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 Sleep  Holistic-online.com

Restless Legs Syndrome

Symptoms Of RLS

Causes of RLS

Treatment of RLS

Conventional Treatment

Alternative Treatments

Restless legs is a disorder that causes unpleasant sensations in the legs while lying down. These sensations, which are often described as a creeping or crawling sensation in the calves, typically occur at bedtime when the person is still awake, and can therefore make it difficult to fall asleep. Many people with Periodic limb movements also have restless legs syndrome, and almost all people with restless legs have Periodic limb movements.

Restless leg syndrome affects as much as 2-5 percent of the population.

Symptoms Of Restless Legs Syndrome (RLS)

According to American Academy of Sleep Medicine, the symptoms of Restless Legs Syndrome are:

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An urge to move the legs, often accompanied by uncomfortable sensations in the legs, usually described as a creeping or crawling feeling, but sometimes as a tingling, cramping, burning or just plain pain. Some patients have no definite sensation, except for the need to move. (The arms may also be affected, but that's much less common.)

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The need to move the legs to relieve the discomfort, by stretching or bending, rubbing the legs, tossing or turning in bed, or getting up and pacing the floor. Moving usually offers some temporary relief of symptoms.

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A definite worsening of the discomfort when lying down, especially when you're trying to fall asleep at night, or during other forms of inactivity, including just sitting.

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A tendency to experience the most discomfort late in the day and at night.

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Sleep disturbances

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If leg twitching or jerking is also present, periodic limb movements during sleep (PLMS) may be the cause. 

Causes of Restless Legs Syndrome (RLS)

The cause of RLS is not known. 

bullet RLS may be associated with nerve damage in the legs due to diabetes, kidney problems or alcoholism. 
bulletRLS can be a side effect of a pinched nerve root from arthritis in the lower back (sciatica). 
bulletRLS may be inherited.
bullet Stress, diet or other environmental factors may play a role in RLS. 
bullet Pregnancy or hormonal changes may temporarily worsen RLS symptoms.

RLS can begin at any age. It becomes more severe in middle-to-old age.

Treatment of Restless Legs Syndrome (RLS)

Conventional Treatment

There are three main classes of medication that have been shown to be effective in treating RLS.

bulletBenzodiazepines - such as diazepam (Valium),clonazepam (Klonopin), temazepam (Restoril) and triazolam (Halcion).
bulletL-Dopa - This enhances dopamine. Examples: L-Dopa with carbidopa, pergolide (Permax) and bromocriptine (Parlodel).
bulletOpiates - Used for the more severe symptoms. Examples: codeine (Tylenol #3), oxycodone (active ingredient in Percocet), propoxyphene (Darvon) and methadone (in very severe cases only).

Alternative Treatments

The sensations by restless legs result in a strong urge to move the legs, massage them, or walk around, all of which alleviate the discomfort. Complementary therapies for restless legs syndrome include exercise, elimination of caffeine, and some dietary supplements such as iron, calcium, and folic acid.

Nutritional Therapy

Iron

Research studies showed that iron deficiency in the blood can contribute to restless legs syndrome, especially in the elderly. A blood test that measures levels of a protein called ferritin reveals this iron shortage. The level of ferritin indicates the level of stored iron. Treatment with iron supplements can produce good results.

In a study conducted at the Department of Geriatric Medicine of the Royal Lierpool University in Liverpool, U.K., levels of ferritin in the blood were found to be lower in the eighteen patients who had restless-legs syndrome than in the eighteen control subjects. Ferritin levels were inversely correlated with the severity of restless-legs syndrome symptoms. In other words, the lower the ferritin level, the more severe the restless legs. Blood levels of iron, vitamin B12, folic acid, and hemoglobin did not differ between the two groups. Fifteen of the patients who had restless-legs syndrome were treated with iron (ferrous sulfate) at a dosage of 200 mg three times daily for two months, with excellent results. The researchers concluded that "Iron deficiency, with or without anemia, is an important contributor to the development of restless legs syndrome in elderly patients, and iron supplements can produce a significant reduction in symptoms."

5-HTP

If your iron levels are normal, then 5-HTP supplementation may significantly improve, or even eliminate, restless legs and myoclonus. Take 100 to 200 mg of 5-HTP about twenty minutes before retiring. Don't take 5-HTP for restless legs until you have had your iron levels checked, since 5-HTP will not supply you with iron your blood and your muscles need.

See Also: Melatonin and 5-HTP

Folic Acid

If there is a family history of restless-legs syndrome (about one-third of all patients with this syndrome have a family history), high- dosage folic acid (35 to 60 mg daily) therapy can be helpful. Dosages in this range will require a prescription. In cases of familial restless-legs syndrome, there appears to be a higher need for folic acid.

Vitamin E

Vitamin E supplements of 400 IU two or three times a day are extremely effective in alleviating RLS.

In one study concerning vitamin E and restless leg syndrome, a seventy- eight-year-old female with a history of restless and "jumpy" legs found that after two months of 300 IU daily, she was completely cured. In another study, a thirty-seven-year old female with a ten-year history of severe nightly "restless legs" was placed on 300 IU daily for six weeks and 200 IU daily for the following four weeks with complete relief.

Warning: Vitamin E can elevate the blood pressure slightly. 

Various treatments have been attempted for restless leg syndrome, but nothing seems to work consistently for everyone. Some research strongly suggests that anemia may play a major role in this disorder. Taking the proper vitamin and mineral supplements is important to manage this problem. The supplements that help this condition most are calcium, potassium, magnesium, and zinc.

Homeopathy

Restless leg syndrome and PLMS are treated with Rhus tox. (for rheumatism-related conditions) or Causticum (for nervous system-related conditions). Pelvic or prostate problems should also be treated.

See Also: Alternative and Complementary therapies for Insomnia

Nocturnal Myoclonus

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