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What Causes Restless Leg Syndrome To Get Worse

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Restless Legs Syndrome And Periodic Limb Movement Disorder

Restless Leg Syndrome

Most people who have RLS also have a condition called periodic limb movement disorder . PLMD involves repetitive flexing or twitching of the limbs while asleep at night. It is different from RLS in that these movements are not accompanied by uncomfortable sensations and because they occur during sleep, patients are often not aware of them. However, PLMD-associated movements can cause a person to wake up and therefore can compound sleep issues in patients who also have RLS.

Although most people with RLS have PLMD, many with PLMD do not have RLS.

What Is The Prognosis For People With Restless Legs Syndrome

RLS is generally a lifelong condition for which there is no cure. However, current therapies can control the disorder, minimize symptoms, and increase periods of restful sleep. Symptoms may gradually worsen with age, although the decline may be somewhat faster for individuals who also suffer from an associated medical condition. A diagnosis of RLS does not indicate the onset of another neurological disease, such as Parkinsons disease. In addition, some individuals have remissionsperiods in which symptoms decrease or disappear for days, weeks, months, or yearsalthough symptoms often eventually reappear. If RLS symptoms are mild, do not produce significant daytime discomfort, or do not affect an individuals ability to fall asleep, the condition does not have to be treated.

Symptoms Of Restless Legs Syndrome

The main symptom of restless legs syndrome is an overwhelming urge to move your legs.

It can also cause an unpleasant crawling or creeping sensation in the feet, calves and thighs.

The sensation is often worse in the evening or at night. Occasionally, the arms are affected, too.

Restless legs syndrome is also associated with involuntary jerking of the legs and arms, known as periodic limb movements in sleep .

Some people have the symptoms of restless legs syndrome occasionally, while others have them every day.

The symptoms can vary from mild to severe. In severe cases, restless legs syndrome can be very distressing and disrupt a person’s daily activities.

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How Is Restless Legs Syndrome Diagnosed

Since there is no specific test for RLS, the condition is diagnosed by a doctors evaluation. The five basic criteria for clinically diagnosing the disorder are:

  • A strong and often overwhelming need or urge to move the legs that is often associated with abnormal, unpleasant, or uncomfortable sensations.
  • The urge to move the legs starts or get worse during rest or inactivity.
  • The urge to move the legs is at least temporarily and partially or totally relieved by movements.
  • The urge to move the legs starts or is aggravated in the evening or night.
  • The above four features are not due to any other medical or behavioral condition.

Diagnosing RLS in children may be especially difficult, since it may be hard for children to describe what they are experiencing, when and how often the symptoms occur, and how long symptoms last. Pediatric RLS can sometimes be misdiagnosed as “growing pains” or attention deficit disorder.

If Im Pregnant Are My Dietary Needs The Same

Is Restless Leg Syndrome the Real Cause of Your Insomnia ...

According to a 2009 study, up to 26 percent of pregnant women have RLS. The exact cause isnt clear, but changing hormones, low dopamine levels, and nutrient deficiencies may be responsible.

If youre pregnant and have RLS symptoms, you should talk to your doctor about getting your iron levels checked. If theyre low, your doctor may recommend eating more iron-rich foods or taking iron supplements.

If diet and lifestyle changes dont help, your doctor may prescribe antiepileptic drugs, opioids, and certain benzodiazepines. According to a 2008 study, these drugs are safe to use during pregnancy. Because all drugs pass through the placenta to your unborn baby, you should use the least amount necessary for the shortest amount of time.

In many cases, pregnancy-related RLS goes away on its own after your baby is born.

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Does Dehydration Cause Restless Legs

RLS can be aggravated by dehydration from a lack of water intake. So in addition to avoiding diuretics such as the caffeine sources listed above, you may also want to avoid nighttime alcohol intake, and drink liberal amounts of sparkling water, filtered water, or decaffeinated teas throughout the day.

Primary Restless Legs Syndrome

Primary restless legs syndrome tends to begin slowly, around the age of 40. This is earlier than most secondary RLS cases. RLS also runs in families, suggesting a genetic link.

There is research that suggests restless legs syndrome may be connected to problems with a part of the brain called the basal ganglia, which uses dopamine to control muscle movement. If transmission of dopamine signals in this part of the brain becomes impaired, it can result in muscle spasms and jerky movements.

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Establish A Bedtime Routine

Creating a bedtime routine is essential for several reasons, most notably better quality of sleep. Studies show that a regular sleep schedule promotes sound sleep quality. If you struggle getting to sleep, a bedtime routine can help turn off your brain and help you reach optimal sleep.

Try setting an alarm to wake you up in the morning, as well as for bedtime. You can use an app on your phone to manage a sleep schedule that will set an alarm to wake you up and silence your phone so you can get peacful sleep. Its important to go to bed and wake up at the same time every day, even on the weekend so your body is getting optimal rest.

Restless Legs Syndrome Faqs

Restless Leg Syndrome Treatment Stop Symptoms Causes

Q: Is restless legs syndrome painful?A: Not generally. People tend to describe the sensations caused by restless legs syndrome as uncomfortable, such as feelings of crawling or itching. In severe cases, people may report feeling pain.

