Restless Legs Syndrome (RLS) is a neurological disorder characterised by an irresistible urge to move the legs.
Often accompanied by uncomfortable sensations in the legs, RLS typically occurs when at rest, especially in the evening or at night.
What is RLS?
Restless Legs Syndrome (RLS) is a neurological condition characterised by an irresistible urge to move the legs, often accompanied by unpleasant sensations such as crawling, creeping, itching, pulling, or throbbing. These sensations are typically relieved by movement, such as walking or stretching, but they often return when movement stops (1) . RLS can disrupt sleep and lead to daytime fatigue or impaired functioning (2).
The exact cause of RLS is not fully understood, but it is believed to involve abnormalities in the brain’s dopamine system and possibly iron deficiency. RLS can occur as a primary condition or secondary to other medical conditions such as Parkinson’s disease, pregnancy, or kidney disease.
Treatment options for RLS include lifestyle changes, medications to regulate dopamine levels or supplement iron, and managing any underlying conditions contributing to symptoms.
What causes RLS & how is it associated with Parkinson’s?
RLS and Parkinson’s share common features, including dopamine dysfunction. Both conditions respond to dopaminergic medications, suggesting an underlying dopamine-related mechanism (2). Studies have shown that RLS is more common in people living with Parkinson’s, and it can be an early clinical feature of the condition. The prevalence of RLS in people living with Parkinson’s highlights the need for further research to understand the shared pathophysiology and develop targeted treatments.
Causes of RLS:
- Dopamine dysfunction: Abnormalities in the brain’s dopamine system are believed to play a significant role in RLS. Dopamine is a neurotransmitter that helps regulate movement, and its dysfunction can lead to the symptoms of RLS (2) .
- Iron deficiency: Low levels of iron in the brain can also contribute to RLS. Iron is essential for the proper functioning of dopamine-producing neurons (2) .
- Genetic factors: There is evidence to suggest that RLS can run in families, indicating a genetic component.
- Secondary conditions: RLS can be secondary to other medical conditions such as Parkinson’s disease, pregnancy, kidney disease, and peripheral neuropathy.
What is RLS?
Treatments for RLS
- Simple lifestyle adjustments can help alleviate symptoms. These include:
- Regular Exercise: Engaging in moderate exercise, such as walking or stretching, can provide temporary relief.
- Good Sleep Hygiene: Establishing a regular sleep routine and creating a comfortable sleep environment can improve sleep quality.
- Avoiding Stimulants: Reducing intake of caffeine, nicotine, and alcohol, especially before bedtime, can help manage symptoms.
- Warm Baths and Massages: Soaking in a warm bath or massaging the legs can relax muscles and reduce discomfort.
- If lifestyle changes are not effective, medications may be prescribed. These include:
- Iron Supplements: If RLS is caused by iron deficiency, supplements may be recommended.
- Dopamine Agonists: Medications like pramipexole and ropinirole can help regulate dopamine levels in the brain.
- Other Medications: Alpha-2-delta ligands (e.g., gabapentin) and benzodiazepines may also be prescribed to manage symptoms.
- Medical Devices: Devices that provide compression or vibration can reduce discomfort. These include foot wraps and vibrating pads.
Strategies for Coping with RLS
- Regular physical activity and stretching can help reduce symptoms. It’s important to find a balance, as excessive exercise may aggravate symptoms.
- Practicing relaxation techniques such as yoga, meditation, or deep breathing exercises can help manage stress and improve sleep quality.
- Applying warm or cool packs to the legs can provide relief from uncomfortable sensations.
- Joining a support group for individuals with RLS can provide emotional support and practical advice.
How do I access help for RLS?
If you suspect you have RLS, it’s important to consult a healthcare professional. Your GP can conduct a medical history review, physical examination, and possibly order blood tests to check for iron deficiency. If necessary, you may be referred to a sleep specialist or neurologist for further evaluation and treatment.
It’s advisable to explore all available pathways to find the support that best suits your individual needs. Look to:
- getting a neurologist or GP referral to an sleep specialist Parkinson‘s experience
- your state-based Parkinson’s organisation for advice on services to access
- private health to see what is covered in relation to sleep disorder consultations and expenses
- NDIS or My Aged Care plan supports.
Infosheet under review
References:
(1) Peeraully, T., & Tan, E.-K. (2012). Linking restless legs syndrome with Parkinson’s disease: Clinical, imaging and genetic evidence. Translational Neurodegeneration, 1(6). https://doi.org/10.1186/2047-9158-1-6
(2) Adler, C. H., McDonnell, M. D., & Elton, R. (2000). Randomized trial of modafinil for treating subjective daytime sleepiness in patients with Parkinson’s disease: A double-blind, placebo-controlled study. Movement Disorders, 15(5), 819-825. https://doi.org/10.1002/mds.10390
(3) Szatmari, S. J., Bereczki, D., Fornadi, K., Kalantar-Zadeh, K., Kovesdy, C. P., & Molnar, M. Z. (2017). Association of Restless Legs Syndrome With Incident Parkinson’s Disease. Sleep, 40(2), zsw065. https://doi.org/10.1093/sleep/zsw065
(4) Calzetti, S. (2021). Does Restless Legs Syndrome Have a Different Phenotype in Parkinson’s Disease? Journal of Movement Disorders, 14(3), 203-210. https://doi.org/10.14802/jmd.21021
