levels are adequate with a blood test, and usually a sleep study to characterise the leg movements and look for co-existing conditions that can worsen restless legs such as sleep apnea.
What treatments are available for RLS?
Restless legs symptoms can be improved by iron replacement if iron levels are low, and simple measures such walking or pacing can provide short-term relief. Frequent or severe symptoms can be treated with daily medication, usually taken at night 1-2 hours before symptoms usually develop. A number of medications are effective, and in more severe cases a combination of medications may be required. The medications that can be used include dopamine agonists, anti-epileptics such as gabapentin/pregabalin, opiates and benzodiazepines.