What is Restless Leg Syndrome, the condition that won't let you sleep at night? What causes it and how can it be treated? Read more about it.
Restless leg syndrome. (Representational image/Prostock Studio)
Nayana, a 42-year-old woman, found herself constantly needing to move her right leg while seated or lying down, a persistent sensation that had haunted her since she was 30 years old. Puzzled by why these sensations predominantly occurred in the evenings or at night, she sought medical help.
“She would experience a crawling discomfort in her right leg when sitting or lying down for extended periods, alleviated only by a vigorous jerk or shake of her leg,” narrates Dr Sudhir Kumar, the renowned neurologist from Apollo Hospitals, Hyderabad, whom Nayana had consulted.
Initially, Nayana sought the opinions of several physicians, who, finding no apparent cause, treated her with calcium and multivitamin supplements. At one point, she was even referred to a psychiatrist under suspicion of a psychosomatic condition. Frustrated by the lack of progress after numerous consultations, she opted to ignore it.
However, nearly five years later, Nayana’s resolve waned and she sought the expertise of Dr Sudhir Kumar, who, upon analysing her symptoms, identified them as typical of Restless Leg Syndrome (RLS).
“This is a clinical diagnosis, requiring no testing for confirmation, and is a prevalent condition affecting nearly 10 per cent of the population,” asserts Dr Sudhir, speaking to South First.
Doctors explain that Restless Leg Syndrome (RLS) is a condition that manifests as an irresistible urge to move one’s legs, especially when seated or reclined, often disrupting relaxation or restful sleep.
Those afflicted may also experience unpleasant sensations like tingling, crawling, or itching in their legs, with movement offering temporary relief. Dr Sudhir highlights the lack of awareness surrounding RLS among physicians, with 40-50 per cent of cases remaining undiagnosed for over five years.
“It typically affects both legs, although it can sometimes affect one leg or even the arms. Anyone experiencing discomfort or unusual sensations while at rest, particularly during the night, should seek medical attention,” emphasises Dr Sudhir.
Dr Sudhir says RLS may start in childhood or even when one is in their 90s, however, diagnosis is most often made in the third decade of life or later. He says that women are affected more than men.
He notes that RLS is particularly prevalent among pregnant women, with one-third experiencing symptoms, most commonly during the third trimester, though symptoms tend to subside within weeks after delivery.
Meanwhile, Dr Belehalli Pavan, a podiatrist at the Karnataka Institute of Diabetology and Nano Hospitals in Uttarahalli, adds that while RLS is prevalent in the general population, it can also affect diabetics, often mirroring the signs and symptoms of Diabetic Peripheral Neuropathy. However, specific criteria must be met for a definitive RLS diagnosis.
“Patients typically present with loss of sleep due to discomfort in their legs, specially at night, and they may also experience fatigue and tiredness because of this. A classic feature of RLS is the abating of symptoms once the person moves the affected limb(s). Hence the name of the condition,” explains Dr Pavan.
He cautions, “It’s crucial for physicians to rule out underlying diabetic neuropathy or other conditions before diagnosing RLS.”
Dr Sudhir underscores that RLS is prevalent among patients with chronic kidney disease, particularly those undergoing haemodialysis, affecting 25-50 per cent of them.
Dr Prapti Reddy, Principal Consultant of Neurology at HOSMAT Hospitals in Bengaluru, further notes that increased caffeine intake, smoking, alcohol consumption, deficiencies in Vitamins B12 and folate, iron deficiency anaemia, and certain medications like antipsychotics and antidepressants can also trigger RLS.
Moreover, RLS may occur independently or alongside conditions like Parkinson’s, peripheral neuropathy, and psychiatric disorders such as insomnia, anxiety, depression, and somatoform disorders.
Addressing iron deficiency is paramount in RLS cases, with comprehensive blood tests recommended to assess levels of calcium, magnesium, Vitamin B12, and Vitamin D.
In Nayana’s case, Dr Sudhir prescribed “a single dose of a dopamine agonist to be taken nightly”. She responded well and had no symptoms at her one month follow-up. “She had never felt so relaxed while sitting or sleeping in the past 12 years!” he exclaims.
Agreeing with this approach, Dr Reddy suggests medications like levodopa/dopa agonists following a neurological examination.
Here are some home remedies suggested by doctors:
(Edited by Kamna Revanoor)
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