Restless Leg Syndrome and Sleeplessness By Cindy Asbjornsen, DO, FACPh W


hen it’s time for bed at the end of the day, do your legs twitch and keep you awake? If you’ve


ever tried to fall asleep at night but been stymied by the overwhelming urge to move your legs, then you might be experiencing Restless Leg Syndrome or RLS.


RLS is considered a disruptive neuro-


logic disorder, affecting approximately 10 percent of the U.S. population. It occurs in men and women, though the incidence is twice as high in women. RLS is not diag- nosed through laboratory testing, but rather through evaluation of symptoms.


According to the International Rest- less Legs Syndrome Study Group, the four primary features of RLS are:


• An urge to move, usually due to uncomfortable sensations that occur primarily in the legs


• Motor restlessness (expressed as ac- tivity) that relieves the urge to move


12 ELM™ Maine - January/February 2019


• Worsening of symptoms by relaxation


• Variability over the course of the day- night cycle, with symptoms worse in the evening and early in the night


These throbbing, pulling, or creeping sensations in the lower limbs most often affect both legs, though they can occur on just one side of the body and sometimes even alternate between sides. The sensa- tions can feel mildly irritating to downright painful, but whatever the severity, tossing and turning in bed can result in poor sleep and impairment of daytime function.


In most cases, the cause of RLS is


unknown. In fact, a single unifying cause of Restless Leg Syndrome (RLS) has yet to be established. We do know that there are many potential causes for RLS, includ- ing pregnancy, diabetes, and rheumatoid arthritis. RLS also appears to be related to other underlying conditions such as end-


stage renal disease and hemodialysis, iron deficiency, and neuropathy. Medications such as certain antihistamines, anti-nausea drugs, or anti-psychotic drugs may aggra- vate RLS symptoms.


Is there a vein correlation?


As it turns out, about 40 percent of people with RLS have problems with their veins— although we don’t yet fully understand the relationship between RLS and venous disease. Research shows that there is high correlation of patients who see their RLS resolve when they receive venous treatment.


One study showed that treatment


of venous reflux eliminated or significantly reduced 98 percent of a person’s RLS symp- toms. (Ninety-two percent of symptoms did not return after one year.) Another study showed that 95 percent of an individual’s restless legs symptoms were reduced, and 53 percent of symptoms were completely


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