Q: Does restless legs syndrome get worse with age?A: Primary restless legs syndrome has no cure. Although symptoms may worsen with age, treatment and therapy can bring symptoms under control and minimize disruption to everyday life.

Q: What vitamins help restless leg syndrome?A: Sometimes restless legs syndrome is caused by an iron deficiency, in which case iron supplements can ease or reverse symptoms. If a person has a healthy and balanced diet, there is usually no need for supplements. A medical professional can assess whether symptoms of RLS are caused by a vitamin or mineral deficiency and can recommend supplements where necessary.

Q: Does magnesium help restless legs syndrome?A: Although some people with restless legs syndrome report that products like magnesium oil spray have been helpful, and others report magnesium supplements helped with insomnia,, Harvard Menâs Health Watch notes that studies on magnesium and sleep have, to date, been small and of short duration. A well grounded scientific basis for using magnesium to help with restless legs syndrome is currently lacking.

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Periodic Limb Movements In Sleep

Up to 80% of people with restless legs syndrome also have periodic limb movements in sleep .

If you have PLMS, your leg will jerk or twitch uncontrollably, usually at night while you’re asleep. The movements are brief and repetitive, and usually occur every 10 to 60 seconds.

PLMS can be severe enough to wake up both you and your partner. The involuntary leg movements can also occur when you’re awake and resting.

Hot And Cold Treatments

While theres not a lot of research backing up using heat and cold to relieve RLS symptoms, many healthcare organizations recommend it. They include the Restless Legs Syndrome Foundation .

These organizations suggest taking a hot or cold bath before going to bed, or applying hot or cold packs to your legs .

Some peoples RLS symptoms are aggravated by cold, while others have problems with heat. This could explain the benefits of these hot or cold treatments.

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When Should I See A Doctor About Restless Legs Syndrome

You should see a doctor to confirm the diagnosis of RLS and to exclude other conditions that may resemble RLS. The doctor can treat associated problems like iron deficiency.

If you have RLS, you should also see a doctor if you are:

  • Feeling depressed or anxious
  • Having trouble concentrating

You don’t have to wait until one of these things happens. If you just want to feel better, see your doctor.

Testing For Restless Legs Syndrome

Restless Leg Syndromes Little

Because restless legs syndrome is caused by underlying conditions, there is not a lab test or scan that can be used to diagnose restless legs syndrome. However, your doctor can test for underlying medical conditions such as anemia, diabetes, or kidney disease that is linked to restless legs syndrome. Blood tests can measure your blood count, hemoglobin levels, basic organ functions, and thyroid hormone levels.

I found that the following ranges for hormone levels are where my patients at my clinic thrived, not just lived:

  • TSH levels of 1-2 UIU/ML or lower
  • FT4 levels > 1.1 NG/DL
  • RT3 levels < 10:1 ratio RT3:FT3
  • TPO TgAb levels < 4 IU/ML or negative

Remember, it is the individual level of each hormone that determines if your hormones are in balance. Conventional medicine tests for isolated hormones on their own, which will not pick up on whether your hormones are out of balance.

Labs such as Ulta Labs offer at-home tests for hemoglobin, liver and kidney function, and thyroid hormone levels.

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Causes Of Restless Legs Syndrome

In many cases, the exact cause of restless legs syndrome is unknown.

When no cause can be found, it’s known as “idiopathic” or primary restless legs syndrome.

Research has identified specific genes related to restless legs syndrome, and it can run in families. In these cases, symptoms usually occur before the age of 40.

What Is Primary Versus Secondary Rls

Experts categorize RLS into two groups: primary RLS and secondary RLS.

These two groups differ in what is the underlying cause of symptoms. Most cases are categorized as primary RLS. Primary, or idiopathic, means that there is no known cause of the condition.

Secondary RLS is when another underlying condition causes RLS .

We will discuss the possible causes of RLS later in the article.

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Treatment Of Restless Legs Syndrome In Children

The US Food and Drug Administration has not approved any medication for treating restless legs syndrome in children. The long-term effects of treating children with medication approved for adults are unknown.

Benzodiazepines, such as clonazepam, are not recommended for children because they can increase the risk of collapse of the upper airway. Up to 20 percent of children taking levodopa and carbidopa develop a side effect of feeling nauseous.

Good sleep habits are recommended for treating restless legs syndrome in children, as is avoiding caffeine and antihistamines. Vitamin and mineral supplements may help, when taken in consultation with a doctor.

Restless Legs Syndrome Prognosis

How can I relieve restless leg syndrome during pregnancy?

Restless legs syndrome is a lifelong condition that might get worse with age. But some people go into remission and donât have symptoms for days to years.

Keep your doctor updated on how youâre doing. If you start to feel worse, they might suggest different lifestyle changes or medications.

It can help to talk to other people who know what youâre going through, whether itâs a family member who has RLS or a support group.

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How Long Will Restless Legs Syndrome Last

Symptoms of primary or idiopathic RLS typically worsen over time, but, for some people, weeks or months may pass without any symptoms. If the RLS stems from a condition, illness, pregnancy, or medication, it may go away as soon as the trigger has gone.

