Some suffer from a strong desire to move the legs when lying down, which causes them disturbance and difficulties in sleeping.
If you suffer from similar symptoms, you may have restless legs syndrome, what are they, symptoms and causes, and then how is the treatment?
What restless legs syndrome?
Restless legs syndrome - also called Willis-Ekbom disease - is a condition that causes uncomfortable sensations in the legs and an irresistible urge to move them, as defined by the National Institute of Neurological Disorders and Stroke in the United States. .
Symptoms most commonly occur in the late afternoon or evening hours, and are often more severe at night when a person is resting, such as sitting or lying in bed.
It may also occur when someone is inactive and sitting for long periods (for example, when taking an airplane trip or watching a movie).
Because symptoms can become more severe during the night, it may be difficult to fall asleep or return to sleep after waking up.
Moving the legs or walking usually relieves the symptoms of restless legs, but symptoms often reappear once the movement stops.
Classification of restless legs syndrome
Restless legs syndrome is classified as a sleep disorder because the symptoms prevent one from falling asleep, and it is also classified as a movement disorder, especially since sufferers have to move their legs in order to relieve symptoms.
However, it is best described as a sensorineural disorder with symptoms arising from within the brain itself.
Restless legs syndrome is one of several disorders that can cause tiredness and daytime sleepiness, which can severely affect mood, concentration, job and school performance, and personal relationships.
Many sufferers of Willis-Ekbom disease say they are often unable to concentrate, have poor memory, or fail to complete daily tasks. Untreated, moderate to severe restless legs syndrome can lead to a 20% decrease in productivity. Work can contribute to depression and anxiety.
Do men and women suffer equally?
Restless legs syndrome occurs in both men and women, although women are more likely to develop it than men.
The infection may begin at any age;
Many severely affected individuals are middle-aged or older, and symptoms usually become more frequent and last longer with age.
Symptoms of restless legs syndrome
An irresistible desire to move.
Uncomfortable feeling in the lower extremities.
What the sufferer feels can be described as aching, pulling, or itching.
The nagging feeling often affects both sides.
Because moving the legs (or other affected parts of the body) relieves discomfort, people with Willis-Ekbom disease often keep their legs moving to reduce or prevent uncomfortable sensations. They may step on the floor, move their legs constantly while sitting, and toss and turn in bed. .
RLS symptoms get worse at night with a distinct symptom-free period in the early morning, allowing for a more refreshing sleep at that time.
Some sufferers have difficulty falling asleep and staying asleep.
They may also notice a worsening of symptoms if their sleep is reduced by events or activity.
Restless legs syndrome symptoms may vary from day to day, in terms of severity and frequency, and from person to person.
In moderately severe cases, symptoms occur only once or twice a week, but often lead to a significant delay in sleep onset, with some disturbances in daytime functions.
In severe cases of Willis-Ekbom disease, symptoms occur more than twice a week and lead to stressful interruptions in sleep and impairment in daytime function.
Causes of Willis-Ekbom disease
In most cases, the cause of restless legs syndrome is unknown.
However, it has a genetic component and can be found in families where the onset of symptoms occurs before the age of 40.
Evidence suggests that low levels of iron in the brain may also be responsible for the syndrome.
There is also ample evidence that restless legs is linked to dysfunction in a part of the brain that controls movement called the basal ganglia, which uses the brain chemical dopamine.
Dopamine is necessary for smooth, purposeful muscle activity and movement.
Disruption of these pathways often leads to involuntary movements.
And individuals with Parkinson's disease, another disorder of the dopamine pathways in the basal ganglia, have an increased chance of developing restless legs syndrome.
Restless legs syndrome may be associated with or associated with one of the following conditions:
Kidney disease and dialysis.
Iron deficiency.
Certain medications that may worsen symptoms of RLS, such as anti-nausea medications (such as prochlorperazine or metoclopramide), antipsychotic drugs (such as haloperidol or phenothiazine derivatives), antidepressants that increase serotonin (eg, fluoxetine or sertraline), and some cold and allergy medicines that contain older antihistamines (eg, diphenhydramine).
Use of nicotine and caffeine.
Pregnancy, especially in the third trimester, and in most cases symptoms usually disappear within 4 weeks after delivery.
Neuropathy.
Sleep deprivation and other sleep conditions such as sleep apnea may also worsen or trigger symptoms in some people.
Reducing or completely eliminating these factors may relieve symptoms.
Restless legs syndrome treatment
Restless legs syndrome can be treated, taking care to relieve symptoms.
Moving the affected limb may provide temporary relief.
Sometimes, symptoms can be controlled by finding and treating an associated medical condition, such as peripheral neuropathy, diabetes, or iron deficiency anemia.
Restless legs syndrome treatment options:
1- Changing the lifestyle
Certain lifestyle changes and activities may provide some relief for people with mild to moderate symptoms of restless legs syndrome. These steps include:
Avoid or reduce tobacco use.
Regular sleep pattern.
Do moderate exercise.
Legs massage.
Take a warm bath.
Use a heating pad or an ice pack.
New medical devices have been approved by the US Food and Drug Administration (FDA), including a foot wrap that compresses the bottom of the foot and a cushion that delivers vibrations to the back of the legs.
Aerobic exercise and leg stretches of moderate intensity may provide some relief from mild symptoms.
2- Iron
For individuals with low blood measurements called ferritin and transferrin saturation, trying iron supplementation is recommended as first treatment.
Iron supplements are available without a prescription.
3- Anticonvulsant drugs
Anti-seizure medications have become a first-line prescription for those with restless legs syndrome.
Gabapentin Enacarbil has been approved by the U.S. Food and Drug Administration for the treatment of moderate to severe restless legs syndrome, and it appears to be as effective as a dopaminergic treatment.
4- Dopaminergic agents
These drugs, which increase the effect of dopamine, are largely used in the treatment of Parkinson's disease.
It has been shown to reduce symptoms of restless legs syndrome when taken at night.
The U.S. Food and Drug Administration has approved ropinirole, pramipexole, and rotigotine for the treatment of moderate to severe RLS.
These drugs are generally well tolerated but can cause nausea, dizziness or other short-term side effects.
Although dopamine-related medications are effective in managing the symptoms of restless leg syndrome, their long-term use can worsen symptoms in many individuals. With chronic use, a person may start to feel symptoms in the early evening or even earlier. Until symptoms appear around the clock.
Over time, the initial evening or bedtime dose can become less effective, symptoms at night become more severe, and symptoms can begin to affect the arms or torso.
Fortunately, this apparent progression can be reversed by the person removing all dopamine-related medications.
5. Opioids
Sometimes medications such as methadone, codeine, hydrocodone, or oxycodone are prescribed to treat individuals with more severe symptoms of restless leg syndrome who have not responded well to other medications.
Side effects include constipation, dizziness, nausea, worsening of sleep apnea, and risk of addiction.
However, very low doses are often effective in controlling symptoms of restless legs syndrome.
6- Benzodiazepines
These medications can help people get more restful sleep.
However, even if taken only at bedtime, they can sometimes cause daytime sleepiness, reduce energy, and affect concentration.
Benzodiazepines such as clonazepam and lorazepam are generally prescribed to treat anxiety, muscle spasms, and insomnia.
Because these medications may also cause or worsen sleep apnea in some cases, they should not be used in people with this condition.