Condition Center: Restless Legs Syndrome

Photo Illustration by Ava Cruz
Photo Illustration by Ava Cruz

This informational guide, part of POPSUGAR's Condition Center, lays out the realities of this health concern: what it is, what it can look like, and strategies that medical experts say are proven to help. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment.

It's estimated that up to 10 percent of the US population may have restless legs syndrome (RLS) regardless of gender or age, according to the National Institute of Neurological Disorders and Stroke (NINDS). RLS is classified as a neurological sensory disorder, because the symptoms stem from the brain, and a sleep disorder, because it makes it difficult to fall or stay asleep. The resulting exhaustion impacts mood, concentration, memory, and productivity; it can even contribute to depression and anxiety, per NINDS. Fortunately, it can be treated.

What Is Restless Legs Syndrome?

Restless legs syndrome (RLS), also called Willis-Ekbom disease, is "a nervous-system disorder that's based on the sensation of an irresistible urge to move the legs or even arms," says Shelby Harris, MD, a licensed clinical psychologist specializing in behavioral sleep medicine and director of sleep health for Sleepopolis. RLS usually strikes in the evening while lying or sitting down, Dr. Harris says. Symptoms can vary in severity and frequency. "People may experience pain or uncomfortableness in the legs, a tingling or burning sensation, increased sleep disturbances, or excessive daytime sleepiness," she adds. According to Mayo Clinic, other symptoms include:

  • Sensations that begin when resting for an extended period of time.
  • Relief when moving, stretching, or walking.
  • Worsening discomfort at night.
  • Leg twitching while asleep (otherwise known as periodic limb movement of sleep).

Causes of Restless Legs Syndrome

"Oftentimes, RLS is caused by other existing medical conditions or medications," Dr. Harris says. Medical conditions that can lead to RLS include peripheral neuropathy, Parkinson's disease, rheumatoid arthritis, kidney failure, spinal-cord conditions, and diabetes, because they all impact the nervous system. Also, due to the neurological correlation between iron and the nervous system, "low iron is also a common cause of RLS but can be effectively treated with iron supplements after being diagnosed by a doctor," she adds.

"But sometimes RLS can be a 'primary' disorder, meaning there are no other existing causes," she says. Research also shows that it can be genetic, according to Mayo Clinic. RLS can be found in all genders, but both the last trimester of pregnancy and perimenopause seem to increase the risk, leading some experts to believe the condition may be linked to changes in levels of the hormone estrogen, according to an article in the International Journal of Environmental Research and Public Health.

Most Effective Restless Legs Syndrome Treatments

RLS is often a lifelong condition, but if there's an identifiable cause — like anemia — it can be controlled or managed, says Mayo Clinic. Even without an identified cause or trigger, there are ways to minimize symptoms and increase one's ability to sleep well. If you think you're experiencing RLS, you should see a doctor for help. Potential treatments include:

  • Lifestyle changes. "There are a few things you can try at home to lessen the symptoms, such as limiting caffeine and alcohol, reducing stress, and avoiding strenuous exercise in the evening," Dr. Harris says. "Gentle massages, light exercise, and cold or warm packs may also help to alleviate RLS symptoms."
  • Iron. After receiving low iron results from a prescribed blood test, over-the-counter iron supplements are often the first line of treatment, per NINDS.
  • Medication. Dopaminergic agents that increase dopamine are typically used to treat Parkinson's and have been shown to reduce symptoms of RLS when taken before bed. The FDA has approved gabapentin, ropinirole, pramipexole, and rotigotine to treat moderate to severe RLS. Also, very low doses of opioids or benzodiazepines can help with obtaining more restful sleep, according to NINDS. However, they are last-line drugs due to side effects.