Restless Legs Syndrome Guide: Causes and Symptoms of RLS

Restless legs syndrome, also known as Willis-Ekbom disease, is a medical condition that causes uncontrollable leg movements due to unpleasant sensations. Symptoms of restless legs syndrome also include evening discomfort, excessive daytime sleepiness, sleep deprivation, some of which can be relieved through self-care, home remedies, medications, and lifestyle changes.

Typically, the most severe symptom of RLS is the irresistible urge to move the legs, particularly in the late afternoon or evening. People with RLS describe these sensations as throbbing, crawling, itching, or creeping. Here are some common signs and symptoms of restless legs syndrome:

1. 1. Uncomfortable sensations: RLS can cause symptoms of pain or numbness in the legs or feet. These sensations include burning, itching, stinging, and tightness or tugging in the lower legs. Some experience the feeling of insects crawling on their feet or legs when nothing is there at all. Muscle spasms and cramps are also common sensations.
2. 2. Evening discomfort: Most people with RLS report an inability to rest soundly for long periods. RLS legs tend to worsen at night, which makes it harder to fall asleep and stay asleep. These symptoms may not occur every night if you have mild RLS. However, for severe cases of RLS, it’s more difficult to ignore. People with RLS typically report symptom-free morning hours, which can help them catch up on some sleep.
   
3. 3. Leg twitching during sleep: Periodic limb movement disorder (PLMS) is another more common condition associated with RLS (reported in about 80 percent of people with the disease), which causes the legs to kick and twitch throughout a night’s sleep. These jerking movements occur every 15 to 40 seconds during sleep, sometimes throughout the night. Many individuals with RLS develop PLMS; however, most people with PLMS do not experience RLS symptoms.
4. 4. Sleepiness and sleep deprivation: RLS often causes daytime drowsiness or sleep disorders. Effects of sleep deprivation can include memory issues, mood swings, and microsleep, all of which can impact physical and emotional health. According to the National Institute of Neurological Disorders and Stroke, individuals with untreated moderate to severe RLS cases have reported a 20 percent decrease in work productivity.

While the exact causes of RLS are primarily unknown (there can be a genetic link), data shows that anemia, renal disease, Parkinson’s disease, and peripheral neuropathy may increase the risk of developing the condition. Here are some other factors that can potentially increase the risk of RLS development:

1. 1. Dopamine imbalance: Research suggests that dopamine imbalance is a potential risk factor for RLS. Dopamine is the brain chemical responsible for sending messages to control muscle movement. For those with RLS, studies show a decrease in dopamine receptors and an increased amount of proteins associated with its production. The resulting malfunction may potentially mean that dopamine signals other brain cells during an inappropriate time of day.
2. 2. Genetics and environmental factors: RLS can be hereditary, especially if it surfaces before 40. Researchers have found that specific gene variants, even when subtle, can increase the risk of developing RLS. Iron deficiency, which may occur before birth, during infancy, or in adult life, is also associated with RLS.
3. 3. Pregnancy: For those who are pregnant, RLS can occur within the last trimester and then disappear within four weeks after delivery. While experts are still unsure of its cause for this demographic, they hypothesize that increases in hormones, such as estradiol and progesterone, may be contributing factors.
4. 4. Injuries: Injuries to the spinal cord or nervous system damage may increase the risk of developing RLS. For muscles to twitch, jerk, or move in any way, they must first receive a nervous system signal. If there is any irritation or compression on the nerve, it can potentially cause that nerve to misfire and possibly result in symptoms related to RLS.

You can find information on the treatment of restless legs syndrome at The Restless Legs Syndrome Foundation, National Institutes of Health (NIH), National Institute of Neurological Disorders and Stroke, and American Academy of Sleep Medicine. Consult your doctor for medical advice if you think you are experiencing RLS symptoms.

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