Restless Legs Syndrome (RLS): 10 Frequently Asked Questions

What Causes Restless Legs Syndrome (RLS)?

Restless legs syndrome's cause is usually unknown. Leading experts suspect that in people with restless legs syndrome (RLS), the brain takes up or uses iron abnormally.

Genetics also plays a key role. About half of those with restless legs syndrome have family members affected, too.

Many medical conditions are associated with RLS, including iron deficiency, diabetes, end-stage kidney disease, Parkinson's disease, and even pregnancy. These cases account for a minority of people with restless legs syndrome, however. Treating these conditions, if present, can improve restless legs syndrome symptoms.

Who Gets Restless Legs Syndrome (RLS)?

No one knows the true number of people with restless legs syndrome. About 10% of the population is affected, and about 2% to 3% have moderate to severe symptoms that affect their quality of life. We do know that:

• Women are affected slightly more often than men
• Most people with severe disease are middle-aged or older
• Those with affected family members usually get restless legs syndrome at a younger age, but it progresses more slowly

Does Restless Legs Syndrome Ever Go Away by Itself?

There are reported cases of spontaneous remissions of restless legs syndrome. However, according to Mark Buchfuhrer, MD, a sleep specialist and national expert in restless legs syndrome, "these are very rare." Instead, he says, "for most people, this is a progressive disease, with symptoms getting gradually worse over time."

For those with RLS symptoms caused by a medical condition, treatment of that condition can relieve or improve their restless legs syndrome.

Will Restless Legs Syndrome Develop Into Something More Serious?

Most people with restless legs syndrome have the "idiopathic" form -- meaning there's no known cause. For them, says Buchfuhrer, "there is no risk of progression to more serious conditions, such as Parkinson's disease."

Restless legs syndrome can also be caused by medical conditions or diseases (such as iron deficiency, diabetes, or kidney disease). If untreated, these medical conditions can cause serious health problems, as well as worsen RLS.

How Can I Get a Good Night's Sleep Despite Restless Legs Syndrome (RLS)?

Experts agree that simply changing behavior can often help. For those with mild to moderate restless legs syndrome, these steps could reduce or prevent symptoms:

• Reduce caffeine intake
• Cut down on alcohol
• Stop smoking, or at least cut back
• Maintain a regular sleep pattern
• Exercise regularly, but moderately (heavy exercise can worsen symptoms)
• Apply heat or ice, or soak in a hot bath

When Should I Consider Seeing a Doctor About Restless Legs Syndrome (RLS)?

No one should live with significant discomfort without discussing their symptoms with a physician. Even if you feel your RLS symptoms are mild, they might be seriously affecting your sleep.

Only you can decide when your restless legs symptoms are affecting your life. If you have the symptoms of restless legs syndrome, consider if you're also:

• Losing sleep frequently
• Feeling depressed or anxious
• Having trouble concentrating

If any of these are present -- or if you just want to feel better -- it's time to talk to your doctor. 

Are There Treatments for Restless Legs Syndrome?

There are two FDA-approved medicines for restless legs syndrome: Mirapex and Requip. Both were proven effective in clinical trials in reducing the symptoms of RLS.

Physicians also use other medicines not specifically designed for treating restless legs syndrome. These include:

• Anti-seizure medicines, such as gabapentin
• Opiate pain medicines, such as hydrocodone, propoxyphene, or tramadol
• "Sedative-hypnotics," such as clonazepam or zolpidem.

What Else Can I Do to Cope With Restless Legs Syndrome (RLS)?

Depression and anxiety commonly result from restless legs syndrome. If you have moderate to severe RLS, it's important to find ways to cope with the stress it can cause. Here are a few ways to take control:

• Work with your doctor: changes or combinations of medicines are often necessary to control symptoms.
• Join a support group: www.rls.org and www.rlshelp.org can get you started.
• If you feel overwhelmed by RLS, consider speaking with a professional mental health provider.

Restless Legs Syndrome (RLS): 10 Frequently Asked Questions

What Is the Connection Between Iron and Restless Legs Syndrome (RLS)?

Iron deficiency is one of the uncommon causes of restless legs syndrome. Replacing the low iron may improve or eliminate RLS in these people.

Even for people whose restless legs syndrome has no clear cause -- and who have normal iron levels -- iron is probably involved. Studies show a "brain iron deficiency" in many people with restless legs syndrome. Research is ongoing to discover how and why this happens, and whether therapy can be targeted to this problem.

People with normal iron levels and restless legs syndrome should not take iron pills. Excess iron can cause liver damage and other problems.

What Is the Relation Between Restless Legs Syndrome and Periodic Limb Movement Disorder?

More than 80% of people with restless legs syndrome also have periodic limb movement disorder (PLMD). In PLMD, the arms or legs twitch or jerk involuntarily throughout the night. The movements disturb sleep and can contribute to chronic fatigue.

Many people have periodic limb movement disorder by itself, and will never develop restless legs syndrome. However, periodic limb movement disorder sometimes precedes the onset of restless legs syndrome.

WebMD Medical Reference

SOURCES: Mark Buchfuhrer, MD, attending staff physician, Downey Regional Medical Center, Downey, Calif. Georgianna Bell, executive director, Restless Legs Syndrome Foundation. James Connor, PhD, professor and vice chairman, department of neurosurgery, Penn State University, State College, Pa. Walt Kolakowski, Jackson, Mich. National Institute of Neurological Disease and Stroke, National Institutes of Health web site: "Restless Legs Syndrome Fact Sheet." Ekbom, K. Acta Medica Scandinavica, 1945; vol 158: pp 4-122. Willis, T. London Practice of Physick, publisher unknown, 1685. eMedicineHealth web site: "Restless Legs Syndrome." Earley, C. New England Journal of Medicine, 2003; vol 348: pp 2103-2109. Restless Legs Syndrome Foundation web site message boards. Walters, A. Movement Disorders, 1995; vol 10: pp 634-638. Allen, R. Sleep Medicine, 2003; vol 4: pp 101-110. Ekbom, K. Neurology, 1960; vol 10: pp 868-874. Kavanagh, D. American Journal of Kidney Diseases, 2004; vol 43: pp 763-771. Lopes, L. Diabetes Care, 2005; vol 28: pp 2633-2636. Garcia-Borreguero, D. Neurology, 2003; vol 61: pp S49-S55. Manconi, M. Neurology, 2004; vol 63: pp 1065-1069. Press release, GlaxoSmithKline. Medscape Medical News: "FDA Approvals: Allegra Oral Solution, Noxafil, Mirapex." Comella, C. Neurology, 2002; vol 58: pp S87-S92.

Reviewed by Celia E. Dominguez, MD on February 15, 2007

© 2007 WebMD, Inc. All rights reserved.

©2005-2007 WebMD, Inc. All rights reserved.
WebMD does not provide medical advice, diagnosis or treatment.