Restless legs syndrome: causes, symptoms and treatment

What does it take to be able to fall asleep? A prerequisite is maintaining good sleep hygiene. Take care of routines to promote drowsiness, avoiding lights or exercise, proper temperature, all the silence we can get, etc. We also need to feel relaxed and free from physical discomfort, which is not achieved by people with restless leg syndrome.

These people, in terms of resting the body, begin to experience a series of sensations in the lower trunk that prevent them from sleeping and cause them to move their legs in an attempt to alleviate the discomfort. The discomfort is released to return when the person is again at rest.

Symptoms of restless legs syndrome

Patients with restless legs syndrome, feeling discomfort or tingling in the legs, they urgently need to move – to end the itchy rash that interferes with rest. The kind of sensations that a person with restless legs can experience are wide ranging from itching, very slight pain, vibrating tactile sensations, small bites that move, etc.

It rarely occurs in the arms, chest, or even the face. In addition, the sensations are generally indiscriminately bilateral, that is, they can occur on either side of the body without any criteria. Some patients describe a certain alternation, as if when the sensations disappear from one side, they move to the other side of the body.

These sensations cause a lot of discomfort, and the longer you wait for the individual to go, the more irritated you become.. This is why these people, when they are at rest, sitting or lying down, keep their legs moving. This way the discomfort disappears during the time they are in motion. However, the symptoms reappear when one wants to rest completely, entering a circle that is difficult to break.

Evolution of the disorder

One of the hallmarks of restless leg syndrome is that it fluctuates. Discomfort does not present itself the same throughout the day, but the morning often disappears and reappears in the afternoon and evening. Therefore, people without restless leg syndrome have many problems reconciling and maintaining sleep.

They are also not present every day. In most cases, which are mild, they appear once or twice a week, which is already enough to disturb sleep and call for a professional. In the most severe cases, we are talking about an occurrence of more than twice a week. Sometimes there are certain periods of remission where symptoms go away completely for weeks or months. However, it is a feature of the early stages of the disease; the tendency of symptoms is to get worse over time.

the causes

The first link in the causal chain is usually unknown. Most cases have an uncertain origin, although there are cases of genetically transmitted restless leg syndrome. The current hypothesis investigates the possibility that the dopamine circuits in the basal ganglia are not functioning properly. In the opinion of people who already have a dopaminergic disorder in this area, as in the case of Parkinson’s disease, have a significantly higher risk of suffering from restless legs.

Some medical factors have been linked to the appearance of restless legs, but they do not explain all cases. These factors include:

  • Iron deficiency
  • Certain drugs such as antiemetics
  • Consumption of alcohol, nicotine or caffeine
  • Be in the third trimester of pregnancy
  • neuropathy

possible treatments

The management of the disease is symptomatic, there is no definitive cure. However, symptomatic treatment is already very effective on its own. In most cases, changes in the daily routine can already be of great benefit. Having a regular sleep schedule, exercising continuously in the morning, or bathing your legs in hot or very cold water at night may be enough to prevent the onset of these annoying tickles.

There are also effective drugs such as anticonvulsants, which are almost first-line pharmacological treatment due to their dopaminergic effects, or the dopaminergic agents themselves which are administered in diseases where these circuits are dysfunctional such as in Sickle’s disease. Parkinson’s. However, prolonged use of this medication seems to make symptoms worse. This phenomenon is stopped when the dopaminergic drug is withdrawn.

Other medications like opioids or benzodiazepines can be helpful because they help you fall asleep, but they really don’t have any effect on the discomfort and tingling in your legs. In addition, the use of benzodiazepines beyond the first two or three weeks is not recommended, as they have great addictive potential. So maybe they would only be of help in these days when, despite all the advice and taking the right medicine, the discomfort persists.

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