Restless Legs Syndrome

What Is It?

Restless legs syndrome is a movement disorder that causes uncomfortable sensations in the legs. These sensations typically are worse during periods of rest, especially just before sleeping at night, but they may happen during daytime periods of inactivity, such as watching a movie, attending a long business meeting, or flying in a plane. Whenever the discomfort of restless legs syndrome occurs, it is usually accompanied by an overwhelming urge to move the legs, and this movement may relieve leg discomfort temporarily. At night, people with restless legs syndrome often find that their leg symptoms make it difficult to fall asleep. Because of this, insomnia is common, together with extreme drowsiness and fatigue during the daytime.

The cause of restless legs syndrome remains unknown. However, evidence suggests that there is dysfunction in dopamine pathways in the brain. Since restless legs syndrome tends to occur in several generations of an affected family, scientists suspect that there is some genetic (inherited) risk for the problem. In some people with restless legs syndrome, anemia or vitamin deficiency may be a contributing factor, while in others restless legs syndrome has been linked to pregnancy, diabetes, rheumatoid arthritis, kidney failure, varicose veins or peripheral neuropathy (nerve damage in the hands and feet). High caffeine intake (coffee, tea, cola beverages, chocolate) also may be related to restless legs syndrome. Although restless legs syndrome tends to be more common and more severe in people over age 50, it can occur in men and women of any age group, even in young people who may be misdiagnosed as hyperactive. Currently, tens of thousands of people in the United States have restless legs syndrome that is severe enough to disrupt normal daily life. However, researchers estimate that even more people — possibly up to 3 percent to 8 percent of the U.S. population — may have occasional, milder symptoms of restless legs syndrome.

Symptoms

Restless legs syndrome causes a wide range of uncomfortable leg sensations, which may be described as any of the following: tingling, prickly, wormy, boring, crawling, pulling, drawing and, sometimes, pain. Although the muscles of the lower legs are affected most often, restless legs syndrome occasionally can cause symptoms in the arms as well. The discomfort of restless legs syndrome is almost always accompanied by an irresistible need to move the legs, and leg movement, such as walking, stretching and deep knee bends, seems to bring temporary relief. A leg massage or a warm bath also may help.

In addition to leg discomfort, restless legs syndrome also can cause periodic jerking leg movements during sleep. These involuntary leg movements often disturb both the patient and the patient's bed partner. Also, because symptoms of restless legs syndrome tend to be worse at bedtime, people with restless legs syndrome may find it hard to fall asleep and to stay asleep. This can cause chronic insomnia and severe daytime drowsiness that may interfere significantly with work, school and social life.