I developed Restless Leg Syndrome when I was a teenager in the 80's, before it was a widely accepted syndrome with a name. My restless leg syndrome symptoms would come only at night, so as darkness approached I'd begin to dread bed-time. I tried to explain to my mother what this strange syndrome felt like, and she looked at me as if I needed psychiatric intervention. I simply called it: "The Thing."  I would say:  "I had The Thing again last night" and go on to describe this odd sensation that would build up in my legs (sometimes just one leg) culminating in such an intense "tingley"  feeling that I'd have to tense my muscles or beat on my legs in order to make it stop.  This temporarily assuages the sensation, for seconds to minutes, but the relief is always short-lived necessitating frequent leg movements.  RLS symptoms have been described in a myriad of ways.

  Fortunately, some research has been done on restless leg syndrome since then.  Although there are no restless leg syndrome cures, there are restless leg syndrome medications that have proven helpful for some people.  What causes restless leg syndrome is not clear, it is called "idiopathic" meaning its origin and cause is uncertain or unclear.  There are, however, some promising theories resulting from recent research.  As a result, RLS treatment continues to advance. 

RLS sufferers will know what I mean when I say describing Restless Leg Syndrome symptoms is very difficult. It's been likened to "creepy, crawley sensations", bugs crawling on the legs, burning, uncomfortable and unpleasant sensations in the legs accompanied by an overwhelming urge to move the legs. The symptoms are completely or partially assuaged by continuous movement. For some, the symptoms only occur at night, when one is still and lying in bed. Others have symptoms throughout the day, normally while sitting at a desk, in the car, in a movie, watching TV, etc. Normally restless leg syndrome symptoms arise the more relaxed one is. The symptoms are more likely to rear their ugly head the longer one is inactive. RLS sufferers may also have visible movements in their toes and feet.  They tend to have muscle spasms.  Sleeping with an RLS sufferer may be more like participating in a boxing match than spending a peaceful night in bed! Finally, the symptoms are not always limited to the legs and can affect the arms.

There are two kinds of Restless Leg Syndrome: primary (also called idiopathic) and secondary. Primary RLS has no known cause, is the most common form, and is a persistent syndrome throughout the person's life. Studies show primary RLS gets worse over time, especially when the syndrome begins in childhood. A genetic component for primary Restless Leg Syndrome has been identified. An Iceland gene scan study in 1997 identified a variation of the BTBD9 gene is associated with RLS.

Secondary Restless Leg Syndrome, as the name implies, can develop as the result of certain conditions, diseases, or factors. Common culprits are certain vitamin or mineral deficiencies, in particular iron and magnesium. Peripheral neuropathy, often caused by diabetes, and renal failure are other conditions commonly causing secondary Restless Leg Syndrome. 25% to 40% of pregnant women are affected with the syndrome vanishing soon after delivery. Certain medications and substances have also been linked to its development: cigarette smoking, caffeine, alcohol, anticonvulsants, antidepressants, cold and allergy drugs, beta blockers, and sedatives are among the many.

There are three proposed factors, most likely overlapping, that come together to produce RLS. The first involves the section of the brain responsible for producing the neurotransmitter called dopamine. RLS is considered a neurologic movement disorder, so understanding dopamine's role in movement is at the center of this puzzle. Dopamine is responsible for movement and mood, in addition to other regulations.

The second factor is iron regulation. Brain studies of RLS sufferers have shown an iron deficiency in their brains. In the area of the brain responsible for producing the neurotransmitter dopamine, there is a deficit in the number of iron receptors, presumably contributing to the dopamine deficiency.

As previously mentioned, genetics come into play in this complicated scenario. In addition to the Iceland study, other scientists have identified several regions on different chromosomes as potential genetic evidence.

Before 2005 there were no Restless Leg Syndrome medications. The first one on the market was Requip, which is a dopamine agonist, meaning it simulates or mimics the function of dopamine. Since Parkinson's Disease also involves this dopamine deficiency, medications for Parkinson's have been used succesfully for RLS symptoms. In addition, benzodiazepines (central nervous system depressants), opioids, and anticonvulsants are prescribed.

Aside from medication (and avoiding the medications and substances listed above) there are a number of things you can do to help alleviate your symptoms:

• Exercise is a great defense: walking, riding a bike (stationary or road), yoga, etc... Moving your body during the day certainly can help your urge to move those legs at night.
• Other people swear by taking a very hot bath or soaking in a hot tub.
• Others swear by placing something cold on the legs, like ice packs or frozen pea bags.
• Sometimes, a deep massage is enough to fend off the syndrome (and a great excuse to be the recipient!). Stretching before bedtime can also help.
• Get tested for iron levels. Take iron if you're deficient.
• If you suffer during the day (God forbid in those long work meetings) wear something tight over your legs during the day like pantyhose, ace bandages (I know it sounds weird, but we RLS sufferers get desperate), or leggins.
• Yoga, meditation, or deep breathing can also help relax the body before bed.
• If you develop RLS, staying in bed often only makes it worse, unfortunately. Get up, stretch, go outside, move around a little before trying to sleep again.
• Finally, many RLS sufferers have found a portable TENS unit to be indispensible. These units provide electrical stimulation to the feet and legs, allowing the "movements" to be done for them so that they may relax and go to sleep.

There are certainly mild cases of Restless Leg Syndrome where treatment doesn't seem necessary for the individual. However, RLS can be quite severe. The insomnia resulting from the syndrome can have profound ramifications on one's quality of life. Sleep deprivation can create memory problems, affect problem solving skills, create depression and/or anxiety, and affect one's desire to participate in daily activities from intense exhaustion.

It's recently been suggested there might be a link between heart disease and Restless Leg Syndrome.  The periodic limb movements associated with it can lead to increased blood pressure, thereby increasing one's risk of developing heart disease.

 If you suspect you suffer from Restless Leg Syndrome, see your doctor.  He or she will be able to make a diagnosis or perhaps refer you onto a sleep lab for further studies.  It's also imperative to determine whether or not an underlying condition or disease is the true culprit of your RLS.

If you already have a diagnosis and would like additional support, there are RLS support groups across Canada and the United States.  For example, I know there's one here in Portland, Oregon called Nightwalkers, located at Good Samaritan Hospital.  See below for the relevant link.