Restless Legs Syndrome

Restless legs are best described as those "creepy crawly" sensations in your legs, sometimes described as feeling like "Pepsi Cola in the veins." The sensations can also occur in the arms.

The sensations typically begin in the late evening around bedtime, having a circadian rhythm of their own, or at other times when one is sitting still. To relieve the sensations, the person needs to move, run, rub or walk. Frequently the need to move prevents and interrupts the onset of sleep.

Restless legs chronically affects about five percent of the adult population.

Restless legs and, to some extent, periodic leg movements have been also associated with diabetic peripheral neuropathy, vascular illnesses, kidney disease, and iron deficiency anemia. They are frequent in pregnancy.

Good control of the underlying condition will help relieve symptoms. Alcohol worsens the situation (especially in women), as can tricyclic antidepressants.

Drugs which increase the neurotransmitter dopamine, which affects movement, can be very useful. Many of these are the same as those used to treat Parkinson's disease. Other treatments have been used with varying effects. These include hypnotic and sedative medications to blunt the brain's alerting response to the activity. Additionally, pain medications can be useful for extreme cases. Anti-seizure medications have also been used successfully for restless legs syndrome.

Along with medications, behavioral treatments like relaxation therapy, massage, biofeedback or the trick of keeping your mind active with challenging games or work will help. Avoiding alcohol can also help.

Recent work of Dr. Richard Allen at Johns Hopkins and Drs. Arthur Walters and Wayne Henning at the JFK Memorial Medical Center in Edison, New Jersey, has tried to establish the cause of this disorder. They have shown that the sensations may be linked to an imbalance in the brain of ferritin, a form of iron carried in the blood. Genetic studies are also under way.

Do you have Restless Legs Syndrome?

Symptoms of RLS include:

• an urge to move limbs
• uncomfortable sensations in legs or arms
• motor restlessness
• worsening of these symptoms with relaxation

Symptoms of periodic limb movement include:

• repetitive, stereotyped movements of limbs during sleep that occur every 15 to 40 seconds
• movements usually involve the toe, with flexing at the ankle, knee or hip
• symptoms may increase with alcohol use, pregnancy, or age
• daytime sleepiness