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Restless Legs Syndrome 

Introduction
Restless legs syndrome (RLS) is a condition that causes odd sensations in the legs and an urgency to move the legs.  The symptoms become worse while resting or lying down to fall asleep.  RLS is not a life-threatening condition, but it is uncomfortable and interferes with the natural sleep process.  The symptoms of RLS may be relieved with lifestyle changes and prescription medication.

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Anatomy
Sleep is vital for life, just like eating and breathing.  Sleep allows your body to rest.  It is believed that during sleep your brain performs important functions, such as storing memory and processing brain chemicals. 

In a way, your body goes on “auto-pilot” while you sleep.  Your brain regulates automatic functions for you, such as breathing, heart rate, and blood pressure.  Although sleep is a complex process that is not fully understood, it is known that a good night’s sleep is important for optimal health and functioning.  Restless legs syndrome is concerning because it interrupts or prevents the natural sleep cycle.

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Causes
RLS is considered a neurological and sleep disorder.  Researchers have recently discovered a gene that causes RLS in some people.  RLS may be an inherited condition in some families.  The new research also shows a connection between RLS and low iron levels in the blood. 
 
The incidence of RLS is higher in people with anemia, low iron levels in their blood, and those receiving dialysis for end-stage renal failure.  Some women develop RLS during pregnancy, but the condition usually goes away after childbirth.  This leads researchers to investigate if RLS is related to hormonal changes.  People with neuropathy, nerve damage in their hands or feet from diabetes or other conditions, have a risk for developing RLS.  Further, it appears common for children and adults with attention deficit disorder (ADD) to experience RLS.

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Symptoms
RLS causes an odd feeling in the legs.  You may feel tingling, crawling, tugging, gnawing, or uncomfortable sensations.  You may feel an incredible urge to move your legs or walk to relieve the unusual sensations.  Moving your legs may help make the sensations go away. 

RLS symptoms tend to become worse in the evening or when you are lying down, especially when you are trying to fall asleep.  They may also occur during the day when you are sitting or resting.  Your symptoms may get worse when you feel emotionally upset or stressed.  RLS can contribute to insomnia, the inability to sleep.  RLS may also cause daytime drowsiness, anxiety, depression, confusion, or problems with thinking and remembering.

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Diagnosis
You should contact your doctor if you suspect that you have RLS.  There is not a specific diagnostic test for RLS, but your doctor can determine if you have RLS by reviewing your medical history, listening to your symptoms, and possibly conducting some tests.  Your blood may be tested to rule out anemia or other conditions with similar symptoms.  You may be referred to a sleep disorders clinic for a more detailed examination of your sleep pattern.

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Treatment
Prescription medication can help relieve the symptoms of RLS.  There are several different types of medications that may be used.  It may take a few trials for your doctor to determine which medication works best for you.  You should never stop taking your medication or adjust your dosage without talking to your doctor first.

In addition to medication, your doctor may recommend lifestyle changes.  It can be helpful to avoid medications that may make RLS worse, such as some antihistamines.  It can be beneficial to not consume alcohol or caffeine products.  Relaxation and stretching exercises may be helpful to reduce stress.  Your doctor will let you know if vitamin supplements are appropriate for you.  Some people are able to reduce their need for medication after making lifestyle changes.

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Prevention
There is no known way to prevent RLS at this time.  You can make lifestyle changes that may help reduce the intensity of your symptoms, such as eliminating alcohol and caffeine consumption and using relaxation techniques and stretching exercises.  You should make a list of your prescription and non-prescription medications and have your doctor review them.  Some medications can make the symptoms of RLS worse and your doctor may be able to substitute another similar acting medication that does not.

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Am I at Risk

RLS appears to be more common in middle-aged and older adults, but people of all ages may develop it, including children. 


Risk factors for RLS:


_____ Researchers have identified some of the genes that contribute to RLS in some people.  If your family members have RLS, your risk is increased.
_____ People with anemia or low iron levels in their blood may have an increased risk for RLS.
_____ Neuropathy, nerve damage associated with diabetes or peripheral neuropathy, appears to be associated with an increased risk for developing RLS.
_____ People receiving dialysis for end-stage kidney disease have an increased risk of RLS.
_____ It appears that some women develop RLS during pregnancy, but the condition often resolves after childbirth.

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Complications
RLS is an uncomfortable condition, but it is not life-threatening.  Some people with RLS develop periodic limb movements in sleep, a condition that causes leg jerking during sleep. 

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Advancements
Researchers announced in 2007 that they have discovered specific genes that contribute to RLS in some people.  It appears that many people carry the genes that cause RLS but that not everyone develops the condition.  Researchers are continuing to pursue answers to this phenomenon.  Researchers also confirmed a link between RLS and low iron levels in the blood.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.