Have you recently been kept awake by the tossing and turning, twitching, kicking and constant leg movements of your bed partner? Your beloved may be suffering from a condition called restless legs syndrome; 16% of South Africans do!

Sleep deprivation

Sleep deprivation is a nasty thing that may lead to the grumps, daytime fatigue, exhaustion and even depression for both of you.

Ask your bed partner the following four questions to determine if he or she is indeed suffering from RLS.

  1. Why do you move your legs so much? Can’t you control this urge? Is this urge triggered by uncomfortable sensations in your legs such as throbbing, tingling, the creepy crawlies, itching or jitteriness?
  2. You don’t seem to be able to relax or sit still. Is the above mentioned sensation worse when you are inactive, trying to relax, sitting or being forced to sit still?
  3. Does this urge to move get partially or totally better when you do move, get up, stretch or go for a walk?
  4. It seems to be worse at night, especially when you are trying to fall asleep but better during the early morning hours. Is it?

A “yes” answer to most of these questions clinches the deal; it is RLS! However, it’s most important that your doctor do more tests and confirm the diagnosis before you start with treatment.

Is it a neurological, movement or sleep disorder?

RLS has been described as all the above. Some call it a neurological disorder that interferes with resting or falling asleep while others describe it as a movement disorder because individuals are forced to move their legs to gain relief from the symptoms. Although a 60% genetic predisposition is suspected, nobody seems to be 100% sure what causes the syndrome.

Recent evidence suggests that it may be related to low levels of iron in the brain or to a circuit dysfunction in the parts of the brain that use the neurotransmitter dopamine. A disruption of the basal ganglia’s dopamine pathways often results in symptoms such as the involuntary movements that characterise Parkinson’s disease. Those who have this disease often have RLS too but, fortunately, not vice versa!

Researchers have also uncovered a possible connection between RLS and other medical conditions where RLS may be a symptom or the first sign (but not the cause) of diabetes, kidney failure, rheumatoid arthritis, iron deficiency anaemia and some neurological diseases.

PLMS (periodic limb movement of sleep) is another disorder that is closely associated with RLS. Many who have RLS also develop PLMS but not vice versa. RLS symptoms may also develop during the later stages of pregnancy but usually disappear soon after the baby has been born.

RLS occurs in both sexes, more in women though, and in children too. Symptoms in the latter are sometimes mistakenly identified as growing pains or ADD (attention deficit disorder).

What’s to be done?

You have two choices depending on the severity of the symptoms. Certain self-help and lifestyle changes may be enough to control mild to moderate RLS symptoms but if they do not and your symptoms are severe, a proper diagnosis by your doctor or a specialist is the way to go.

  1. Let your doctor decide. He or she will most probably tell you that although there is no cure there are medicines that may be prescribed to help control the symptoms. Laboratory, blood and sleep tests may be ordered to make sure there is no underlying medical condition causing the symptoms before subscribing medicines. These all come with their own set of side-effects so be sure to ask your doctor or pharmacist what they are. Your doctor may also warn you that certain medicines such as antihistamines (in cold and allergy pills), anti-nausea medication, antidepressants and antipsychotic medicines, as well as over the counter sleeping pills and medicines prescribed for high blood pressure and heart problems, may worsen your symptoms.
  2. Make some lifestyle changes. Start by taking a good look at what you eat and drink. Sorry, but alcohol and caffeine, coffee, tea, soft drinks and chocolates will worsen your symptoms and smoking is a definite no-go. Eat healthy foods especially those high in iron, vitamin B, folic acid and magnesium or take a supplement. Lose weight if necessary. Get into a regular routine of going to bed at the same time each night. Try to eliminate some of the stress in your life. Moderate exercise will help (walking and stretching your legs) but excessive exercise will make symptoms worse. Try sleeping with a pillow between your legs. Massage your legs or apply hot or cold packs to your legs. Either soak in a hot tub or take a cold shower, whatever works for you.

As always, talk to co-workers, friends and family so that they will understand your restlessness and that you need to stand up and stretch frequently or take a quick stroll or sit in an aisle seat at the movies or on a plane. Their understanding and support is crucial in managing this disorder.

 

Sources
Restless Legs Syndrome. Retrieved from: http://www.sassm.org/sleep-disorders/restless-legs-syndrome.htm.
Restless Legs Syndrome Fact Sheet. 2013. Retrieved from: http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm.
Restless Legs Syndrome (RLS): symptoms, treatment and self-help. Retrieved from: http://www.helpguide.org/life/restless_leg_syndrome_irs.htm.
Smith, M. & Robinson, L. 2013. Periodic Leg Movements of Sleep. Retrieved from: http://www.sleeplink.co.za/sleep_disorders.htm#periodic_leg_movements.