Restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED), is a sleep and neurological sensorycondition, meaning it's related to your nervous system (which includes your brain and spinal cord). It causes urges to move your body due to unusual sensations you feel in your legs. About 7% to 10% of people in the United States experience RLS.
Symptoms of RLS often improve with movement and worsen during periods of inactivity, like when you're lying in bed. You might experience symptoms several nights a week or most nights, which can disrupt your sleep. Treatment options focus on reducing your symptoms and addressing potential underlying causes, such as iron deficiency.
Healthcare providers may classify restless legs syndrome as primary or secondary.
- Primary RLS is also known as idiopathic RLS. Idiopathic means there's no known cause. However, many people with idiopathic RLS have a family history of the condition.
- Secondary RLS is a condition that occurs from a known cause, such as iron deficiency, kidney disease, or pregnancy.
About 11% to 29% of pregnant people experience symptoms of restless legs syndrome. RLS during pregnancy usually resolves within a few weeks after delivery, but it might increase the risk of developing chronic RLS.
Symptoms
Restless legs syndrome symptoms can vary in severity, though most people's symptoms get worse or occur later in the day.
Primary symptoms include:
- Unusual sensations in your legs that may feel like aching, crawling, itching, pulling, or creeping. These sensations may less commonly affect the arms, chest, and head.
- The urge to move your legs in response to the unpleasant sensations.
- Sensations that begin after you have not moved for a while, such as when watching television or riding in the car for an extended time period.
- Sensations that improve when you move, like when you pace, walk, or move your legs while sitting or lying down.
- Symptoms that worsen at night and may keep you from falling asleep or staying asleep.
If you have moderate symptoms, you may only notice them once or twice a week. If you have severe symptoms, you may have symptoms three or more times a week.
Poorer sleep quality due to restless legs syndrome can also affect your cognition and emotions. For example, you might experience:
- Anxiety
- Depression
- Difficulty concentrating
- Extreme fatigue and daytime sleepiness
- Memory problems
- Mood changes
Your symptoms might go into remission, meaning they decrease or disappear for a period of time, then reappear at a later time. About 70% of people with restless legs syndrome experience progressively worse symptoms over time. Symptoms might also move to your arms.
Researchers do not know exactly what causes restless legs syndrome, but the condition may result from other conditions.
Potential contributors include:
- Dopamine deficiency: Low dopamine levels may affect how your nerves sense the environment. Healthcare providers often prescribe medications to increase dopamine levels when treating RLS symptoms.
- Neurotransmitter abnormalities: Neurotransmitters are substances that help nerves communicate with your brain. Imbalances in neurotransmitters such as glutamate, histamine, and gamma-aminobutyric acid (GABA) may result in RLS symptoms.
- Abnormal function of the peripheral nerves: Restless legs syndrome can cause more exaggerated responses to light physical touch. This response suggests that peripheral nerves in the legs that sense stimulation may not function effectively in people who have RLS.
- Medical conditions: People with certain medical conditions experience RLS at higher rates. These conditions include spinal cord disease, multiple sclerosis, celiac disease, and Parkinson's disease.
- Iron deficiency: Low blood iron levels may affect nervous system transmission and lead to RLS symptoms. People with iron deficiency anemia are five to six times more likely to have RLS.
Some medications might cause or worsen RLS symptoms. These include:
- Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs): Classes of medications typically used to treat depression
- Antidopaminergic medications, like neuroleptics: A class of medications used to treat psychiatric disorders like schizophrenia
- Beta-blockers: A class of medications used to reduce hypertension (high blood pressure), control heart rhythm, and treat angina (chest pain)
Alcohol, nicotine, and caffeine use can also contribute to RLS.
People assigned female at birth are more likely than people assigned male at birth to experience RLS. There also seems to be a genetic component as well. Up to 65% of people with RLS have a family history of the condition, and there's about an 80% correlation with identical twins. In other words, when one identical twin has RLS, there's an 80% probability that the other twin also has symptoms.
15 Iron Deficiency Signs and Symptoms
Diagnosis
There are not any specific tests to diagnose restless legs syndrome. A healthcare provider will ask you about your symptoms and your family history, review your medications, and consider possible causes.
