Restless legs syndrome

About 5-15 per cent of people may have trouble getting to sleep because they suffer from restless legs syndrome (RLS).

Symptoms of restless legs syndrome

People with RLS report feeling unpleasant sensations in their legs causing a compelling need to move the legs. Both legs are usually affected but it is possible to experience the sensations in only one leg. Occasionally the arms or other body parts are involved as well.

The symptoms are often described as general uneasiness or discomfort, with tingling, itching, burning, crawling, or twitching sensations. Symptoms can be mild, moderate or severe, and while they can be felt at any time, they seem to occur more often when the person is sitting or lying quietly and often when trying to get to sleep. Because the unpleasant sensations are relieved by movement, people with RLS tend to move their legs around a lot.

RLS can result in insomnia and this is usually due to trouble falling and staying asleep.

Causes of restless legs syndrome

The cause of RLS is not known, although it sometimes occurs in the presence of a wide range of other medical conditions, including iron-deficiency anaemia, kidney disease, diabetes and arthritis. However, most people with RLS are otherwise healthy.

RLS is more common in women and older people (but it can occur at any age). Some women experience RLS for the first time in pregnancy, particularly in the third trimester. The condition usually goes away after the baby is born.

Certain drugs, such as antipsychotics and antidepressants, can increase leg restlessness in some people.

Restless legs syndrome treatment

The first steps your doctor will take in treating your RLS will be to make sure the diagnosis is accurate and address any factors that could possibly be causing the problem or making it worse. The symptoms of RLS need to be distinguished from arthritis pain, muscle cramps and the numbness associated with a peripheral neuropathy (a problem with the nerves). Discussion with your doctor will also help to determine whether any medicines you are taking could be contributing to the symptoms of RLS.

Successfully managing an underlying condition such as iron deficiency anaemia or diabetes can sometimes help relieve the symptoms of RLS.

Developing healthy sleep patterns (also known as sleep hygiene) can be very helpful in mild cases of RLS. This includes such things as trying to establish a regular bedtime, avoiding caffeinated drinks after lunch, and avoiding excessive alcohol intake and tobacco. Doing a relaxing and quiet activity before bed, such as a crossword or reading a book can be helpful as can having a light snack before bed.

If your symptoms are severe and persistent, there are a number of medicines that might help.

Two medicines called ropinirole (brand names Repreve, Appese and Ropaccord) and pramipexole (brand names Sifrol and Simpipex) are approved specifically for the treatment of restless legs syndrome. These medicines may cause side effects such as stomach upset, dry mouth or nausea.

Other medicines used to treat RLS include medicines more commonly used to treat Parkinson’s disease, as well as medicines such as clonazepam. These medicines are not registered in Australia for treating RLS, so they should only be considered after careful discussion with your doctor, and taken under medical supervision.

Last Reviewed: 19 December 2012
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References

1. Mayo Clinic. Restless legs syndrome. Last updated Jan 19 2012. http://www.mayoclinic.com/health/restless-legs-syndrome/DS00191 (accessed Feb 2013).
2. eTherapeutic Guidelines complete. Periodic limb movements of sleep/wakefulness and restless legs syndrome. Last updated Oct 2008. http://online.tg.org.au/complete/tgc.htm# (accessed Feb 2013).
3. Australian Prescriber. August 2008: 31: 90-93. Thyagarajan D. Restless legs syndrome. http://www.australianprescriber.com/magazine/31/4/article/967.pdf (accessed Feb 2013).
4. eMIMS. Feb 2013. Prescribing Information for Appese, Repreve, Ropaccord, Sifrol, Simipex. Accessed Feb 2013).
5. NINDS. Restless legs syndrome. Last updated 25 Nov 2011. http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm (accessed Feb 2013).
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