Restless Legs Syndrome (RLS) is probably the only thing in medicine that actually is what it sounds like – your legs feel restless. Well, almost. While it occurs for most people in their legs, some people may feel it more in their arms, trunk, neck or head. And, just to make things confusing, it does have another name – Willis Ekbom Disease. It affects around 5% to 15% of the population in the United States. The sensations affected people feel can be annoying, unpleasant, jittery, creepy crawly, itchy, burning, mild, moderate or miserable.
RLS mainly occurs when you are sitting or lying quietly. The only thing that relieves it is movement of your affected body parts (we’re going to keep saying “legs” for the purposes of this article). For most people it occurs in the evening or at night and tends to be less in the early morning hours. This can be a real problem while you’re trying to sleep – or driving a truck through the night.
What causes RLS? Unfortunately, no one knows. There are some theories about faulty neurotransmitters, the chemicals in our brains that make our muscles work (among other things). What is known about it is that there are some triggers – behaviors or substances – associated with the restless feelings. Substances include tobacco (chewed or smoked), alcohol, caffeine, and some medications like anti-depressants and cold remedies. RLS occurs mostly when a person is in a quiet, still state, so that includes bedtime, traveling on a plane, or in a car or truck.
Although RLS is not a fatal disorder, it can disturb a person’s quality of life. After all, if you can’t sleep because you have to move your legs or arms all the time, how can you feel well-rested and face the new day – or drive a truck safely – if you’re always exhausted? In some cases, there may be an underlying disease that is causing RLS. For example, people with diabetes, kidney disease, and Parkinson’s disease may suffer from RLS. A person with a vitamin or iron deficiency might have symptoms of RLS, as well. Age and gender might be factors, too (RLS seems to occur more in people over 50 and happens more in women).
There are no specific blood tests or images like x-rays to help determine if you have RLS. However, a health care provider can check your blood to see if you have something like iron deficiency anemia or vitamin deficiencies that might contribute to the restless feelings. Doing certain blood tests would also give information about diabetes and kidney disease, other possible contributors to RLS. The tests done for people with sleep disorders measure the amount of moving a person does while sleeping, so these tests can help determine if you have RLS. A history of needing to move while at rest, feeling relief with moving, having these feelings mostly at night, and not being able to relate it to arthritis or some other disorder, are the required criteria for calling it RLS.
So, what can you do about it? Even though there is no cure for RLS, it is not a totally hopeless situation. For many people, the symptoms will go away for a time. If your health care provider finds that you have an iron or vitamin deficiency contributing to your RLS, taking those supplements might improve the underlying disorder, thereby improving your condition. If you have diabetes or kidney disease, treating those disorders is essential to prevent other complications, as well.
The triggers mentioned above (behaviors and/or substances) are things you can manage and control yourself to help prevent symptoms. Cutting back on your tobacco and caffeine may relieve some discomfort. When you are driving, you can plan to take breaks on a regular basis to get out and walk around for a while and not remain seated for the whole trip. Massaging your legs and doing mild stretches can help, too – a soak in a hot bath might be just the ticket before going to sleep if you have an available tub and the time. If you are in a situation where you have to be still, doing something to distract yourself can be useful. For example, listening to the radio, especially the shows where there’s a puzzle to do, can be distracting (as long as you’re not too distracted to drive). If you are on a plane or in a theater, choose the aisle seat so you can move your legs when you need to.
There are some medicines for RLS, but they should be reserved only for severe cases that can’t be relieved by “home remedies” like massage and a warm bath before going to sleep. With RLS, some of the side-effects of medicines are worse than the disorder itself and can create more problems if you take them for a long time (they can sometimes become addictive). This is one of those cases where it is better to try alternatives to medicines first, for sure.
Most of us don’t have a lot of control over our work schedules – we have to be where the boss says to be at a particular time. However, if you have any leeway in this, try going to sleep later so that the majority of your sleep time is in the early morning hours when your legs might feel less restless. Avoid anything else that might be disturbing your sleep. For example, it’s well-known now that using a computer or watching TV right before going to sleep can disrupt normal sleep patterns. Drinking alcohol before you sleep might make you feel very sleepy but it does not allow you to get into the normal cycles of deep sleep that are the most refreshing and restorative. Tobacco is a stimulant and can also get in the way of a good night’s sleep – if you can’t quit, try to cut down some and see if that helps (but you really should quit).
Information is power, so go and get yourself more informed. You can learn more about RLS at several websites to stay on top of new information about possible causes and available treatments. Some of those websites include www.clevelandclinic.org, www.mayoclinic.org, and www.rls.org. Being “restless on the road” can be a serious problem, so get informed and then get help, if you need it.
