Restless Leg Syndrome Affects Sleep Patterns

Approximately one in ten adult Americans suffer from Restless Legs Syndrome, also known as Willis-Ekbom Disease. This sleep-related movement disorder is known best for its overwhelming and often unpleasant urges to move the legs while at rest. 

This condition is a neurologic sensorimotor disorder that is characterized by an overwhelming urge to move the legs when they are at rest. The urge to move the legs is usually, but not always, accompanied by unpleasant sensations.

Restless Leg and Sleep

Considered a sleep disorder, it can interfere with falling asleep—and remaining asleep.  The result can be chronic fatigue during day-time activities.  Diagnosis of this annoying condition involves ruling out other causes (such as sleep position, arthritis, or a vitamin deficiency). 

The symptoms usually occur at night, and can limit your ability to sleep.  RLS can have a major impact on sleep — making it difficult for people to experience REM (or deep sleep) in order to get a good night's sleep. Some RLS-sufferers resort to sleeping pills which can lead to drug dependence. Patients should look into valerian root and chamomile as alternative treatments to induce sleep. 

How Restless Leg Syndrome is Diagnosed

 The Willis-Ekbom Disease Foundation lists five criteria used to determine if RLS is the cause of symptoms, noting symptoms as they worsen in the evening. 

1. You have a strong urge to move your legs (sometimes arms and trunk), usually accompanied or caused by uncomfortable and unpleasant sensations in the legs. 
    
2. Your symptoms begin or become worse when you are resting or inactive, such as when lying down or sitting. 
    
3. Your symptoms get better when you move, such as when you walk or stretch, at least as long as the activity continues. 
    
4. Your symptoms are worse in the evening or night than during the day, or only occur in the evening or nighttime hours. 
    
5. Your symptoms are not solely accounted for by another condition such as leg cramps, positional discomfort, leg swelling or arthritis. WED/RLS often causes difficulty in falling or staying asleep, one of the chief complaints of the syndrome. Many people who have the disease also have periodic limb movements (PLMs)—jerking of the arms or legs that is often associated with sleep disruption.

An iron deficiency has been associated with Restless Leg Syndrome. Due to this, doctors will take a blood sample detecting for serum ferritin level testing. Unlike the hematocrit level (which is a measure of the volume of blood composed of red blood cells), the serum ferritin measures the amount of ferritin in the blood—which is the major iron storage protein in the body. 

Dopamine Affects RLS

The Centers for Disease Control reports that a dopamine abnormality is also present in persons with RLS. Dopamine is a chemical signal in the brain that signals for predicted rewards —often associated with feelings such as motivation, addiction, attention, lust and a key brain signal that is considered in psychosis. Some studies and experts have suggested there is a connection between dopamine levels and RLS, eluding to a potential disorder such as anxiety or obsessive compulsive disorder. But no solid evidence has been put forth. 

Population Affected by RLS

An estimated 10 percent of the U.S. population has Restless Leg Syndrome (according to the National Institute of Neurological Disorders and Stroke).  It is more common in middle-aged people but can be diagnosed in children. This disorder affects approximately 10 percent of the elderly, per the American Parkinson Disease Association.  It is a lifelong disorder for most people who experience it, and further research is needed to find a cure.

Tips to Improve Sleep and RLS

• Take a hot bath with two cups of Epsom salts, which contains magnesium. Soaking magnesium into your muscles before bed will relax them.
• Eat a protein snack before bedtime, such as a hard-boiled egg, a bit of chicken, or meat to keep your blood sugar stable. Low blood sugar is a trigger for RLS, and protein stabilizes it.
• Avoid carbohydrates or sweets before bedtime, which cause a spike and then a crash in blood sugar.
• Take the amino acid L-tryptophan, which Dr. Teitelbaum says some reports have suggested works as a sleep aid for RLS.  Or try the related compound, 5-HTP, a natural sleep aid, as it’s hard to get L-tryptophan without a prescription.
• Check your over-the-counter and prescription medications. Antihistamines and anti-nausea compounds can make RLS worse as well as drugs used to treat high blood pressure, heart conditions, colds, allergies, and depression.
• Drink a lot of water and eat bananas, dehydration and low potassium trigger RLS. 
• Elevate your legs, keep the temperature cool in the room, and do deep-breathing exercises.
• Get tested for sleep apnea if you’re over 40 and overweight. 
• Use a leg-raising pillow. Dee Delezene Browers, RLSsufferer and Director of Volunteers for the U.S. Pain Foundation, says,“They usually sell them in orthopedic catalogs; I got mine at an orthopedic doctor’s clinic. It is about 12 inches tall, very rigid foam that allows your legs to sit on top raised while sleeping.”
• Avoid alcohol and caffeine.
• Change your temperature. Sometimes a switch from hot to cold or vice versa can help. Try alternating warm and cold packs.
• Exercise—but not too much. Exercise to fatigue your muscles is helpful, but too much exercise may trigger your RLS.
• Keep a sleep diary to identify your triggers.