Do your legs have
heebie-jeebies and creepy-crawlies, especially at night? Do you just have to move them? Do these symptoms play heck with your sleep? Then you just might have restless legs syndrome (RLS), a condition for which treatment is available.While I was still in training to become a neurologist, I got excited when I made a diagnosis of Ekbom's syndrome, as RLS was then known. In those days,
condition seemed rare and exotic, something a doctor almost never encountered.
Nowadays, in my community practice of neurology, I see cases of RLS almost every day. So where were all these people 25 years ago? Unless
disease has suddenly started propagating like mad, one has to conclude that previously
patients weren't talking,
doctors weren't listening—or both.
Estimates of
prevalence of this condition vary widely, but in a large study conducted in five European countries, 5.5% of
population over
age of 14 had this condition. RLS occurs in both genders, but is slightly more frequent in women. RLS occurs at any age—including in childhood—but becomes more common with advancing years.
Although there is now much more awareness of restless legs syndrome among doctors and patients alike, it is still often underdiagnosed or misdiagnosed. For example, a child's symptoms might get misdiagnosed as due to growing pains or attention deficit disorder, and an adult's symptoms might get interpreted as due to nerve damage or poor circulation.
What are
usual symptoms? In 1995 an international conference of experts agreed upon
following four features:
#1. There is a desire to move
legs in association with unusual or uncomfortable sensations deep within
legs;
#2. There are overt restless movements in a response to or in an effort to relieve
unusual sensations or discomfort;
#3. Symptoms are worse or exclusively present at rest (inactivity or relaxation) and might be temporarily improved by voluntary movements of
affected limbs; and #4. Symptoms occur most frequently during
evening or early part of
night.
In addition, most people who have restless legs syndrome also have "periodic leg movements of sleep" or PLMS, previously abbreviated as PMS, but this was, uh, confusing. PLMS refers to abrupt, brief leg movements, generally affecting both legs, and which occur repeatedly during
first several hours of sleep.
The person with PLMS might know only that their bedclothes are a mess
next morning. However,
spouse or other sleeping partner might experience disruption of their own sleep by
movements. Sometimes they relocate to another bed because of them.