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Restless Legs Syndrome and Sleep Disturbances

By

Sarah Lewis, PharmD

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Restless legs syndrome (RLS) isn’t in your imagination—it’s a real neurological disorder. RLS involves the overwhelming urge to move the legs, often accompanied by unpleasant sensations in the legs. About 1 in 10 American adults suffer from RLS. But experts believe doctors often mistake RLS for something else, such as depression or a muscular disorder.

Some of the confusion comes from symptoms that are similar to other conditions. And people with RLS often have other sleep disturbances, which can become the focus. So it’s important to understand what other sleep problems may accompany RLS.  

RLS can cause insomnia

It’s easy to see how RLS can disrupt normal sleep. The overwhelming urge to move your legs makes it difficult to relax. And the unpleasant sensations can be distracting. The result is often insomnia—difficulty either falling asleep or staying asleep. People with RLS tend to find it hard to fall asleep. Either way, insomnia can interfere with your daily life, causing fatigue and daytime sleepiness.

Insomnia is a symptom of a variety of conditions. If you’re seeking a diagnosis, focus on the reason you can’t fall asleep and not the insomnia itself. It will help your doctor find the underlying cause and avoid overlooking RLS as a possibility. Using a sleep diary can help you identify exactly what you experience when you have trouble sleeping.

Periodic limb movements of sleep is common in people with RLS

More than 80% of people with RLS also suffer with periodic limb movements of sleep (PLMS). PLMS is a condition in which you experience involuntary muscle twitching and jerking during sleep. It usually affects the lower legs and occurs repeatedly throughout the night, usually several times in a minute. The predictable result is frequent awakening during the night and severely disrupted sleep.

It’s rare to have PLMS without another sleep disorder, so having RLS is an important clue to help your doctor diagnose PLMS. Your doctor may order a sleep study to confirm a PLMS diagnosis.

Treating RLS usually resolves other sleep disturbances

Finding an effective treatment for RLS may help resolve other sleep problems. Controlling bothersome RLS symptoms will ease insomnia by helping you fall asleep faster. For some people, this may involve simple lifestyle changes. For others, medicines may be necessary. And the medicines that treat RLS also work for PLMS.

FDA-approved medicines to treat RLS include:

  • Gabapentin enacarbil (Horizant) 

  • Ropinirole (Requip) 

  • Pramipexole (Mirapex)

  • Rotigotine (Neupro)

Other drugs that may help RLS symptoms include:

  • Anti-seizure medicines

  • Benzodiazepines

  • Narcotic pain relievers

Talk with your doctor about the best treatment for you. Be sure to discuss any other medical issues or sleep problems you have. Drugs to treat RLS can make some conditions—such as sleep apnea—worse. And be sure to stay in touch with your doctor. Finding the right treatment for RLS may take some trial and error.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 18, 2017

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Medical References

  1. RLS Facts. International Restless Legs Syndrome Study Group. http://irlssg.org/rls-facts/
  2. How Is Insomnia Diagnosed? National Sleep Foundation. http://sleepfoundation.org/sleep-disorders-problems/insomnia/diagnosis
  3. Restless Legs Syndrome (RLS) Treatment. National Sleep Foundation. http://sleepfoundation.org/sleep-disorders-problems/restless-legs-syndrome/treatment
  4. Symptoms & Diagnosis: Periodic Limb Movement Syndrome. National Association of Managed Care Physicians. http://www.namcp.org/sleepdisorders/practicingdocs/html/disorders/plms/diagnosis.html
  5. Restless Legs Syndrome Fact Sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm
  6. Common Sleep Disorders. Princeton HealthCare System. http://www.princetonhcs.org/phcs-home/what-we-do/university-medical-center-of-princeton-at-plainsbor...

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