Restless Legs Syndrome (RLS) is a neurological disorder characterised by an uncontrollable urge to move the legs, typically occurring in the evening or at night. This condition can significantly impact sleep quality and overall well-being. This article will explore RLS, including its causes, symptoms, and advice from London’s leading sleep clinician on managing the condition effectively.

What is restless legs syndrome?

Restless Legs Syndrome, also known as Willis-Ekbom Disease, is a sensorimotor disorder that affects the nervous system. It is characterised by uncomfortable sensations in the legs, often described as tingling, itching, crawling, or aching. These sensations create an overwhelming urge to move the legs, which can temporarily relieve discomfort. Symptoms typically worsen during periods of inactivity and are most pronounced in the evening or night, leading to significant sleep disturbances. Individuals with RLS often report the following symptoms:

• Unpleasant sensations in the legs, such as throbbing, pulling, or creeping feelings.
• An irresistible urge to move the legs to relieve discomfort.
• Symptoms that worsen at night or during periods of rest.
• Temporary relief from movement, such as stretching, walking, or massaging the legs.
• Sleep disturbances due to discomfort lead to daytime fatigue and impaired cognitive function.

The severity of symptoms can vary, with some individuals experiencing mild, occasional discomfort and others facing severe, chronic symptoms that significantly impact their quality of life.

Causes of RLS

Several underlying factors contribute to the development of RLS. These include:

• Genetics: Studies indicate that RLS has a hereditary component, mainly when symptoms manifest before the age of 40.
• Dopamine dysfunction: Dopamine is a neurotransmitter responsible for regulating movement, and an imbalance in dopamine levels is believed to play a role in RLS.
• Iron deficiency: Low iron levels in the brain can interfere with dopamine function, potentially triggering RLS symptoms.
• Chronic diseases: Medical conditions such as kidney disease, diabetes, and peripheral neuropathy are associated with an increased risk of developing RLS.
• Pregnancy: Some women develop RLS during pregnancy, particularly in the third trimester, due to hormonal changes and temporary iron deficiency.
• Medications: Certain drugs, including antihistamines, antidepressants, and antipsychotics, may worsen symptoms.
• Lifestyle Factors: Consumption of caffeine, alcohol, and nicotine, along with insufficient physical activity, may exacerbate RLS symptoms.

Risk factors for RLS include ageing, female gender, genetics, iron deficiency, chronic diseases, and neurological disorders. Pregnancy, sleep deprivation, and certain medications can also worsen symptoms.

How is restless legs syndrome diagnosed?

RLS is diagnosed clinically based on symptom patterns, including an urge to move the legs, worsening symptoms at night, and temporary relief with movement. A detailed medical history, including family history and lifestyle factors, helps to rule out other conditions. While no specific test confirms RLS, blood tests may check for iron deficiency, kidney function, or neurological issues contributing to symptoms.

In severe cases, a sleep study (polysomnography) may be conducted to assess limb movements and overall sleep quality. Neurological examinations help to exclude disorders like neuropathy or Parkinson’s disease. The International Restless Legs Syndrome Study Group (IRLSSG) criteria provide a standardised diagnostic approach, ensuring accurate evaluation and management.

Tips to help

While there is no cure for RLS, several treatment options can manage symptoms and improve sleep quality. 

Lifestyle modifications

Adopting healthy lifestyle habits can alleviate RLS symptoms and improve sleep quality. Here are some effective lifestyle modifications that can help to manage RLS:

• Maintaining a regular sleep schedule.
• Engaging in moderate physical activity, such as walking or stretching exercises.
• Reducing caffeine, alcohol, and nicotine intake, as these can exacerbate symptoms.
• Practicing relaxation techniques, such as yoga, meditation, and deep breathing exercises.
• Using warm baths or massage therapy to relieve leg discomfort.

Dietary adjustments

A well-balanced diet can play a crucial role in managing Restless Legs Syndrome. Ensuring adequate iron intake through iron-rich foods such as red meat, spinach, and fortified cereals is essential, as iron deficiency is closely linked to RLS symptoms. In some cases, iron supplements may be necessary under medical supervision.

Additionally, incorporating magnesium- and folate-rich foods like nuts, legumes, and leafy greens may support nerve function and reduce symptoms. Reducing caffeine, alcohol, and sugar intake can also help to minimise disruptions to sleep and alleviate discomfort associated with RLS.

Addressing underlying conditions

Managing underlying conditions is crucial in reducing RLS symptoms. Chronic illnesses such as diabetes, kidney disease, and peripheral neuropathy should be treated appropriately, as they can contribute to RLS. Addressing nutritional deficiencies, such as iron deficiency, through supplements or dietary changes can also alleviate discomfort. 

Other treatment options

If lifestyle changes and diet adjustments are not enough to manage restless legs syndrome, other approaches may be needed. Doctors may check for iron deficiency, as low iron levels can worsen symptoms. Iron supplements can help in such cases but should only be taken under medical guidance. For severe cases, doctors may recommend medicines that help to relax the nerves and muscles, making sleeping easier. These options vary for each person, so it is important to discuss them with your doctor to find the best solution.

By following these tips, individuals can experience significant relief and improved sleep quality. Untreated RLS can cause chronic sleep deprivation, leading to fatigue, irritability, and cognitive decline. It may also contribute to depression, anxiety, and impaired daily functioning due to poor rest and reduced concentration.

How can Dr Sandip Banerjee help?

If Restless Legs Syndrome (RLS) is affecting your sleep or daily life, it is important to seek medical advice. Dr Sandip Banerjee specialises in diagnosing and treating RLS, helping patients find relief from discomfort and sleep disturbances. Through detailed assessments, he identifies the root cause of symptoms and develops a treatment plan tailored to each patient’s needs. His approach focuses on improving sleep quality, reducing leg discomfort, and preventing RLS from impacting overall well-being.

With extensive experience in sleep medicine, Dr Banerjee offers advanced sleep studies, medication options, and lifestyle recommendations to manage RLS effectively. His patient-centred care ensures that individuals receive the right interventions to control symptoms. By addressing RLS early, he helps patients achieve better sleep and improve their quality of life.