Restless Legs Syndrome

Restless legs syndrome (RLS) also known as Willis-Ekbom Disease is a neurological disorder that affects a significant number of individuals. It is characterized by uncomfortable sensations in the legs, accompanied by an irresistible urge to move them.

Manuela Băbuș
Medical Writer
Restless Legs Syndrome

These symptoms are most commonly experienced during the late afternoon or evening hours and tend to intensify when a person is at rest or attempting to sleep. 

Consequently, RLS often disrupts sleep patterns, making it challenging to fall asleep or return to sleep after waking up. Temporary relief can be obtained by moving the legs or engaging in walking, but the sensations often reoccur once the movement stops.

Restless Legs Symptoms are categorized as both a sleep disorder and a movement disorder

  • As a sleep disorder, the symptoms manifest during periods of rest and when individuals are attempting to sleep. 
  • As a movement disorder, individuals with RLS feel compelled to move their legs to alleviate the discomfort.

The prevalence of RLS is estimated to be around 7% to 10 % of the U.S. population, and it can develop at any age. 

Both males and females can be affected, although females have a higher likelihood of experiencing RLS. The condition is often more severe in middle-aged or older individuals, with symptoms tending to become more frequent and enduring as they age.

The Causes of Restless Legs Syndrome

The exact causes of RLS remain elusive, but both genetic and environmental factors are believed to play a role. 

Imbalances in neurotransmitters, such as dopamine, and alterations in iron metabolism have been implicated in RLS development. 

Some conditions, including chronic diseases (Parkinson’s, kidney, diabetes, peripheral neuropathy) and medications, can also trigger or exacerbate symptoms.


In some cases, Restless Legs Syndrome (RLS) exhibits a familial pattern, particularly when the onset of the condition occurs before the age of 40. Through scientific investigations, researchers have identified specific locations on the chromosomes that may harbor genes associated with RLS.


RLS can occur during pregnancy, predominantly in the third trimester, and often resolves after delivery.


Certain medications have the potential to exacerbate symptoms of Restless Legs Syndrome (RLS). These include anti-nausea medications, antipsychotics, certain antidepressants, as well as cold and allergy medications containing antihistamines.

Lifestyle factors 

Inadequate sleep or the presence of other sleep disorders, such as sleep apnea, can trigger or exacerbate RLS symptoms. Additionally, the use of alcohol, tobacco, and caffeine has been associated with an increased likelihood of experiencing RLS symptoms or making them worse.

Symptoms of Restless Legs Syndrome

Individuals with RLS experience a range of distressing sensations in their legs, such as tingling, itching, or an urge to move

These symptoms typically emerge in the evening or during periods of rest, causing considerable discomfort. 

Sleep disturbances, including difficulty falling asleep and frequent nighttime awakenings, are common among RLS sufferers.

Diagnosis of Restless Legs Syndrome

There is no specific medical test to diagnose Restless Legs Syndrome (RLS).

Your doctor may rely on a combination of criteria and evaluations to assess your symptoms. 

The diagnosis of RLS typically involves the following five basic criteria:

  1. An overwhelming urge to move the legs is often accompanied by uncomfortable or unusual sensations.
  2. The urge to move the legs becomes more pronounced during periods of rest.
  3. Movement provides partial or total relief from the urge to move.
  4. Symptoms tend to worsen in the evening.
  5. The presence of other conditions, such as leg cramps, arthritis, or muscle pains, is ruled out as the cause of symptoms.

A neurological and physical examination, combined with a comprehensive assessment of medical history, family history, and current medication list, can be valuable in diagnosing Restless Legs Syndrome (RLS). 

Often, patients may struggle to accurately describe their condition, which can potentially mislead the physician.

It is important to have a discussion with the doctor regarding the frequency, duration, and intensity of the symptoms

Blood tests may be conducted to rule out other potential causes of RLS symptoms, such as kidney failure, low iron levels, and sleep disturbances caused by conditions like sleep apnea or pregnancy. 

Polysomnography, a sleep study, may also be conducted to evaluate for the presence of other sleep disorders that could contribute to RLS symptoms.

Diagnosing RLS in children can be particularly challenging due to difficulties in describing their symptoms. Pediatric RLS may sometimes be misdiagnosed as "growing pains" or attention deficit hyperactivity disorder (ADHD).

Treating  Restless Legs Syndrome

While RLS is a lifelong condition for which there is no cure, treatments are available to alleviate its symptoms. These treatments aim to manage discomfort and improve sleep quality for individuals affected by RLS.

Medications for RLS:

  1. Iron Supplements (can be beneficial, especially for individuals with low iron levels)
  2. Anti-seizure Drug (can help reduce sensory disturbances and nerve pain associated with RLS).
  3. Dopaminergic Agents (increase dopamine levels in the brain and are taken at night to alleviate RLS symptoms).
  4. Opioids ( may be prescribed for individuals with severe RLS symptoms unresponsive to other medications)
  5. Benzodiazepines (could be prescribed for anxiety, muscle spasms, and insomnia, can improve sleep quality for individuals with RLS)

! Please note that only a healthcare professional can determine the severity of the diagnosis and the necessary treatment for Restless Legs Syndrome (RLS)

There are lifestyle measures that are accessible to everyone and have significant beneficial effects  for mild to moderate RLS:

  1. Avoid or Reduce Alcohol, Nicotine, and Caffeine:
  2. Maintain a Regular Sleep Pattern (establishing a consistent sleep schedule and practicing good sleep hygiene) 
  3. Engage in moderate, regular exercise:
  4. Self-Care Measures (massaging the legs, taking warm baths, applying heat or cold packs, using foot wraps or vibration pads can offer some relief)
  5. Aerobic and Leg-Stretching Exercises (Incorporating aerobic exercises and moderate-intensity leg-stretching exercises into your routine may help manage RLS symptoms)

Some individuals with RLS may refrain from seeking medical attention due to concerns about not being taken seriously. However, RLS can disrupt sleep, lead to daytime drowsiness, and impact overall quality of life. 

It is advisable to consult with a healthcare provider if there are suspicions of having RLS!

Please note that the information provided on this blog is for educational and informational purposes only. It is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.

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Manuela Băbuș.
Medical Writer