restless in rochester

by Kenneth Plotkin, M.D.

Is it hard for you to sit still? Do you feel the irresistible urge to move your legs or arms when you are trying to relax? Do these feelings keep you from sleeping, and are they accompanied by odd sensations in your legs and arms? If so, you may have a condition called Restless Legs Syndrome (RLS), shared by up to 10% of the population. This condition can be inherited, or can be caused by other medical problems such as kidney disease, diabetes, spine problems, low iron, or a variety of neurological conditions. These symptoms may also accompany pregnancy. People should begin talking more about this disorder with their doctors beginning in July, when a national campaign for awareness of RLS is rolled out by the Restless Legs Syndrome Foundation and the National Sleep Foundation.

Restless Legs Syndrome becomes most troublesome when the urge to move causes disruption of sleep, leaving a person feeling chronically tired. A bed partner may observe arm or leg movements, or in some cases the movements may be so subtle that they go unnoticed. The physical effects of sleep loss can go much farther than fatigue, as sleep deprivation has been shown to worsen inflammation in the body, and decreases the effectiveness of some immune processes. RLS increases in prevalence with advancing age, occurring in up to a third of people over the age of 60 years, and is twice as common as sleep apnea, another important sleep disorder.

A doctor’s diagnosis of RLS will rely on a person’s history of symptoms, but it can be clearly diagnosed and differentiated from other sleep disorders by a sleep study (polysomnogram, or PSG). The PSG may also be used to help determine whether treatment is helping in complicated cases.

Fortunately, this is a condition that may improve with simple changes in habits, such as stopping tobacco, alcohol, and/or caffeine use. There are also medications that aggravate its symptoms, thus a medication change may provide some relief. Iron supplements only help the small percentage of RLS sufferers who have low iron stores, best shown by a blood test for ferritin. If another medical problem is causing your symptoms, they may improve as the causative medical condition is treated. Finally, there are prescription medications that can be prescribed for RLS symptoms, including medications that enhance or mimic the neurotransmitter dopamine, whose function appears to be impaired in RLS. One of these dopamine-enhancing medications called ropinerole was recently given formal FDA approval for use in RLS.

Your physician would be the best person to consult if you think you have RLS, and in some cases, referral to a sleep disorders center may also help you get a better night’s sleep.