Restless Legs Syndrome (RLS) causes an urge to move the legs, often with uncomfortable sensations that become more noticeable during rest and in the evening or at night.
RLS is a neurological and sleep-related condition characterised by an irresistible urge to move the legs. People may describe crawling, pulling, aching, tingling, itching or other uncomfortable sensations.
Symptoms commonly begin or become worse while sitting, lying down, travelling or trying to sleep.
Walking, stretching or moving the legs may reduce the discomfort, although symptoms can return when movement stops.
RLS often becomes more troublesome later in the day and can make it difficult to fall asleep or return to sleep after waking.
Repeated sleep disruption can contribute to fatigue, sleepiness, poor concentration and reduced daytime functioning.
Periodic limb movements of sleep (PLMS) are repetitive movements that occur during sleep. They can occur in people with RLS, but many people with PLMS do not have RLS. A sleep study can identify PLMS when clinically indicated.
There is no single blood test or scan that confirms RLS. Diagnosis is mainly clinical, based on the characteristic symptom pattern, medical history and examination, while other causes of leg discomfort or sleep disturbance are considered.
The timing, triggers, relief with movement, severity and effect on sleep are reviewed.
Some medicines and substances can worsen symptoms, so the complete medication and sleep history matters.
Serum ferritin and transferrin saturation are important in clinically significant RLS because iron status can influence treatment decisions.
Polysomnography may be considered when another sleep disorder is suspected or when periodic limb movements need to be evaluated.
Management often starts with identifying aggravating factors and correcting iron deficiency when present. For persistent clinically significant RLS, medication may be considered after an individual assessment.
Review iron status, sleep schedule, caffeine/alcohol use, medications and coexisting sleep or medical conditions.
Current sleep-medicine guidance recommends checking iron studies regularly in clinically significant RLS and using oral or intravenous iron when indicated by the clinical picture and laboratory values.
Alpha-2-delta ligands such as gabapentin, gabapentin enacarbil or pregabalin are among treatments recommended by current AASM guidance for adults with appropriate indications.
Current AASM guidance advises against using dopamine agonists as standard long-term treatment because of the risk of augmentation; selected short-term or individual circumstances may differ.
Dr. Prakash Kothari G provides online Sleep Medicine consultations for adults and children. Consultation can help clarify whether symptoms fit RLS, review contributing factors and decide whether blood tests, a sleep study or other evaluation is appropriate.
When uncomfortable leg sensations repeatedly interfere with sleep, identifying the symptom pattern and checking important contributors such as iron status can help guide the next step.