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-norepinepherine 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 patient^6,7:

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:

American Academy of Neurology website. Restless legs syndrome. http://patients.aan.com/disorders/index.cfm?event=view&disorder_id=1053. Accessed January 2, 2018.
Restless Legs Syndrome Foundation website. Understanding RLS. https://www.rls.org/understanding-rls. Accessed January 2, 2018.
National Sleep Foundation. Restless legs syndrome (RLS) and sleep. https://sleepfoundation.org/sleep-disorders-problems/restless-legs-syndrome. Accessed January 2, 2018.
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.
Patient website. Restless legs syndrome. https://patient.info/health/restless-legs-syndrome-leaflet#nav-0. Accessed January 3, 2018.
Sleep Management Institute website. RLS/PLMD. http://www.sleepmanagement.md/sleepdisorders/RLS-PLMD.aspx. Accessed January 3, 2018.
Medscape website. Restless legs syndrome. https://emedicine.medscape.com/article/1188327-overview?pa=X8cK751reBLkQHumBlaS7uj1ahok2I99zZS7FDPyOZZmJlFKiddE%2BB79UeoqnUM3LY5dv1GLa9D%2BIsS%2BmSdmuodcsLcCFocixa0acF7OcZE%3D#a4. Accessed January 4, 2018.
Medscape website. Fact sheet: prescription medication use by older adults. https://www.medscape.com/viewarticle/501879. Accessed December 29, 2017.
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.