How do you beat rls

Sleep and its disorders. Bradley's Neurology in Clinical Practice. Durmer JS. Restless legs syndrome, periodic leg movements and periodic limb movement disorder. Principles and Practice of Pediatric Sleep Medicine. Elsevier Saunders; chap Interventions for chronic kidney disease-associated restless legs syndrome.

Cochrane Database Syst Rev. Comparative efficacy and acceptability of treatments for restless legs syndrome in end-stage renal disease: a systematic review and network meta-analysis. Nephrol Dial Transplant. J Prim Care Community Health. Genetics of restless legs syndrome: An update. Sleep Med Rev. Kalra S, Gupta A. Diabetes Ther. The influence of antidepressants on restless legs syndrome and periodic limb movements: A systematic review. Therapeutic utility of opioids for restless legs syndrome.

Opioids for restless legs syndrome. Owens JA. Sleep medicine. In: Kliegman RM, St. Nelson Textbook of Pediatrics. Pediatric restless legs syndrome diagnostic criteria: an update by the International Restless Legs Syndrome Study Group. Ramar K, Olson EJ. Management of common sleep disorders. Am Fam Physician. Mayo Clin Proc. Cannabinoid therapies in the management of sleep disorders: A systematic review of preclinical and clinical studies.

Sleep disorders. Goldman-Cecil Medicine. Philadelphia, PA: Elsevier Saunders; chap Wijemanne S, Ondo W. Restless Legs Syndrome: clinical features, diagnosis and a practical approach to management.

Pract Neurol. Practice guideline summary: treatment of restless legs syndrome in adults: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Reviewed by: Joseph V. Review provided by VeriMed Healthcare Network.

Editorial team. Highlights Overview Restless legs syndrome RLS is a condition in which one has feelings of "pulling, searing, drawing, tingling, bubbling, or crawling" beneath the skin, usually in the calf area.

Specific characteristics of RLS include: Uncomfortable feelings of "pulling, searing, drawing, tingling, bubbling, or crawling" beneath the skin, usually in the calf area, causing an irresistible urge to move the legs. These sensations occur mostly in the lower legs, but they can sometimes affect the thighs, feet, and even in the arms. These may be the first symptoms of RLS in some people. Semi-rhythmic movements during sleep known as periodic limb movement disorder PLMD , which occurs in about 4 out of 5 patients with RLS.

See description below. Itching and pain, particularly aching pain. Symptoms usually occur at night when people are most relaxed, with their legs at rest, lying down. In more severe cases, symptoms also occur during the day while sitting.

Movement relieves the symptoms. RLS episodes usually occur between 10 p. Symptoms are often worse shortly after midnight and disappear by morning. If the condition becomes more severe, people may begin to have symptoms during the day, but the problem is always worse at night. Disturbed nighttime sleep due to the unpleasant sensations and strong urge to move the legs. Resisting the urge to move the legs usually leads to tension build up until the legs jerk uncontrollably.

People who experience daytime symptoms may find it difficult to sit during air or car travel, or through classes or meetings. People may feel excessively tired during the daytime as a result of inadequate or poor sleep. Late-onset and Early-onset Forms Restless Legs Syndrome can be either an early-onset or late-onset form of the syndrome.

Each form may have different characteristics: People with early-onset RLS occurring in the teenage years or earlier tend to have a family history of the disorder. They usually have RLS without accompanying pain. Early-onset RLS is more common in women than in men. The condition is more likely to result from a problem with the nervous system. Symptoms may also include pain in the lower legs. Contractions and jerking of the leg muscles every 20 to 40 seconds during sleep. Movements of PLMD do not wake the person who actually has it, but they are often noticed by their bed partner.

This condition is distinct from the brief and sudden movements that occur just as people are falling asleep, which can interrupt sleep. Causes The main cause of RLS is unknown. Neurological Abnormalities Dopamine and Neurologic Abnormalities in the Brain Several studies support the theory that an imbalance in neurotransmitters chemical messengers in the brain , notably dopamine, may play a part in RLS.

Neurologic Abnormalities in the Spine Other research suggests that RLS may be due to nerve impairment in the spinal cord. Neuropathy A disorder of the peripheral nerves is known as neuropathy. Abnormalities of Iron Metabolism Iron deficiency, even at a level too mild to cause anemia, has been linked to RLS in some people. Deficiencies in Cortisol Other research suggests that low levels of the hormone cortisol in the evening and early night hours may be related to RLS.

Pregnancy About 1 in 5 pregnant women reports having RLS. Dialysis RLS is relatively common in people with chronic kidney disease undergoing kidney dialysis. Anxiety Disorders Anxiety can cause restlessness and agitation at night. Others may have a common cause, or they may coexist due to other risk factors: Osteoarthritis degenerative joint disease.

