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Sleep Disorders

Restless Legs Syndrome
Restless legs syndrome (RLS) is a common yet under-diagnosed movement disorder that is characterized by unpleasant limb sensations occurring at rest and is associated with an irresistible urge to move.

Periodic limb movements (PLM) may accompany these sensations and often interfere with sleep onset or sleep quality. Discomfort, sleep disturbances, and fatigue are direct results of RLS and may have a negative impact on a person's quality of life.

Although RLS was first recognized several centuries ago, it was not until recently that progress began in defining the clinical features of RLS. Specifically, an International RLS Study Group, (the IRLSSG), has organized and has started to define the characteristic symptoms of RLS.

Criteria for the diagnosis of RLS, as described by the IRLSSG, include four features:

  1. An urge to move the legs usually accompanied or caused by uncomfortable and unpleasant sensations in the legs. (Sometimes the urge to move is present without the uncomfortable sensations and sometimes the arms or other body parts are involved in addition to the legs.)
  2. The urge to move or unpleasant sensations begin or worsen during periods of rest or inactivity such as lying or sitting.
  3. The urge to move or unpleasant sensations are partially or totally relieved by movements, such as walking or stretching, at least as long as the activity continues.
  4. The urge to move or unpleasant sensations are worse in the evening or night than during the day or only occur in the evening or night. (When symptoms are very severe, the worsening at night may not be noticeable but must have been previously present.)
    Epidemiologic studies have indicated that 5% to 15% of the adult population may experience RLS symptoms.

RLS is easily diagnosed by Actigraphy and PSG studies. No single therapy has been globally approved for the treatment of RLS. Germany and Switzerland are the only countries with an approved treatment available specifically for RLS. A number of treatments have been used off label in the UK, including levodopa, dopamine agonists, benzodiazepines, opioids, and anticonvulsants.

RLS may also occur as part of another disease or illness and may be the first sign of these. This type of RLS is called secondary RLS and occurs in people with Diabetes, Parkinson's disease, Rheumatoid Arthritis, Iron Deficiency Anaemia, in Pregnancy, Neurological diseases and some drugs may cause RLS.

The Sleep Medicine group of sleep centres is actively involved in Research in RLS. Please contact us for further information.

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