What Causes Restless Legs Syndrome?

Restless legs syndrome's cause is usually unknown. Leading experts suspect that in people with restless legs syndrome, also called RLS, the brain takes up or uses iron abnormally.

Genetics also plays a key role. About half of those with restless legs syndrome have family members affected, too.

Many medical conditions are associated with restless legs syndrome, including iron deficiency, diabetes, end-stage kidney disease, Parkinson's disease, and even pregnancy. These cases account for a minority of people with restless legs syndrome, however. Treating these conditions, if present, can improve restless legs syndrome symptoms.

Some medicines, such as antipsychotic drugs -- like aripiprazole (Abilify) and risperidone (Risperdal) -- also can cause involuntary leg movements similar to RLS.

Who Gets Restless Legs Syndrome?

No one knows the true number of people with restless legs syndrome. About 10% of the population is affected, and about 2% to 3% have moderate to severe symptoms that affect their quality of life. We do know that:

• Women are affected slightly more often than men.
• Most people with severe disease are middle-aged or older.
• Those with affected family members usually get restless legs syndrome at a younger age, but it progresses more slowly.

Does Restless Legs Syndrome Ever Go Away by Itself?

There are reported cases of spontaneous remissions of restless legs syndrome. However, they are rare. RLS is a progressive disease for most people, with symptoms getting gradually worse over time."

For those with restless legs symptoms caused by a medical condition, treatment of that condition can relieve or improve their restless legs syndrome.

Can Restless Legs Syndrome Develop Into Something More Serious?

Most people with restless legs syndrome have the "idiopathic" form -- meaning there's no known cause. Consequently, there is no risk of RLS progressing to more serious conditions, such as Parkinson's disease.

Restless legs syndrome can also be caused by medical conditions or diseases (such as iron deficiency, diabetes, or kidney disease). If untreated, these medical conditions can cause serious health problems as well as worsen the symptoms of restless legs syndrome.

How Can I Get a Good Night's Sleep Despite Restless Legs Syndrome?

Experts agree that simply changing behavior can often help you sleep better with restless legs syndrome. For those with mild to moderate restless legs syndrome, these steps could reduce or prevent symptoms:

• Reduce caffeine intake
• Cut down on alcohol
• Stop smoking, or at least cut back
• Maintain a regular sleep pattern
• Exercise regularly, but moderately (heavy exercise can worsen symptoms)
• Apply heat or ice, or soak in a hot bath

When Should I Consider Seeing a Doctor About Restless Legs Syndrome?

No one should live with significant discomfort without discussing their symptoms of restless legs syndrome with a doctor. Even if you feel your symptoms are mild, they might be seriously affecting your sleep.

 Only you can decide when your restless legs symptoms are affecting your life. If you have the symptoms of restless legs syndrome, consider if you're also:

• Losing sleep frequently
• Feeling depressed or anxious
• Having trouble concentrating

If any of these are present -- or if you just want to feel better -- it's time to talk to your doctor.

Are There Treatments for Restless Legs Syndrome?

There are three FDA-approved drugs for restless legs syndrome: pramipexole (Mirapex), rotigotine (Neupro), ropinirole (Requip), and gabapentin enacarbil (Horizant). All were proven effective in clinical trials in reducing the symptoms of restless legs syndrome.

Physicians also use other medicines not specifically designed for treating restless legs syndrome. These include:

Certain anti-seizure medicines other than gabapentin enacarbil, such as carbamazepine (Tegretol)
Opiate pain medicines, such as hydrocodone or tramadol
"Sedative-hypnotics," such as clonazepam or zolpidem.

What Else Can I Do to Cope With Restless Legs Syndrome?

Depression and anxiety commonly result from restless legs syndrome. If you have moderate to severe restless legs symptoms, it's important to find ways to cope with the stress it can cause. Here are a few ways to take control:

• Work with your doctor: Changes or combinations of medicines are often necessary to control symptoms.
• Join a support group: www.rls.org can get you started.
• If you feel overwhelmed by restless legs syndrome, consider speaking with a professional mental health provider.

What Is the Connection Between Iron and Restless Legs Syndrome?

Iron deficiency is one of the uncommon causes of restless legs syndrome. Replacing the low iron may improve or eliminate symptoms in these people.

Even for people whose restless legs syndrome has no clear cause -- and who have normal iron levels -- iron is probably involved. Studies show a "brain iron deficiency" in many people with restless legs syndrome. Research is ongoing to discover how and why this happens, and whether therapy can be targeted to this problem.

People with normal iron levels and restless legs syndrome should not take iron pills. Excess iron can cause liver damage and other problems.

What Is the Link Between Restless Legs Syndrome and Periodic Limb Movement Disorder?

More than 80% of people with restless legs syndrome also have periodic limb movement disorder (PLMD). In PLMD, the arms or legs twitch or jerk involuntarily throughout the night. The movements disturb sleep and can contribute to chronic fatigue.

Many people have periodic limb movement disorder by itself, and will never develop restless legs syndrome. However, periodic limb movement disorder sometimes starts before restless legs syndrome.

Source: WebMD. Ten Common Questions About Restless Legs Syndrome. http://www.webmd.com/brain/restless-legs-syndrome/restless-legs-syndrome-rls-10-frequently-asked-questions