About three-quarters of patients with RLS also have osteoarthritis, a common condition affecting older adults. Varicose veins. Varicose veins occur in about 1 in 7 patients with RLS. People with type 2 diabetes may have higher rates of secondary RLS. Nerve pain neuropathy related to their diabetes cannot fully explain the higher rate of RLS.

Hypertension high blood pressure. Rheumatoid arthritis. Chronic obstructive pulmonary disease COPD. Chronic alcoholism. Sleep apnea pauses in breathing during sleep and snoring. Chronic headaches. Brain or spinal injuries. Many muscle and nerve disorders. Of particular interest is hereditary ataxia, a group of genetic diseases that affects the central nervous system and causes loss of motor control. Researchers believe that hereditary ataxia may supply clues to the genetic causes of RLS.

Attention-deficit hyperactivity disorder ADHD. Psychiatric disorders, such as depression. People who are deficient in iron are at risk for RLS, even if they do not have anemia. Folic acid or magnesium deficiencies. Alcohol abuse. Coffee drinking is specifically associated with PLMD. Prolonged exposure to cold. Complications RLS rarely results in any serious consequences. Sleep Deprivation Inability to sleep during the night due to RLS symptoms and subsequent daytime sleepiness can cause mood changes.

Effect on Daily Performance and Activities Sleeplessness has a negative effect on the ability to function while awake. Areas that can be affected include: Concentration. Loss of deep sleep can impair the brain's ability to process information. Task performance. Missing several hours of sleep every night can negatively affect a person's mood and ability to function. People deprived of sleep show lowered performance levels on a par with those of people who are intoxicated.

The extent to which sleeplessness impairs learning is unclear. Some studies have reported problems in memorization. Psychiatric Effects People with RLS are more likely to suffer problems such as social isolation, frequent daytime headaches, and depression.

Diagnosis A diagnosis of RLS often relies mainly on the person's description of symptoms. The doctor may ask the following questions: How would you describe your sleep problem? How long have you had this sleep problem? How long does it take you to fall asleep? How many times a week does the problem occur? How restful is your sleep? What do your leg problems feel like such as cramps, twitching, and crawling feelings?

What is your sleep environment like? Not dark enough? What medications are you taking including the use of antidepressants and self-medications -- such as herbs, alcohol, and over-the-counter or prescription drugs?

Are you taking or withdrawing from stimulants, such as coffee or tobacco? How much alcohol do you drink per day? What stresses or emotional factors may be present in your life? Have you experienced any significant life changes?

Do you snore or gasp during sleep? This may be an indication of sleep apnea. Sleep apnea is a condition in which breathing stops for short periods many times during the night. It may worsen symptoms of RLS or insomnia. If you have a bed partner, does he or she notice that you have jerking legs, interrupted breathing, or thrashing while you sleep? Are you a shift worker? Keeping a Record of Sleep To help answer some of these questions, the person may need to keep a sleep diary for 2 weeks.

Sleep Disorders Centers Some people may need to consult a sleep specialist or go to a sleep disorders center in order for the problem to be diagnosed. Signs that may indicate the need to go to a sleep disorders center are: Insomnia due to psychological disorders Sleeping problems due to substance abuse Snoring and sudden awakening with gasping for breath possible sleep apnea Severe RLS Persistent daytime sleepiness Sudden episodes of falling asleep during the day possible narcolepsy Polysomnography Overnight polysomnography involves a series of tests to measure different functions during sleep.

Polysomnography tracks the following: Brain waves Body movements Breathing Heart rate Eye movements Changes in breathing and blood levels of oxygen There are simpler sleep studies that can be performed in one's own home and may provide information that excludes a sleep disorder or necessitates further confirmation.

Actigraphy Actigraphy uses a small wristwatch-like device such as Actiwatch worn on the wrist or ankle. Sleepiness Scale The Epworth Sleepiness Scale uses a simple questionnaire to measure excessive sleepiness during common situations, such as sitting or watching TV. There are two steps in making this diagnosis: The first step is to determine if a person is actually deficient in iron.

If iron stores are low, the second step is to diagnose the cause of the iron deficiency, which will help determine treatment. The following tests may be used: Blood smear. Blood cells viewed under the microscope appear pale hypochromic and abnormally small microcytic. These observations suggest iron deficiency, as well as anemia resulting from chronic disease and thalassemia an inherited blood disorder.

Hemoglobin, iron, ferritin. Low levels of hemoglobin and iron further suggest iron deficiency, but can also occur in cases of anemia due to chronic disease or other causes.

Low levels of ferritin, a protein that binds to iron typically indicate a lack of iron in the body. However, normal levels of ferritin in the blood do not always mean a patient has enough iron.

For example, pregnant women in their third trimester or patients with a chronic disease may not have enough iron even with normal or high ferritin levels. A test that measures a factor called serum transferrin receptor sTfR helps in identifying iron deficiency in some patients, including older people with chronic diseases and possibly pregnant women. When iron deficiency anemia is diagnosed, the next step is to determine the cause of the iron deficiency itself.