There are five basic criteria for diagnosing restless legs syndrome:
- A strong, sometimes overwhelming, need or urge to move your legs, often with unpleasant or uncomfortable sensations
- Increased urge during periods of rest
- Increased urge in the evening or at night
- Symptom relief during movement
- Symptoms with no other medical or behavioral causes
Your healthcare provider may also conduct the following tests:
- Blood testing: Blood tests might indicate a potential underlying cause for RLS. For example, your healthcare provider will likely test your iron levels to rule out iron deficiency as a potential cause of your symptoms.
- Electromyography (EMG) and nerve conduction studies: Tests for nerve function can help a healthcare provider rule out other potential causes, like neuropathy (nerve damage). These tests record your muscles' responses to nerve stimulation.
- Sleep studies: Sleep studies, also known as polysomnography, involve monitoring you overnight while you sleep and recording any unusual movements.
Diagnosing Children
Diagnosing children with restless legs syndrome can be challenging because they might not be able to accurately describe their symptoms.
In addition, many childhood conditions can mimic RLS, including growing pains and nocturnal leg cramps (which both occur in the evening and during the night), as well as motor tics. RLS is also often seen in children who have attention deficit hyperactivity disorder (ADHD), and the two conditions share symptoms like irritability and motor restlessness (the urge to move).
Sporadic or milder symptoms of restless legs syndrome might not require treatment. However, for many people, restless legs syndrome is a life-long condition that can worsen over time. Around the age of 50, you might experience daily sleep disruptions that significantly affect your quality of life.
While there's no cure for RLS, treatments can help reduce symptoms. Treatments include over-the-counter and prescription medications as well as practicing certain lifestyle habits.
Medications
Medication is typically the primary treatment approach for restless legs syndrome, especially in more severe cases.
Medications to treat RLS include over-the-counter iron supplements as well as prescription medications, such as:
- Anti-seizure medications: These medications are usually the first medications a healthcare provider prescribes. Examples of medication treatments include Horizant (gabapentin enacarbil) or Lyrica (pregabil).
- Benzodiazepines: These anti-depressant medications may help to reduce muscle spasms and promote sleep. Examples include Klonopin (clonazepam) and Ativan (lorazepam).
- Dopaminergic agents: Dopaminergic agents, like the combination medication Sinemet (carbidopa-levodopa), increase the amount of dopamine in the brain. Healthcare providers prescribe them to treat moderate to severe RLS.
- Opioids: Opioid medications like codeine, methadone, or oxycodone may be prescribed if no other medications are effective. These medications can be habit-forming and require frequent monitoring by your healthcare provider.
Lifestyle
If you have mild to moderate restless legs syndrome, you may be able to reduce your symptoms through lifestyle choices. Recommendations from your healthcare provider may include:
- Refrain from consuming alcohol or caffeine
- Avoid nicotine
- Maintain a regular sleep schedule
- Take a warm bath at night
- Massage your legs in the evening
- Engage in regular leg-stretching exercises, such as calf and hamstring stretches
Using vibrating leg massaging devices may also reduce your symptoms.
Prevention
While you can't always prevent restless legs syndrome, you may be able to prevent mild RLS or minimize flares.
Prevention strategies are similar to treatment strategies. They include the following:
- Avoid caffeine, alcohol, and nicotine
- Get plenty of sleep at night (usually at least seven hours)
- Engage in regular, moderate-intensity exercise in the morning or early afternoon, as evening exercise may worsen symptoms
- Engage in relaxing activities to reduce your anxiety levels, such as taking baths, reading, meditating, and stretching
- Take iron supplements if your healthcare provider prescribes them for low iron levels
Restless legs syndrome may be related to some of the following disorders, which commonly affect your neurologic (nervous system) health:
- End-stage renal (kidney) disease
- Neuropathy (nerve damage)
- Pregnancy, usually in the last trimester (beginning in week 28), possibly due to hormonal shifts
- Sleep deprivation
- Sleep disorders, such as sleep apnea
Possible complications of RLS stem from disrupted sleep and resulting fatigue.
Living With Restless Legs Syndrome
Restless legs syndrome varies from person to person. You may experience infrequent and milder symptoms, or you may find that more frequent and severe symptoms significantly affect your sleep and overall quality of life.
