Most people are familiar with the occasional involuntary muscle movement. It is not unusual to experience a sudden jerky movement just as you are falling asleep. These are known as hypnic jerks or sleep starts and may wake you out of a light sleep.
Restless Leg Syndrome (RLS) is a sleep disorder where sufferers experience movement and unpleasant sensations in the legs during the evening or when falling asleep. Periodic Limb Movement Disorder (PLMD) involves the rhythmic extension of the big toe and movement of the ankle, knee and hip. They are often seen with other sleep disorders, specifically Narcolepsy and REM Sleep Behaviour Disorders.
RLS is probably the most frequent movement disorder, although it often remains undiagnosed and under treated. Restless Leg Syndrome was considered to be a fairly rare condition until fairly recent research showed that many people from different age groups suffer from the condition.
RLS affects more women than men and affects all age groups, although it increases with advancing age. If there is a family connection, symptoms are likely to present before the age of 20. There is some evidence that it is higher in specific populations. Sufferers of Attention Deficit and Hyperactivity Disorder (ADHD) and children experiencing ‘growing pains’ are more likely to suffer from the disorder.
RLS often accompanies the sleep breathing disorder, Sleep Apnea. This is often treated with Continuous Positive Airway Pressure which helps the sufferer breath during sleep. Research has shown that the treatment fails to affect the symptoms of RLS and in some cases the symptoms have even increased.
RLS syndrome has also been connected with kidney disease and pregnancy.
Although it may accompany some sleep disorders it may also affect those who are healthy and unaffected by sleep problems.
Symptoms that start during the evening may interfere with sleep. As the sufferer can only relieve the discomfort by moving or walking they may delay going to bed or need to get up to walk around. This means that they may experience difficulty getting to, or staying asleep. Although many people do not suffer from any problems during the day, it is important that sufferers get sufficient sleep.
Symptoms and Treatment
The main symptom of RLS is the uncontrollable urge to move and unpleasant sensations in the legs. They are usually worse in the evening and at night, and can be relieved by moving.
There is no clear evidence of what causes the condition. Some experts suggest a connection between the disorder and the Circadian Rhythms that influence sleep and waking. Researchers are currently looking into the connection of Dopamine and the spinal cord. There has been a good response to treatment with dopaminergic drugs. It is believed that the role of Dopamine is connected to the evidence that dopamine is at its lowest level in the body during the night when the symptoms are at their worst.
One study into insomnia and RLS has shown that these conditions may be related to low levels of magnesium. Magnesium levels may be low in the body due to stress or too much sugar. Supplements may be taken in the evening and magnesium is found in nuts, seeds, green vegetables and seafood.
Iron supplements may also be recommended.
Learning Breathing Techniques and avoiding stimulants such as caffeine and heavy exercise in the hours before bedtime will help sufferers relax and return to sleep.
It is important that those experiencing symptoms of RLS are correctly diagnosed. They may be accompanied by other sleep related disorders which could be helped with treatment or therapy. Sufferers may delay going to bed or find it difficult getting to sleep knowing that the discomfort may start at any time. By learning how to relax, taking nutritional advice and avoiding alcohol they may be able to improve their quality of sleep.