Menstrual blood loss is a common cause of iron deficiency in women of reproductive age. Tests to check for an underlying cause of iron deficiency, such as gastrointestinal digestive tract bleeding, are particularly important in men, postmenopausal women, and children.

Other Laboratory Tests The following laboratory tests may be helpful in determining causes of RLS or identifying conditions that rule it out.

Blood glucose tests for diabetes Tests for kidney problems In certain cases, tests for thyroid hormone, magnesium, and folate levels Electromyography recording the electrical activity of muscles for neuropathy or radiculopathy problem with the nerve roots Central nervous system MRI for myelopathy or stroke Ruling Out Other Disorders In addition to other sleep-related leg disorders, many other medical conditions may have features that resemble RLS. Peripheral Neuropathies Peripheral neuropathies are nerve disorders in the hands or feet, which can produce pain, burning, tingling, or shooting sensations in the arms and legs.

Akathisia Akathisia is a state of restlessness or agitation, and feelings of muscle quivering. Meralgia Paresthetica An uncommon nerve condition, meralgia paresthetica causes numbness, pain, tingling, or burning on the front and side of the thigh.

Nocturnal Nighttime Leg Cramps Benign nocturnal leg cramps Charley horse are muscle spasms in the calf. Among the conditions that might cause leg cramps are: Calcium and phosphorus imbalances, particularly during pregnancy. Disorders of the peripheral nerves, such as polyneuropathy due to diabetes, chemotherapy, kidney disease, or others. Disorders of the motor neuron, such as amyotrophic lateral sclerosis ALS.

Low potassium or sodium levels. Overexertion, standing on hard surfaces for long periods, or prolonged sitting especially with the legs contorted. Having structural disorders in the legs or feet such as flat feet. Medical causes of muscle cramping which include hypothyroidism, Addison's disease, uremia, hypoglycemia, anemia, and certain medications. Various diseases that affect nerves and muscles, such as Parkinson disease, cause leg cramps.

Nighttime leg cramps can generally be treated with lifestyle changes. The doctor should first try to treat any underlying medical conditions that may be causing restless legs. If medications may be causing RLS, the doctor should try to prescribe alternatives, depending on the risk to benefit ratio. Lifestyle Changes Some people report that making the following changes help control RLS: Taking hot baths or using cold compresses. Quitting smoking. Getting enough exercise during the day.

Doing calf stretching exercises at bedtime. Using ergonomic measures. For example, working at a high stool where legs can dangle helps some people. Also, sitting in an aisle seat during meetings or airplane travel can allow for more leg movement. Changing sleep patterns.

Some people report that symptoms do not occur when they sleep in the late morning. Therefore, people may consider changing their sleep patterns if feasible. Avoiding caffeine, alcohol, and nicotine also improves some cases of RLS. Foot wraps have been shown to help some people with RLS in preliminary studies.

Dietary Iron RLS is often associated with iron deficiency, so people with RLS related to iron deficient should make sure they get enough iron in their diet. Iron is found in foods either in the form of heme or non-heme iron: Foods containing heme iron are the best for increasing or maintaining healthy iron levels.

Such foods include clams, oysters, organ meats, beef, pork, poultry, and fish. Many people with RLS report that drinking can lead to more restless legs symptoms. Try omitting alcohol to see whether your restless legs improve and whether you feel more rested in the morning.

Vigorous exercise. Getting moderate exercise during the day can help ease restlessness at night. But vigorous exercise, especially close to bedtime, can have the opposite effect in some people.

A number of medications can make RLS worse. Antidepressants that increase serotonin and antipsychotic medications can also aggravate the condition. Let your doctor know if your restless legs symptoms worsen after you take a new medication. A change in dosage or to a different medication may do the trick. Salas says recent research shows it may not be that big of a problem. In fact, she says, it may be beneficial in some people. Try cutting out coffee, tea, colas, sports drinks, and even chocolate to see if your symptoms improve or worsen.

Other Restless Legs Triggers Other health conditions can also cause restless legs. According to Dr. In some cases, caffeine makes the symptoms of Restless Legs Syndrome worse.

Try to avoid drinking tea and coffee and see if it makes a difference. Alcohol can also cause issues so consider giving up booze. These NHS services can help you quit. A warm bath before bed can help you relax and may ease symptoms. You can also alternate between hot and cold compresses to relieve the twitching or pain. Magnesium may help relax the muscles and lesson symptoms. Credit: BetterYou. Alternatively, add more magnesium-rich foods to your diet, such as leafy greens, nuts, bananas, and salmon and mackerel.

Avoid too much sugar, alcohol, caffeine and stress, which can deplete magnesium levels. Eat plenty of iron-rich foods, including red meat, liver though avoid liver during pregnancy , beans, nuts, dried fruit and fortified breakfast cereals.

A lack of sleep can have numerous detrimental effects.