RLS can pose problems for women during pregnancy.

Women who already have RLS can find that symptoms get worse during pregnancy. However, becoming pregnant can lead to RLS in its own right. Symptoms tend to get worse as the pregnancy progresses and are especially likely in the third trimester.

The cause of the increased incidence of RLS during pregnancy is unknown, but the following factors are believed to be involved:

  • low levels of minerals or vitamins, such as iron and folate
  • sleep deprivation as a result of changes in the body and discomfort
  • changes in the hormones
  • increased sensitivity of the senses

This condition has not been widely researched during pregnancy. However, some of the drug treatments used outside of pregnancy, such as rotigotine and gabapentin, have not been assessed for safe use in women who are pregnant.

Behavioral treatments, such as mild exercise and a healthy sleeping pattern, are often recommended as a first-line treatment for women during pregnancy.

If iron levels are low and thought to be the cause of RLS, oral iron supplements are safe to prescribe during pregnancy. In severe cases, higher concentrations may be administered intravenously through a drip.


There are two main types of RLS:

What Can Be Done For Rls

  • Lifestyle changes. RLS is worse if you are tired. It is important to obtain sufficient sleep but of course RLS can make it difficult to both initiate sleep and stay asleep. Keeping your feet out of the bedclothes or having a fan in the bedroom at night may help you stay asleep. See the sleep hygienepage for day-to-day things you can do which may make you sleep better or worse.
  • Avoid caffeine. It is important to avoid taking any caffeinated drinks after around 1800, and not to take too many early in the day.
  • Change drugs. Medication given for another condition may induce RLS and an alternative may need to be found.
  • Treat the cause. If RLS is due to another medical condition such as iron deficiency or kidney failure these should be treated wherever possible.
  • Drug treatment. This is often effective but it is best to only have a low dose and to take care with the timing of the medication so that the RLS symptoms can be suppressed as much as possible. The most effective drugs are the dopaminergic agents which compensate for any lack of availability of dopamine within the brain. Several of these are available and each has its advantages and disadvantages. Alternatives are conventional sleeping tablets although these may cause hangover sleepiness on the next morning, and drugs like codeine may help. Some of the anticonvulsants, particularly gabapentin, are also useful.

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Treatment If The Condition Gets Worse

What Causes Restless Legs Syndrome?

Over time, treatment of RLS with a dopamine medicine may not work as well as it did at first. This is called augmentation.

You might notice that your symptoms:

  • Begin earlier in the day.
  • Become more intense.
  • Spread to another part of your body.

If you are taking a dopamine medicine for RLS and your symptoms change, tell your doctor. Do not stop taking your medicine without talking to your doctor first. You can work with your doctor to decide what treatment is the best one for you.

If you continue to have symptoms even though you are receiving treatment with drugs and are exercising regularly, eating right, and not smoking, drinking alcohol, or using caffeine, your symptoms may need to be reevaluated. Many other conditions can cause the sensations found in restless legs syndrome, including several vitamin and mineral deficiencies.

Your doctor may recommend different drugs or a combination of drugs. Follow up with your doctor if your symptoms do not improve.

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What Are The Symptoms Of Restless Legs Syndrome

Symptoms of restless legs syndrome include:

  • Leg discomfort: These uncomfortable limb sensations are often described by adults as creeping, itching, pulling, crawling, tugging, throbbing, burning, or gnawing. These sensations usually occur at bedtime but can occur at other times of limb inactivity.
  • Urge to move legs : To relieve limb discomfort, you have an uncontrollable urge to move your limbs especially when resting, such as when sitting or lying down.
  • Sleep disruption: Additional time is often needed to fall asleep because of the urge to move your limbs to relieve the discomfort. Sometimes staying asleep may also be difficult.
  • Bedtime behavior problems: Because of the discomfort, you may need to get out of bed to stretch your limbs to relieve the discomfort.
  • Daytime sleepiness: Problems with falling asleep and staying asleep may result in daytime sleepiness.
  • Behavior and work performance problems: Again, due to sleep disruption, problems may emerge in daytime behavior and work performance.

Can Restless Leg Syndrome Be Prevented Or Avoided

RLS cant be prevented because doctors arent sure what causes it. But there are some things you can do to help lessen your symptoms.

Lifestyle changes to treat RLS:

  • For mild symptoms, use an over-the-counter pain reliever to reduce twitching and restless sensations.
  • Cut back on alcohol, caffeine, and tobacco.
  • Try taking a hot bath and massaging your legs before bedtime to help you relax.
  • Relaxation techniques, such as meditation and yoga, can help you relax before bed.
  • Apply warm or cool packs to your legs, which can help relieve sensations.
  • Try to distract your mind by reading or doing a crossword puzzle while you wait for sleep to come.
  • Moderate exercise may help, but dont overdo it. Exercising vigorously or late in the day may make symptoms worse.
  • Try to go to bed at the same time every night and wake up at the same time every morning. Also try to get a sufficient amount of sleep each night.

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