by EBSCO Medical Review Board
(RLS)

Definition

Restless legs syndrome (RLS) is a problem of the nerves. It causes unpleasant sensations in the legs and urges to move them. RLS symptoms are worse at rest and can make it hard to sleep well. Poor sleep can lead to exhaustion and problems working or getting through the day.

Causes

The exact cause is not known. Certain genes may be cause or increase the risk RLS. It may also be unmasked or worsened by some medicine, changes in level of iron, and other illnesses.

Risk Factors

RLS is more common in women. It is also more common in people over 65 years of age. Other things that may raise the risk are:

  • Family history
  • Taking certain medicines, such as antidepressants and antihistamines
  • Low iron levels—may or may not be caused by anemia
  • Pregnancy
  • Chronic kidney disease

Symptoms

RLS can cause:

  • An urge to move the legs and symptoms ease with movement
  • Feelings of pins and needles, creeping, pulling, prickling, or pain in the legs
  • Problems that get worse in evening and night
  • A hard time falling asleep and staying asleep

Diagnosis

You will be asked about your symptoms and past health. A physical exam will be done. This is often enough to make the diagnosis. There is no test for RLS itself. Tests may be done to look for things triggering RLS. Tests may include:

  • Blood tests to check iron levels or kidney changes
  • Sleep study to check leg activity and sleep problems
Nerves of the Leg
Leg Nerves
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Treatment

Treatment can help to ease symptoms that are getting in the way of day-to-day life. Home care steps may include:

  • Avoiding alcohol, caffeine, and tobacco
  • Developing a healthy sleep routine
  • Regular exercise

Iron supplements may be helpful if low iron levels are linked to problems. Managing current medicine or other health problems may also ease symptoms.

Medicine may be needed for severe symptoms. They may help to ease symptoms and improve sleep. Types of medicine that may be used include:

  • Dopamine agonists
  • Antiseizure medicine
  • Opioids
  • Benzodiazepine

Prevention

There are no steps to prevent RLS.

RESOURCES

National Sleep Foundation  http://www.sleepfoundation.org 

Restless Legs Syndrome Foundation  http://www.rls.org 

CANADIAN RESOURCES

Canadian Sleep Society  http://www.css-scs.ca 

Health Canada  https://www.canada.ca 

References

Garcia-Borreguero D, Cano-Pumarega I. New concepts in the management of restless legs syndrome. BMJ. 2017 Feb 27;356:j104.

Gonzalez-Latapi P, Malkani R. Update on restless leg syndrome: from mechanisms to treatment. Curr Neurol Neurosci Rep. 2019;19(8):54.

Restless legs syndrome fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/restless%5Flegs/detail%5Frestless%5Flegs.htm. Accessed October 2, 2020.

Restless legs syndrome (RLS). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/restless-legs-syndrome-rls. Accessed October 2, 2020.

Understanding RLS. Restless Legs Syndrome Disease Foundation website. Available at: https://www.rls.org/understanding-rls. Accessed October 2, 2020.

Winkelman JW, Armstrong MJ, et al. Practice guideline summary: Treatment of restless leg syndrome in adults: Report of the Guideline, Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2016;87(24):2585-93.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 03/2021
  • Update Date: 05/25/2021