Researchers are learning more about the causes and treatments for RLS. While there is not currently a cure, medications and lifestyle choices can help you manage your symptoms. Talk to your healthcare provider if you think you might benefit from treatment.
Frequently Asked Questions
Is RLS a form of Parkinson's disease?
Parkinson's disease is a condition that causes uncontrolled movements. While this symptom may sound similar to RLS, they aren't the same. However, both conditions may be due to imbalances in the neurotransmitter dopamine.
At what age is restless legs syndrome most common?
RLS can affect people of all ages, including children. However, the symptoms tend to worsen more rapidly around the age of 45.
Is RLS linked to dementia?
One retrospective cohort study observed participants from 2002-2013 and identified a connection between dementia causes (such as Alzheimer's disease) and RLS. However, the research regarding this connection is newer and requires further investigation.
(Video) Restless Legs Syndrome and Sleep - Diagnosis and Treatments
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FAQs
Is there a way to prevent restless leg syndrome? ›
Ideally, have a cool, quiet, comfortable sleeping environment; go to bed and rise at the same time daily; and get at least seven hours of sleep nightly. Exercise. Getting moderate, regular exercise may relieve symptoms of RLS , but overdoing it or working out too late in the day may intensify symptoms. Avoid caffeine.
What stops restless leg syndrome immediately? ›massaging your legs. taking a hot bath in the evening. applying a hot compress to your leg muscles. doing activities that distract your mind, such as reading or watching television.
What is the number one cause of restless leg syndrome? ›In most cases, the cause of RLS is unknown. However, RLS often runs in families and specific gene variants have been associated with the condition. Low levels of iron in the brain also may be responsible for RLS. RLS also may be related to a dysfunction in a part of your brain that controls movement.
What vitamin helps with restless leg? ›Taking magnesium and vitamin B6 supplements can reduce the severity of symptoms of RLS/WED patients and improve their sleep quality.
What is a natural calm for restless leg syndrome? ›Alternative remedies for RLS
sitting in a warm bath, which can relax muscles. getting massages. getting moderate exercise regularly, which can reduce symptoms of RLS. avoiding caffeine, which can agitate RLS and decrease magnesium in the body.
Healthy sleep tips like finding consistency in your sleep schedule, bedtime routines, diet, and exercise are a good starting point. Finding the best mattress for your personal needs, and making your bedroom comfortable with as few distractions as possible, can reduce the chances of having restless sleep.
How do you stretch restless legs in bed? ›Stretches for RLS
Slightly bend your right knee and step your left leg back a foot or two, positioning its heel and foot flat on the floor. Hold for 20 to 30 seconds. Now bend your left knee while still keeping its heel and foot flat on the floor. For a deeper stretch, move your foot back a bit farther.
Did you know that research shows that ripened bananas are found to contain magnesium, potassium, and a natural form of dopamine? These substances work together and may be a significant help in relieving your restless leg syndrome (RLS) symptoms.
Does walking reduce restless leg syndrome? ›Since the symptoms of the syndrome appear or worsen in resting and immobility times, these symptoms may improve by moving. Therefore, moderate exercise can be helpful (2). Exercises like walking, massaging, stretching, swimming, and stationary cycle can help relieve symptoms (12).
What is the best medication for restless leg? ›Dopamine agonists: These are most often the first medicines used to treat RLS. These drugs, including pramipexole (Mirapex), rotigotine (Neupro), and ropinirole (Requip), act like the neurotransmitter dopamine in the brain.
What are the dangers of restless leg syndrome? ›
People with RLS have impaired sleep, often associated with periodic limb movements, and increased risk of depression and anxiety, all of which combine to reduce quality of life.
Is restless leg syndrome a serious problem? ›Restless legs syndrome is not life threatening, but severe cases can disrupt sleep (causing insomnia) and trigger anxiety and depression. The charity Restless Leg Syndrome UK (RLS-UK) provides information and support for people affected by restless legs syndrome.
Does melatonin help restless legs? ›Don't try melatonin
Melatonin also inhibits the secretion of dopamine, which makes it bad news for restless legs syndrome patients. It might increase RLS symptoms in the evening and night, according to researchers at Sacre-Coeur Hospital in Montreal.
