Restless Legs Syndrome

Whilst most people will have experienced these symptoms at some stage in their life, such as during pregnancy, restless legs becomes a problem when symptoms occur most days and result in difficulty getting to sleep or sleep disturbance.

Restless legs syndrome is a common condition characterised by 4 main symptoms:

• A need to move the legs, usually accompanied or caused by uncomfortable, unpleasant sensations in the legs. Sometimes the need to move is present without the uncomfortable sensations and sometimes the arms or other body parts are involved in addition to the legs.
• The need to move and unpleasant sensations are exclusively present or worsen during periods of rest or inactivity such as lying or sitting.
• The need to move and unpleasant sensations are partially or totally relieved by movement such as walking or stretching at least as long as the activity continues.
• The need to move and unpleasant sensations are generally worse or exclusively occur in the evening or night.

Although many individuals may have encountered symptoms like restless legs at some point in their lives, particularly during pregnancy, it becomes a significant issue when these symptoms persist on a daily basis, leading to challenges in falling asleep or disturbances in sleep. Approximately 5% of the population experiences such frequent symptoms that disrupt their sleep. In such cases, it is advisable for individuals to seek assistance, as there are effective treatments available to address this disabling condition.

Assessment of patients with restless legs symptoms requires a careful clinical evaluation, completing an RLS Rating Scale, ensuring iron levels are adequate with a blood test, and usually a sleep study to characterise the leg movements and look for co-existing conditions that can worsen restless legs such as sleep apnea.

If iron levels are found to be low, restless legs symptoms can be alleviated through iron replacement. Additionally, simple measures like walking or pacing can offer temporary relief. However, for individuals experiencing frequent or severe symptoms, daily medication is often prescribed. Typically taken at night, around 1-2 hours before symptoms typically occur, these medications prove effective in managing restless legs. There are various medications available, including dopamine agonists, anti-epileptics like gabapentin, opiates, and benzodiazepines. In more severe cases, a combination of medications may be required.