RESTLESS LEGS SYNDROME
Restless Legs Syndrome (RLS) 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. Symptoms of RLS are most severe in the evening and nighttime hours and can profoundly disrupt a patient’s sleep and daily life.
RLS can run in families and may have a genetic component. Studies have led to the discovery of the RLS gene that may account for approximately 50% of RLS cases. Certain medical and other environmental factors may lead to expression of the symptoms. Iron deficiency is felt to be a common medical condition involved with RLS.
Symptoms
Urge to move the legs often associated with uncomfortable feeling in the legs (e.g. creepy, crawling, itching, tingling, pulling or aching) during periods of inactivity, including both sleep and wakefulness, and improvement with movement.
Involuntary jerking of the limbs that intensifies in the evening or at night and is relieved by movement.
People with RLS tend to have difficulty falling or staying asleep and suffer from chronic sleep loss, leaving them with the cognitive and tired feelings that occur with sleep loss.
TREATMENT
The first thing a patient must do in treating Restless Legs Syndrome (RLS), is talk with a physician and determine whether related conditions (such as iron deficiency anemia, diabetes, arthritis, or the use of anti-depressant medications) are a contributing factor to the symptoms and movements.
Some home remedies are effective in treating symptoms of RLS. Some of these remedies include: a hot bath, leg massage, applied heat, ice packs, pain relievers, exercise and eliminating caffeine.
When home remedies are not effective, RLS can be treated with prescription medication. Until recently, there were no FDA-approved drugs for the treatment of RLS. In May 2005, a drug called Requip® (ropinirole hydrochloride) that is commonly used to treat Parkinson disease was given FDA approval at lower doses for the treatment of moderate-to-severe primary RLS after patients in clinical trials enjoyed more and better-quality sleep as early as one week after starting treatment. In 2006, a drug by the name of Mirapex® was also approved by the FDA for the treatment of moderate-to-severe primary RLS. In clinical trials of Mirapex® it was shown that lower doses (than used for Parkinson’s disease) improve RLS symptoms, sleep satisfaction, and quality of life. Neupro® ( Rotigotine) patch was reintroduced in the US in 2012 and has been available as an option as well.
In addition to Requip® and Mirapex®, Neupro®, there are several drugs approved for other conditions that have been shown to alleviate RLS symptoms. They are:
Dopaminergic agonists — reduce RLS symptoms
Dopaminergic agents — reduce RLS symptoms
Benzodiazepines — allow for a more restful sleep
Opiates — induce relaxation and diminish pain
Other medications — Horizant®
SOURCE: INDIANA SLEEP CENTER