Sleep Health

Coping with Restless Leg Syndrome

Is restless legs syndrome (RLS) the cause of your restless sleep? This exasperating condition triggers abnormal sensations in the legs and an irresistible urge to move them. It can wreak havoc with sleep, leading to daytime fatigue.

As striking as RLS sounds, it sometimes goes unrecognized. “People come in describing insomnia, but they don’t put two and two together,” says Dr. John Winkelman, an RLS specialist at Harvard-affiliated Massachusetts General Hospital. “You have to make that connection and then address the restless legs, and that helps people to sleep better.”

What is RLS?

Up to 10% of adults may experience restless legs to some degree. About 3% of all adults have truly bothersome RLS, with moderate to severe symptoms at least twice a week.

RLS is more than just garden-variety muscle cramps or aches. The sensations seem to come from deep in the legs, often described as a tingling, aching, pulling, itching, or cramping feeling, or the “creepy-crawlies.” This triggers an irresistible urge to move the legs. The symptoms typically start or get worse at night.

RLS and sleep

The leg sensations caused by RLS make it harder to fall asleep or to return to sleep after being awakened by the leg sensations. “People are kind of up and down and up and down during the night,” Dr. Winkelman says.

Sleeping partners can also suffer, since most people with RLS also experience involuntary muscle movements called periodic leg movements of sleep (PLMS). These typically occur in the foot, ankle, or knee every 15 to 30 seconds, lasting for about two seconds (and sometimes longer). People without RLS can also experience PLMS. Unfortunately, there is no specific treatment for it.

Diagnosing RLS

There is no simple test for RLS, but with a few questions your doctor can make the diagnosis. Your doctor will do a blood test to measure how much iron is stored in your body. Taking a daily iron supplement sometimes relieves RLS symptoms.

Your doctor will review the medications you take, since some can cause or worsen restless legs. These include certain kinds of antihistamines, antidepressants, and anti-nausea drugs.

Treating RLS

Gentle leg stretches before bed can help to relieve symptoms of restless legs syndrome as well as help prevent nighttime cramping caused by muscle injury or overuse.