Restless Legs Syndrome

Restless Legs Syndrome (RLS)

Woman awake at night

Restless legs syndrome (RLS), also called Willis-Ekbom disease, causes an uncomfortable urge to move the legs, often with sensations described as crawling, pulling, aching or tingling. Symptoms:

  • Start or get worse when you are resting, sitting or lying down
  • Are relieved, at least partly, by walking or stretching
  • Are worse in the evening and at night
  • Make it hard to fall asleep or stay asleep

RLS can run in families. It is also linked to low iron stores, pregnancy, kidney disease and nerve problems, and it can be triggered or worsened by some medications, such as sedating antihistamines, certain antidepressants and anti-nausea drugs.

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Diagnosis & Treatment

How we diagnose RLS

RLS is diagnosed from your symptoms and history. We check blood tests, including ferritin and iron studies, because correcting low iron can significantly improve symptoms. We also review your medications. A sleep study is not usually required, but it may be ordered if another sleep disorder is suspected.

Treatment options

  • Iron replacement (oral or intravenous) when iron stores are low
  • Adjusting medications that can worsen RLS
  • Reducing caffeine, alcohol and nicotine; regular exercise; leg massage or warm baths
  • Prescription medications for persistent symptoms, following current American Academy of Sleep Medicine guidelines. Some older medications can worsen RLS over time (a problem called augmentation), so we monitor treatment closely

See also: Periodic Limb Movements (PLMS/PLMD) · Insomnia

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