Restless Legs Syndrome (RLS) is a movement disorder associated with sleep. Although it is common in the population, it is often not recognized adequately. Individuals with this syndrome feel the need to move their legs due to discomfort in their legs, especially when resting and during the night. Symptoms can vary from person to person, and most patients have difficulty describing what they feel.
These sensations are typically described as "numbness" or "tingling"; it is a discomfort that is different from cramping or pain. Restlessness is most commonly observed in the calf area. Sitting or lying down for long periods worsens these sensations, while moving or stretching the legs temporarily alleviates the discomfort. Many patients need to get up and walk around to feel relief. In some cases, the arms may also be similarly affected. While RLS occurs intermittently in some individuals, it may occur every night in others. This condition can impair sleep quality, leading to daytime fatigue and negatively affecting social and professional life. Patients may struggle in situations that require sitting for long periods, such as long car or plane trips, watching movies, theater performances, or attending meetings. Sleep disturbances caused by RLS can also lead to anxiety and depression.
How Common is RLS and Who is Affected?
In Turkey, approximately 3 out of every 100 people live with RLS. In Western countries, this rate is between 3% and 5%. RLS can occur in all age groups and both genders, but it is more common in women and in older age groups. Children with a family history of RLS may also experience this syndrome. The symptoms in children are sometimes mistakenly assessed as "growing pains" or "Attention Deficit Hyperactivity Disorder" (ADHD). However, these children are not hyperactive; they feel the constant need to move their legs due to RLS. RLS should be considered, especially in children who refuse to lie down, cry, or cannot stay still.
RLS typically follows the same course for years, and spontaneous remission is rare. It may appear or worsen in the last six months of pregnancy.
What Causes RLS?
The difficulty in describing the symptoms of RLS may lead people to think it is a psychological condition. However, RLS is not a psychological disorder. Although the exact cause is not fully understood, it is believed to be related to a dysfunction in the dopamine system in the brain. Medications that increase dopamine levels may be effective in treatment.
RLS is more common in some diseases. These include:
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Iron deficiency anemia
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Circulation problems in the legs
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Herniated disc or nerve damage
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Kidney diseases
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Muscle disorders
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Alcohol dependency
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Vitamin and mineral deficiencies
Certain antidepressants, allergy medications, and painkillers can trigger or worsen RLS symptoms. Caffeine, smoking, and alcohol can also exacerbate the symptoms.
RLS can be genetically inherited. About 50% of individuals with a family history of RLS may develop the disease. Genetic forms of RLS generally begin at an earlier age and may be harder to treat.
How is RLS Diagnosed?
RLS is diagnosed by specialists in neurology or sleep disorders. There is no specific blood test or imaging method for diagnosis. The diagnosis is made based on a detailed patient history and physical examination. The four main criteria for diagnosing RLS are:
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Uncomfortable sensations in the legs and the urge to move them
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Symptoms occurring during rest and relaxation
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Relief of symptoms with movement
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Absence or mild symptoms in the morning hours
If there is any doubt in the diagnosis or if another disease that predisposes to RLS is suspected, blood tests, electromyography (EMG), or polysomnography (a full-night sleep test) may be necessary.
How is RLS Treated?
First, it is essential to investigate any diseases or medications that may cause or worsen RLS symptoms. Diseases such as iron deficiency anemia, diabetes, and arthritis are important for diagnosis and treatment. Treating underlying diseases or discontinuing medications that exacerbate symptoms may alleviate RLS symptoms. However, these measures are often insufficient.
In mild cases, lifestyle changes such as hot baths, leg massages, hot-cold applications, regular exercise, and a caffeine-free diet can be beneficial. Some patients may also find relief from mental activities, such as solving puzzles in the evening.
In moderate and severe cases, medication is necessary. The choice of medication depends on the patient's age, existing medical conditions, and the severity of the symptoms. Due to the potential side effects of all medications, especially during the initial stages, medical supervision is essential during treatment.
