Is Restless Legs Syndrome (RLS) Behind Your Insomnia?
Unfortunately, that is exactly the situation of the approximately ten percent of Americans who will at one point in their life suffer from Willis-Ekbom disease, more often known as "restless legs syndrome."
The disorder gets its name from its most prominent symptom: an overwhelming urge to move one's legs. This urge starts or worsens during rest, is partially or totally relieved by movement, and is usually more prominent in the evening.
Though patients sometime describe these symptoms as painful, they are more likely to describe them as tingling, pulling, throbbing, aching, itching, creeping, or crawling.
Despite the emphasis on the legs in RLS's name, a small percentage of RLS patients will instead (or additionally) report these unusual creepy crawly sensations in other parts of their body, like the arm, chest, head, or abdomen.
RLS is considered a sleep disorder because it typically results in insomnia, so much so that it has been nicknamed "the sleep thief." However, its symptoms can also appear anywhere else you may be expected to sit for an extended time, from airplanes to theaters to road trips to desks.
RLS is also more likely to appear in older patients, and tends to worsen with age; those who begin experiencing symptoms before the age of 40 are often found to have a family history of the disorder and a particular genetic profile. Restless legs syndrome is also twice as common in women as it is in men. Plus, it is particularly prominent in pregnant women.
This may be related to physical impact of carrying a baby on muscles in the lower limbs, hormonal factors, or micro-nutrient deficiencies that arise as more and more of nutrients are needed by the developing baby. Luckily, pregnancy-associated cases of RLS often disappear following delivery.
RLS should not be diagnosed if the patient's unusual leg sensations result from another disorder, such as leg cramps or arthritis. However RLS can, but by no means must, be caused by certain underlying conditions.
These conditions include Parkinson's disease, kidney disease, diabetes, multiple sclerosis, and peripheral neuropathy. RLS may also be a side effect of certain medications, including anti-depressant, anti-allergy, anti-nausea, and anti-psychotic medications.
There are no specific tests that can confirm an RLS diagnosis, but once your doctor suspects the condition, they may order some to rule out these underlying conditions and address any co-morbid sleep disorders.For example, many people with RLS also suffer from periodic limb movement disorder, which causes the limbs to twitch and jerk during sleep. A higher proportion than expected of sleep apnea patients suffer from RLS as well.
Treating any underlying conditions will often result in improvement in RLS symptoms, but other cases have no clear biological cause. However, some simple lifestyle changes could go also go a long way in ameliorating symptoms.First, RLS patients should avoid alcohol,which has a documented deleterious effect on sleep patterns. They should also stay away from stimulants like tobacco and caffeine, especially in the evenings. They also may benefit from efforts to physically relax their legs, like light stretching, gentle yoga, massages, hot baths, heating pads, ice packs, or even specialized vibrating pads. Some sufferers have also found that placing a pillow between their legs helps prevent symptoms, possibly be discouraging nerve compression.RLS patients may also benefit from forms of moderate exercise like swimming, walking, or cycling, though exercise that is too intense or undertaken too close to bedtime may actually worsen symptoms.They can also try improving their sleep hygiene—for example, trying to go to sleep and wake up at the same time each day and making sure their sleeping space is dark, quiet, comfortable, and free of all digital distractions. Some patients may also find relief via herbal or hormonal remedies like melatonin, essential oils, or chamomile tea.
However, if none of these lifestyle changes seem to be doing the trick, more serious forms of RLS may require medication. Medicines sometimes prescribed doctors for RLS can range from dopaminergic drugs, benzodiazepines, anticonvulsants, alpha 2 agonists, narcotics, and over-the-counter painkillers like ibuprofen.
So what's behind this peculiar disorder? Science still isn't quite sure, but one theory blames the condition on a lack of dopamine, a neurotransmitter critical to normal muscle movement. This explains RLS's associations with Parkinson's disease, a neurological disorder that involves a much more extensive dopamine deficit. RLS has also been associated with ADHD, another condition which is thought to be related to abnormalities in the brain's dopamine system.RLS and ADHD may also both be related to low levels of iron in the brain, which can occur even if blood levels of iron are normal. Some RLS patients have thus found increasing their iron intake helpful. Good 123Diet-safe animal sources of iron include red meat, poultry and seafood, while vegan sources include dark green leafy vegetables and beans. Since Vitamin C is necessary for iron absorption, you may also want to bolster your diet with citrus fruits, citrus fruit juices, leafy greens, and strawberries.RLS has also been associated with altered gut bacteria and excess inflammation, so incorporating more gut-healthy and anti-inflammatory foods into your diet could also help you towards healing.Finally, RLS has been tentatively linked with deficiencies of other micro-nutrients like magnesium, potassium, and Vitamin D3. Some cases of RLS may thus warrant supplements, but you should absolutely talk to your doctor before diving in.Despite its rather whimsical name, RLS is no laughing matter. Severe cases of the disorder can be so debilitating that research has found RLS patients to have a significantly higher suicide risk than the general population.
Along with weight gain, sleep deprivation may also lead to a higher risk of illnesses like heart disease, diabetes, depression, and kidney disease—so best try and get a handle on your unruly limbs before it's too late!
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