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People with RLS sense unpleasant feelings in their legs—creeping, crawling, tingling, pulling or painful sensations. Unlike other conditions, RLS symptoms get worse when relaxing or lessening activity, particularly during the evening and nighttime sleeping hours. If not treated, RLS can cause extreme tiredness and daytime fatigue.

What is Restless Legs Syndrome?

If you have restless legs syndrome (RLS), you may recognize these symptoms:

  • An urge to move the legs, often accompanied by uncomfortable sensations in the legs, usually described as a creeping or crawling feeling, but sometimes as a tingling, cramping, burning or just plain pain. Some patients have no definite sensation, except for the need to move
  • The need to move the legs to relieve the discomfort, by stretching or bending, rubbing the legs, tossing or turning in bed, or getting up and pacing the floor
  • A definite worsening of the discomfort when lying down, especially when you're trying to fall asleep at night or during other forms of inactivity
  • A tendency to experience the most discomfort late in the day and at night
  • Pregnancy or hormonal changes may temporarily worsen RLS symptoms

Sleep disturbances are common with RLS and are a major effect. The sleep disturbances can range from mild to severe, but sleep problems are often the reason that people suffering from RLS seek a doctor's help.

If leg twitching or jerking is also present, a related disorder called periodic limb movements during sleep (PLMS) may be the cause. With PLMS, the leg movements may be severe enough to awaken you or arouse you from your sleep state enough to cause you daytime sleepiness the following day. In RLS, PLMS-like symptoms can sometimes occur during wakefulness, as well as in sleep.

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How Common is RLS?

According to the National Center on Sleep Disorders Research, "restless legs syndrome is a common, under-diagnosed and treatable condition."

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What Causes RLS?

The cause of RLS is still unknown but the symptoms tend to worsen over the years and become more severe in middle-to-old age. The fact that it occurs three to five times more frequently in first-degree relatives of people with RLS than in people without RLS suggests that heredity may be involved.

Pregnancy or hormonal changes may temporarily worsen RLS symptoms.

  • Some cases of RLS are associated with iron deficiency anemia or nerve damage in the legs due to diabetes, kidney problems, alcoholism and Parkinson's disease.
  • Stress, diet or other environmental factors may play a role for some people. All of these cases are said to be secondary RLS.

If there is no family history of RLS and no associated condition causing the disorder, RLS is said to be idiopathic, meaning without a known cause.

RLS can begin at any age and many individuals with RLS can trace their symptoms back to childhood, when their symptoms may have been called "growing pains" or attributed to hyperactivity because they had difficulty sitting quietly

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Is RLS Serious?

The symptoms of RLS can range anywhere from bothersome to incapacitating. Fluctuations in severity are common, and occasionally the symptoms may disappear for periods of time. The following have all been reported in association with RLS:

  • Anxiety as bedtime approaches
  • Frustration with nighttime awakenings
  • Moodiness and depression
  • Difficulty concentrating
  • Excessive daytime sleepiness

It also can affect marital, family and social relations as well as having an adverse effect on school, work or other activities. Another effect can be increased drowsiness while driving or great difficulty performing overnight shift work.

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How is RLS Diagnosed?

The International Restless Legs Syndrome Study Group has established the following clinical criteria for diagnosis of RLS:

  • A compelling urge to move the limbs
  • Motor restlessness; for example, floor pacing, tossing and turning, and rubbing the legs
  • The symptoms may be worse or exclusively present at rest, with variable and temporary relief by activity
  • Symptoms are worse in the evening and at night

If you experience these symptoms, you should visit with your doctor or with a sleep physician at North Dakota Center for Sleep.

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Can RLS Be Treated?

Most cases of RLS responds well to medical, pharmacological treatments.

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Where Do I Go for Help?

The sleep physicians at North Dakota Center for Sleep can help diagnose and manage RLS and sleep disorder of all sorts.

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