From sleep paralysis to exploding head syndrome, there are a number of very strange sleep disorders. Perhaps one of the most mysterious though is restless leg syndrome (RLS). Its mystique is exacerbated by fact that it affects up to 15% of the population, and we do not know its exact causes. What exactly is RLS? This week’s post takes a look at the profile of RLS, its deleterious effects, potential causes, and treatments.
RLS is characterized by tingly sensations in the lower legs, often between the knees and ankles. The sensations occur when an individual is still for any length of time and are relieved by getting up and moving around. These creepy crawly feelings can last for hours, often forcing people to continuously move late into the night. Specific leg movements may include jerky movements of the legs and flexion of the hips, knees, ankles, and toes (click here for a video of RLS symptoms).
RLS generally develops during one’s 40’s or 50’s but can develop at much younger age as well (RLS is common in children diagnosed with ADHD). While sleep researchers have a firm grasp on the clinical features of RLS, its causes are still unclear. One belief is that it is a genetic disorder, and you are five times as likely to develop RLS if a first degree relative is diagnosed (for those interested in genetics, the ME1S1 gene is believed to be the leading genetic risk factor).
Iron deficiency is also a proposed risk factor. For example, in several case studies of subjects with anemia, RLS was reported. Further, following intravenous iron therapy, RLS symptomology not only improved, but was eradicated. Similarly, pregnancy is a major risk factor for RLS, perhaps due to the deficiency of iron during pregnancy.
The causes of RLS remain opaque. Because of this, treatment is also difficult. In patients with moderate to severe RLS, drug therapy is needed (i.e. dopaminergic drugs, opioids, benzodiazepines, iron injections). In less severe cases, daytime exercise and massaging of the legs have been shown to help.
Taking all of his into consideration, it is clear that RLS is a dire disorder. Outside of its harmful effects on sleep, there are also other consequences commonly associated with RLS. The continuous movement of the limbs is associated with increased autonomic activity, which increases risk for high blood pressure and cardiovascular disease. Individuals afflicted with this are also at higher risks for depression, social withdrawal, headaches, and daytime fatigue.
RLS is a mysterious and harmful sleep disorder. If you think that you may have RLS, consult with your primary care physician or a sleep specialist.
Ekbom, K., & Ulfberg, J. (2009). Restless legs syndrome. Journal of internal medicine, 266(5), 419-431.