Restless Leg Syndrome (RLS) Quiz: Test Your Medical IQ

Restless leg syndrome (RLS) is a neurological disorder characterized by throbbing, pulling, creeping, or other unpleasant sensations in the legs and an uncontrollable, and sometimes overwhelming, urge to move them. RLS is classified as a movement disorder, as individuals are forced to move their legs in order to gain relief from symptoms.

Typically, restless leg syndrome symptoms occur primarily at night when a person is at rest or relaxing. RLS also features worsening of symptoms and leg pain during the early evening or later at night with increased severity during the night. A classic feature of RLS is that while the symptoms are worse at night, there is a distinct symptom-free period in the early morning, allowing for more refreshing sleep at that time.

Although RLS can occur in anyone, women are affected nearly twice as much as men.

Some people with RLS will not seek medical attention believing that they will not be taken seriously, that their symptoms are too mild, or that their condition is not treatable.

As many as 10% of the U.S. population may have RLS. Several studies have shown that moderate to severe RLS affects approximately 2%-3% of adults (more than 5 million people). An additional 5% appears to be affected by a milder form. Childhood RLS is estimated to affect almost 1 million school-age children, with one-third having moderate to severe symptoms.

People who suffer with RLS frequently report that their symptoms are triggered by periods of inactivity such as long car trips, sitting in a movie theater, long-distance flights, immobilization in a cast, or relaxation exercises. RLS is also associated with pregnancy, obesity, smoking, iron deficiency and anemia, nerve disease, diabetes, and kidney failure.

In general, RLS symptoms may gradually worsen with age, although the decline may be somewhat faster in individuals who also suffer from an associated medical condition. Some individuals have remission periods; however, the symptoms usually reappear.

Fortunately, there are many treatment options for RLS. Treatment of restless leg syndrome is first directed toward any underlying illness, if known. Prescription medications are also used and may include pain medications, anti-anxiety medications, anticonvulsants, and muscle relaxants. Alternative treatments can include warm/cold baths, electric nerve stimulation, oral magnesium, acupuncture, and tonic water at bedtime.

There are many conditions that can mimic restless leg syndrome, including Parkinson's disease, fibromyalgia, muscle diseases, joint conditions, circulation difficulties, and nerve problems such as peripheral neuropathy caused by diabetes. In children, restless leg syndrome is often misdiagnosed as "growing pains."

The National Institutes of Health established four criteria for the diagnosis of RLS:
- A strong urge to move your legs. This urge often, but not always, occurs with unpleasant feelings in your legs. When the disorder is severe, you also may have the urge to move your arms.
- Symptoms that start or get worse when you're inactive. The urge to move increases when you're sitting still or lying down and resting.
- Relief from moving. Movement, especially walking, helps relieve the unpleasant feelings.
- Symptoms that start or get worse in the evening or at night.

More than 80% of people with RLS also experience a more common condition known as periodic limb movement disorder (PLMD). PLMD is characterized by involuntary leg twitching or jerking movements during sleep that typically occur every 15 to 40 seconds, sometimes throughout the night. These movements are very different from the normal spasms (called hypnic myoclonia) that we often experience initially while trying to fall asleep.

People with RLS feel uncomfortable sensations in their legs, especially when sitting or lying down, accompanied by an irresistible urge to move the affected limb. Left untreated, the condition causes exhaustion and daytime fatigue, as well as sleep deprivation, depression, travel difficulties, memory impairment, difficulty concentrating, and insomnia. Because of lack of sleep, children and some adults may be very drowsy, irritable, and aggressive during daytime hours.