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What Is Restless Legs Syndrome?

They arrive soon after you lie down to sleep: strange sensations creeping through your legs. People variously describe the sensations as tugging, pulling, tingling, stinging, throbbing, itching, or aching; others say it feels as if something is crawling or flowing inside their legs.

The sensations produce a near-irresistible urge to get up and move around. This temporarily alleviates the problem, but it returns when you lie back down. It disrupts your sleep and can disturb your sleeping partner.

Called restless legs syndrome (RLS)—or, more formally, Willis-Eckbom disease—the condition is best characterized as a neurological sensory disorder with symptoms that are produced from within the brain itself. Experts say that for most folks, it’s mild and readily self-managed without medical intervention.

However, for some, restless legs syndrome can be severe and disabling (primarily because of long-term sleep deprivation). The lack of sleep can affect concentration and memory, relationships, work productivity, and even anxiety and depression.

What Causes Restless Legs Syndrome?

Although researchers say RLS involves the neurotransmitter dopamine, they don’t understand what causes the condition in most cases. They say it may have a genetic component, may result from iron-deficiency anemia, and may worsen in stressful situations.

As well as iron deficiency, it may be worsened by alcohol, nicotine, and caffeine. It may also be triggered by certain prescription drugs (for antinausea, antipsychosis, antidepression) and some over-the-counter medications for colds and allergies that contain older antihistamines such as diphenhydramine.

Sleep deprivation and other sleep conditions like sleep apnea also may aggravate or trigger symptoms in some people.  Reducing or completely eliminating these factors may relieve symptoms.

It can also co-occur with serious medical conditions (including cardiovascular disease, diabetes, and neurological disease such as Parkinson’s disease), which medical experts say should be ruled out when RLS is severe.

But the same experts stress that while a diagnosis of RLS may accompany a serious disease, it doesn’t imply the presence or impending onset of one.

Restless legs syndrome can affect people of any age. It affects women twice as often as men, and is especially prevalent during pregnancy, though in those cases it typically disappears after the baby is born. Some people experience RLS as a chronic condition, either continuous or intermittent, and for those it tends to worsen with age.

Is Restless Legs Syndrome Underdiagnosed or Overhyped?  

Many websites and print articles describe RLS as common, underdiagnosed, and undertreated, encouraging people who experience the unpleasant condition to seek medical help.

But a 2006 Public Library of Science (PLOS) article, , makes the case that RLS has been overhyped by drug-company marketing campaigns. They write: “For some people, symptoms are severe enough to be disabling. But for many others with milder problems, these ‘symptoms’ are just the transient experiences of everyday life.”

Non-Drug Therapies for Restless Legs Syndrome

Fortunately, most cases of RLS can be treated with non-drug therapies such as lifestyle changes. Here are some therapies that medical professionals have found helpful with patients:

• Iron supplementation usually helpful for those who find they have low or low-normal blood tests called ferritin and transferrin saturation. Iron supplements are available over-the-counter. 
• Cold or heat packs applied to the legs.
• Moderate daily exercise with special attention to leg-stretching exercises.
• Stretching/massaging legs and feet after exercise and before going to bed.
• A cool shower or warm bath before bed.
• Decreasing the use of alcohol and tobacco. 
• Foot wraps that put pressure underneath the foot (approved by FDA)
• Daily meditation, especially a full or shortened version of the .
• . 
• Going to bed later and sleeping later into the morning. For many, the symptoms abate in the morning hours. Get more information on sleep deprivation and sleeping better.
• Find out how to treat nighttime leg cramps.

As with drug therapy, research hasn’t shown that any of these remedies can prevent or cure restless legs syndrome. But they don’t cost anything to try, and aren’t likely to produce dangerous side effects.

Medical Treatments for Restless Legs Syndrome

In recent years, physicians have begun using a broad array of drugs to treat “moderate-to-severe” RLS.  Both anti-seizure drugs and dopaminergic agents have been approved by the FDA, as well as some more serious drugs. There’s also an FDA-approved  that helps some people but can make the condition worse in others.

But relative to drug therapy, researchers say:

• No single drug works for all people.
• None offers a cure for restless legs syndrome.
• Most are recommended for short-term use only.
• Most have serious side effects.
• The drugs can be expensive.

Reviewing a study of current drug treatments for RLS, one medical reviewer noted that even though many people taking these drugs experience short-term relief of RLS symptoms, “Up to 25 to 50 percent with even moderate-to-severe and longstanding symptoms stop taking these medications after more than a year due to either side effects or lack of benefit.”

Learn More

We hope this helps you understand the basic symptoms, causes, and non-medical treatments for Restless Legs Syndrome. To dig deeper and learn more about RLS, we refer you to  and the  as well as your own medical professional. To explore treatments, speak to your physician.

Do you have any tips for dealing with restless legs syndrome? Let us know below!