Restless Legs Syndrome: A Closer Look

Restless legs syndrome (RLS) is a condition characterized by an uncontrollable and often overwhelming urge to move the legs.1 The symptoms of RLS can range from uncomfortable to painful, and they can significantly impact quality of sleep as well as quality of life.1,2

At a Glance

  • An estimated 10% of U.S. adults suffer from RLS.3
  • Patients may describe RLS symptoms as creeping, tingling, crawling, pulling, itching, the “heebie jeebies,” and simply needing to move.4
  • RLS symptoms typically worsen during inactivity—particularly at nighttime—and improve with activity.4
  • Symptoms most commonly occur between the knees and feet,4 and episodes can last anywhere from 10-60 seconds.5
  • RLS is often unrecognized or misdiagnosed as insomnia or other conditions; it can also be confused with depression.6
  • RLS can start at any age, but the severity seems to increase with age.6

Cause of RLS

In most cases, the primary cause of RLS is idiopathic. However, research suggests that gene variants and a lack or imbalance of neurotransmitters—particularly dopamine—may contribute to RLS.4,5

Secondary causes of RLS may include4:

Iron deficiency

Renal failure

Neuropathy

Pregnancy

Multiple sclerosis

Essential tremor

Parkinson's disease

SCA3 (Machado-Joseph disease)

And others

Additionally, alcohol and caffeine can exacerbate RLS symptoms.7

Rx Medications Associated With RLS

As a healthcare professional, you’re aware that our senior population accounts for a large portion of prescription medication use.8 In fact, a recent AARP survey revealed that the majority of respondents age 65 and older took a prescription medication regularly. Of those respondents, more than 80% took at least two, and more than half took at least four.9

Increased medication usage of course means increased side effects. Did you know certain medications can cause or exacerbate RLS symptoms? These may include7:

Diphenhydramine

Antidopaminergic medications (e.g. neuroleptics)

Selective serotonin reuptake inhibitors

Tricyclic antidepressants

Serotonin-norepinephrine reuptake inhibitors

Beta blockers

Lithium

Non-opioid Theraworx Relief can be used as a companion product to manage symptoms associated with RLS, which may be caused by these medications.

Diagnosing RLS

Recording symptom details and medical information, as well as running certain diagnostic tests, can assist in determining the impact of RLS and the course of action.

Find out from the patient6,7:

  • Where the RLS symptoms occur and what the patient was doing prior
  • What time of day or night symptoms typically occur
  • How long each episode lasts
  • How often symptoms occur
  • Family history of RLS
  • Relevant medical conditions that could contribute to RLS symptoms
  • Current medications that may cause or exacerbate RLS symptoms

Run the following iron-deficiency tests7:

  • Iron levels
  • Ferritin
  • Transferrin saturation
  • Total iron binding capacity

Consider the following tests7:

  • Complete blood count
  • Blood urea nitrogen
  • Creatinine
  • Fasting blood glucose
  • Magnesium
  • Thyroid-stimulating hormone
  • Vitamin B-12
  • Folate

Managing RLS Symptoms

While there are several pharmacological therapy options available for RLS, many of them are associated with side effects. Such options include dopaminergic agents, opioids, anticonvulsants, benzodiazepines, presynaptic alpha-2-adrenergic agonists, and iron salt.4,7

Some research supports non-pharmacologic management methods like exercise, measures to improve sleep quality, avoiding alcohol and caffeine, discontinuing medications that can cause or exacerbate RLS symptoms, and pre-bedtime routines like hot/cold bath, massage, or electrical stimulation.

Theraworx Relief has been shown to reduce the severity of symptoms associated with RLS.

See how Theraworx Relief is different

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REFERENCES:

  1. American Academy of Neurology website. Restless legs syndrome. http://patients.aan.com/disorders/index.cfm?event=view&disorder_id=1053. Accessed January 2, 2018.
  2. Restless Legs Syndrome Foundation website. Understanding RLS. https://www.rls.org/understanding-rls. Accessed January 2, 2018.
  3. National Sleep Foundation. Restless legs syndrome (RLS) and sleep. https://sleepfoundation.org/sleep-disorders-problems/restless-legs-syndrome. Accessed January 2, 2018.
  4. Restless Legs Syndrome Foundation, RLS Webinar Series 2017. “Restless Legs Syndrome” hosted by William Ondo, MD. https://www.rls.org/file/member-publications/webinars/2017/What-is-RLS_Dr.Ondo_5.17.2017.pdf. Accessed January 3, 2018.
  5. Patient website. Restless legs syndrome. https://patient.info/health/restless-legs-syndrome-leaflet#nav-0. Accessed January 3, 2018.
  6. Sleep Management Institute website. RLS/PLMD. http://www.sleepmanagement.md/sleepdisorders/RLS-PLMD.aspx. Accessed January 3, 2018.
  7. Medscape website. Restless legs syndrome. https://emedicine.medscape.com/article/1188327-overview?pa=X8cK751reBLkQHumBlaS7uj1ahok2I99zZS7FDPyOZZmJlFKiddE%2BB79UeoqnUM3LY5dv1GLa9D%2BIsS%2BmSdmuodcsLcCFocixa0acF7OcZE%3D#a4. Accessed January 4, 2018.
  8. Medscape website. Fact sheet: prescription medication use by older adults. https://www.medscape.com/viewarticle/501879. Accessed December 29, 2017.
  9. AARP website. 2015 survey on prescription drugs. https://www.aarp.org/content/dam/aarp/research/surveys_statistics/health/2015/prescription-drug-report-2015.pdf. Accessed December 29, 2017.
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