Magnesium supplementation is often suggested for restless legs syndrome (RLS) or period limb movement disorder (PLMD) based on anecdotal evidence that it relieves symptoms and because it is also commonly recommended for leg cramps.
Does B12 stop restless leg syndrome? ›Researchers have also suggested vitamin B12 may help relieve the symptoms of RLS (x), while others have found that vitamin B complex supplements may help to reduce the frequency, intensity and duration of night-time leg cramps in older people with high blood pressure (xi).
Does drinking water help restless legs? ›drinking more water. Dehydration may cause the urge to move the legs, so some people find drinking a glass of water stops the urges for a short while. soaking your feet in hot water just prior to going to sleep. wearing compression stockings or tights in bed.
Do weighted blankets help with restless legs? ›Weighted blankets have been shown to relieve the unpleasant symptoms of RLS. This comes down to something called Deep Touch Pressure therapy, which happens when you place evenly-distributed weight over your body, triggering pressure points that help in the production of some key relaxation and sleep hormones.
Does pickle juice help with restless leg syndrome? ›Consumption of a quarter-cup of pickle juice in the evening, or before going to bed, is shown to greatly relieve the symptoms of RLS, including jerks, twitches, and leg cramps. Pickle juice is commonly used as a remedy for hangovers. The headache, nausea, and raging thirst can be reduced by the juice.
Why do I wake up at 3am? ›If you wake up at 3 a.m. or another time and can't fall right back asleep, it may be for several reasons. These include lighter sleep cycles, stress, or underlying health conditions. Your 3 a.m. awakenings may occur infrequently and be nothing serious, but regular nights like this could be a sign of insomnia.
Why can't I stop moving my legs when trying to sleep? ›Restless legs syndrome, also known as Willis-Ekbom disease, is a common condition of the nervous system that causes an overwhelming, irresistible urge to move the legs. It can also cause an unpleasant crawling or creeping sensation in the feet, calves and thighs. The sensation is often worse in the evening or at night.
How do I stop fidgeting in bed? ›
Take a warm shower or bath before bedtime. Try a mindful activity before bedtime, such as reading a book or doing a crossword puzzle. Take a quick walk before bed. Try lightly massaging your legs before you sleep.
What is the best sleeping position for restless legs? ›Sleeping Position
Along with a new mattress, how you sleep is essential to alleviating RLS symptoms. For instance, sleeping on your back is ideal because it evenly distributes your body weight and lets your back muscles relax.
Sanyinjiao (SP6): The Leg Tai Yin Spleen Meridian—the point is located on the inner side of the leg, three inches above the ankle and posterior to the medial crest of the tibia.
How long does restless leg syndrome last? ›It is a condition where leg muscles contract and jerk every 20 to 40 seconds during sleep. These movements may last less than 1 second, or as long as 10 seconds.
What foods to avoid with restless legs? ›The top three foods to avoid are chocolate, sugary sodas, and fried foods. Additionally, you will also want to avoid any foods or beverages that contain caffeine, since this can stimulate your nerves and make your symptoms more severe. These include coffee, tea, energy drinks, and chocolate.
Is restless legs a vitamin deficiency? ›Current Knowledge/Study Rationale: Most evidence to date suggests that brain dopaminergic dysfunction plays a key role in the development of restless legs syndrome (RLS), and vitamin D is essential for the function of the dopaminergic system.
Does peanut butter help you sleep? ›Peanut butter also provides many micronutrients and is a good source of vitamin E. Additionally, it contains the amino acid tryptophan, which the body needs to make serotonin and melatonin . Both melatonin and serotonin help regulate the sleep-wake cycle and promote quality sleep .
Do compression socks help with restless legs? ›Compression socks rank high among restless leg syndrome treatments because of how simple they are. You wear them like you would your regular socks. The applied pressure serves to offset the discomfort caused by RLS.
Does ibuprofen help restless legs? ›Medications for RLS
Over-the-counter medications such as acetaminophen or ibuprofen can be helpful in somepeople with RLS.
Fast facts on restless legs syndrome:
The condition is often caused by a combination of mental and physical factors. Women are more likely to be affected with RLS during pregnancy.
