Restless legs syndrome (RLS) is a condition characterized by unpleasant, painful sensations in the lower extremities, which appear mainly at rest (more often in the evening and at night) and force the patient to make movements that facilitate them, which lead to sleep disturbance.
Medstatistiki argues that in the world from 10 to 25% of all adults have some form of RLS. RLS occurs in all age groups, but is more common in middle and old age. Sometimes remissions can occur, during which the symptoms are significantly weakened or disappear altogether. However, symptoms usually reappear after a while and worsen over time. RLS is responsible for approximately 15% of chronic insomnia cases.
The reasons
In most cases, RLS occurs in the absence of any other neurological or medical condition. RLS can be primary ( ideopathic ) and secondary (associated with various pathological conditions).
Medical conditions in which secondary RLS may occur.
- Pregnancy
- Peripheral neuropathy
- Iron deficiency
- Radiculopathy
- Renal failure
- Parkinson’s disease
- Spinal cord injury
- Diabetes
- Postgastrectomy syndrome
- Rheumatoid arthritis
- Abuse of hard liquor, coffee, tea and smoking.
It should be noted that not all patients with these conditions develop RLS. Sometimes there are family cases when the disease is observed in several generations.
Symptoms
First of all, RLS is characterized by the appearance of unpleasant sensations in the lower extremities . This is most often not pain, but itching, trembling, burning, stretching, feeling of internal tension, bursting, tingling and twitching in the depths of the legs, thighs, and feet. These sensations arise in waves, every 5-30 seconds. They usually occur at rest: while sitting or lying down, and especially when falling asleep. To alleviate their condition, patients are forced to stretch and bend their limbs, shake them, rub and massage them, toss and turn in bed, get up and walk around the room, or shift from foot to foot. During movement, the unpleasant sensations weaken or disappear, but as soon as the patient lies down, and sometimes just stop, they intensify again.
RLS symptoms are circadian in nature, i.e. have a clear diurnal rhythm , appearing or intensifying in the evening or at night: between 6 pm and 4 am. Symptoms subside before dawn and may disappear altogether in the first half of the day. In severe cases, the characteristic circadian rhythm disappears and symptoms become permanent. They can occur not only in a lying position, but also in a sitting position and can make it unbearable to visit a movie or theater, or a long trip in transport.
The consequence of unpleasant sensations in the legs and the need to constantly move them is sleep disturbance – insomnia . Patients cannot sleep for a long time and often wake up at night. The consequence of insomnia is drowsiness and fatigue during the daytime.
Periodic limb movements worsen sleep disturbance in RLS . During sleep, patients have involuntary rhythmic short-term twitching of the lower extremities every 5-40 seconds. In mild forms, these movements are within 1-2 hours after falling asleep, in severe forms, they can continue all night.
In idiopathic RLS, clinical manifestations persist throughout life, and in most cases there is a tendency towards a slow onset of symptoms, although prolonged remissions are possible. Severe restless legs syndrome and, as a result, poor health, drowsiness, decreased alertness, asthenia significantly reduces the quality of a person’s life, makes him nervous, irritable, tired.
Diagnosis
To date, no specific nervous system disorders characteristic of RLS have been identified. For the diagnosis, the most valuable is a correctly collected anamnesis and understanding of the clinical picture of the disease. And also a fairly informative test is polysomnography .
Identifying “secondary RLS” requires excluding comorbidities that can cause RLS.
Treatment
Properly prescribed treatment will eliminate the symptoms of restless legs syndrome on the very first night of therapy. Seek the advice of a physician who is a sleep disorder specialist.
Conclusion