Is restless leg syndrome a form of anxiety? ›
Restless Leg Syndrome is a common symptom of anxiety. We traced this symptom to the adverse effects of chronic stress. Specifically, apprehensive behavior stresses the body. A body that becomes chronically stressed can exhibit symptoms of stress.
Is RLS a form of Parkinson's? ›Restless legs syndrome is a condition that causes an overwhelming urge to move your legs. It is also known as Willis-Ekbom disease. Restless legs syndrome is a common problem for people with Parkinson's, but it can also be a separate condition that is unrelated to Parkinson's.
When should I take magnesium for restless legs? ›The recommended daily amount of elemental magnesium in a supplement form is between 200 to 400 mg daily for adults. Taking it at bedtime should benefit sleep. Some doctors recommend taking magnesium as a separate supplement rather than relying on the dose in a multivitamin supplement.
Can too much vitamin D cause restless legs? ›001, 95% confidence interval [CI] 2.3–7.9). After adjusting for all other significant factors in the multivariate logistic model, vitamin D was significantly associated with RLS (OR 3.1, P < . 002, 95% CI 1.51–6.38).
Does salt stop restless legs? ›Restless legs can be a tormenting condition with the power to keep you awake all night. Epsom salt is a natural muscle relaxant that can soothe and relieve these symptoms. While soaking in a Newton Wood Epsom Salt bath, muscle tension is reduced and your whole body is supported for a healthy night's sleep.
What supplements help restless legs at night? ›Studies suggest that vitamins C, D, and E may help people experiencing restless legs syndrome (RLS). People with RLS experience unpleasant sensations in the legs with the irresistible urge to move them.
Does magnesium help restless leg syndrome? ›Magnesium supplementation is often suggested for restless legs syndrome (RLS) or period limb movement disorder (PLMD) based on anecdotal evidence that it relieves symptoms and because it is also commonly recommended for leg cramps.
Can vitamin B12 cause restless legs? ›Such deficiency significantly affects severity of symptoms and depression symptoms. In addition, decreased serum vitamin B12 levels are independently associated with the development of RLS, which illustrates the complex relationship between vitamin B12 and RLS.
When is the best time to take magnesium for restless legs? ›The recommended daily amount of elemental magnesium in a supplement form is between 200 to 400 mg daily for adults. Taking it at bedtime should benefit sleep.
What foods help restless leg syndrome? ›Diet for Restless Leg Syndrome
Incorporate a variety of fresh fruits and vegetables into your diet with an emphasis on dark leafy greens. Eat a variety of iron-rich foods like lean meat. Include seeds, tree nuts, and legumes in your diet.
Can melatonin help with restless leg syndrome? ›
Don't try melatonin
Melatonin also inhibits the secretion of dopamine, which makes it bad news for restless legs syndrome patients. It might increase RLS symptoms in the evening and night, according to researchers at Sacre-Coeur Hospital in Montreal.
If nerve cells become damaged, the amount of dopamine in the brain is reduced, which causes muscle spasms and involuntary movements. Dopamine levels naturally fall towards the end of the day, which may explain why the symptoms of restless legs syndrome are often worse in the evening and during the night.
Are there foods that aggravate restless leg syndrome? ›The top three foods to avoid are chocolate, sugary sodas, and fried foods. Additionally, you will also want to avoid any foods or beverages that contain caffeine, since this can stimulate your nerves and make your symptoms more severe. These include coffee, tea, energy drinks, and chocolate.
Does elevating your legs help with restless legs? ›Elevation - Some people find relief by elevating their legs and allowing gravity to pull blood back toward the heart.
Why wake up at 3am? ›If you wake up at 3 a.m. or another time and can't fall right back asleep, it may be for several reasons. These include lighter sleep cycles, stress, or underlying health conditions. Your 3 a.m. awakenings may occur infrequently and be nothing serious, but regular nights like this could be a sign of insomnia.
What does it mean to toss and turn all night? ›There are many reasons for tossing and turning at night, including poor sleep hygiene, an unbalanced diet, and even underlying medical conditions. Practicing good sleep hygiene, such as turning off electronics and keeping a consistent sleep schedule, can help you stop tossing and turning so much at night.