Restless legs syndrome (RLS) causes a powerful urge to move your legs. Your legs become uncomfortable when you are lying down or sitting. Some people describe it as a creeping, crawling, tingling or burning sensation. Moving makes your legs feel better, but not for long. In most cases, there is no known cause for RLS. In other cases, RLS is caused by a disease or condition, such as anemia or pregnancy. Some medicines can also cause temporary RLS. Caffeine, tobacco and alcohol may make symptoms worse. Lifestyle changes, such as regular sleep habits, relaxation techniques and moderate exercise during the day can help. If those don't work, medicines may reduce the symptoms of RLS.

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Health Topics
Restless Leg Syndrome
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2. Overview
Restless legs syndrome (RLS) causes a powerful
urge
to move your legs. Your legs become
uncomfortable when you are lying down or
sitting. Some people describe it as a creeping,
crawling, tingling or burning
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3. Overview
sensation. Moving makes your legs feel better, but
not for long.
In most cases, there is no known cause for RLS. In
other cases, RLS is caused by a disease or
condition, such as anemia or
pregnancy. Some medicines can also cause
temporary RLS. Caffeine, tobacco and
2

4. Overview
alcohol may make symptoms worse.
Lifestyle changes, such as regular sleep habits,
relaxation techniques and moderate exercise
during the day can help. If those
don't work, medicines may reduce the symptoms
of RLS.
3

5. Causes
**Faulty Use of Iron or Lack of Iron**
Research suggests that the main cause of
restless legs syndrome (RLS) is a faulty use of iron
or a lack of iron in the
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6. Causes
**Faulty Use of Iron or Lack of Iron**
brain. The brain uses iron to make the chemical
dopamine (DO-pah-meen) and to
control other brain activities. Dopamine works in
the parts of the brain that
control movement.
Many conditions can affect how much iron is
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7. Causes
**Faulty Use of Iron or Lack of Iron**
in the brain or how it's used. These conditions
include kidney failure, Parkinson's
disease, diabetes, rheumatoid arthritis, pregnancy,
and iron deficiency. All of
these conditions increase your risk of RLS.
People whose family members have RLS also
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8. Causes
**Faulty Use of Iron or Lack of Iron**
are more likely to develop the disorder. This
suggests that genetics may
contribute to the faulty use of iron or lack of iron in
the brain that triggers
RLS.
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9. Causes
**Nerve Damage**
Nerve damage in the legs or feet and
sometimes in the arms or hands may cause or
worsen RLS. Several conditions can
cause this type of nerve damage, including
diabetes.
8

10. Causes
**Medicines and Substances**
Certain medicines may trigger RLS. These
include some:
Antinausea medicines (used to treat upset
stomach)
9

11. Causes
**Medicines and Substances**
Antidepressants (used to treat depression)
Antipsychotics (used to treat certain
mental health disorders)
Cold and allergy medicines that contain
antihistamines
10

12. Causes
**Medicines and Substances**
Calcium channel blockers (used to treat
heart problems and high blood
pressure)
RLS symptoms usually get better or may even
go away if the medicine is stopped.
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13. Causes
**Medicines and Substances**
Certain substances, such as alcohol and
tobacco, also can trigger or worsen RLS symptoms.
Symptoms may get better or go
away if the substances are stopped.
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14. Risks
Restless legs syndrome (RLS) affects about 5–15
percent of
Americans. Many people who have RLS have family
members with the disorder.
RLS can affect people of any racial or ethnic group,
but the
13

15. Risks
disorder is more common in people of Northern
European descent. RLS affects
both genders, but women are more likely to have it
than men.
The number of cases of RLS rises with age. Many
people who have
RLS are diagnosed in middle age. People who
develop RLS early in life tend to
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16. Risks
have a family history of the disorder.
People who have certain diseases or conditions or
who take certain
medicines are more likely to develop RLS. (For
more information, go to "What Causes
Restless Legs Syndrome?")
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17. Risks
For example, pregnancy is a risk factor for RLS. It
usually occurs
during the last3 months of
pregnancy. The disorder usually improves or goes
away after giving birth. Some
women may continue to have symptoms after
giving birth. Other women may develop
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18. Risks
RLS again later in life.
17

19. Symptoms
The four key signs of restless legs
syndrome (RLS) are:
-- A strong urge to move your legs. This urge
often, but not always, occurs with unpleasant
feelings in your legs. When the
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20. Symptoms
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.
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21. Symptoms
-- Relief from moving. Movement, especially
walking, helps relieve the unpleasant feelings.
-- Symptoms that start or get worse in the
evening or at night.
-- You must have all four of these signs to be
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22. Symptoms
diagnosed with RLS.
**The Urge To Move**
RLS gets its name from the urge to move the
legs when sitting or lying down. This movement
relieves the unpleasant feelings
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23. Symptoms
that RLS sometimes causes. Typical movements
are:
-- Pacing and walking
-- Jiggling the legs
-- Stretching and flexing
-- Tossing and turning
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24. Symptoms
-- Rubbing the legs
-- Unpleasant Feelings
People who have RLS describe the unpleasant
feelings in their limbs as creeping, crawling,
pulling, itching, tingling,
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25. Symptoms
burning, aching, or electric shocks. Severe RLS may
cause painful feelings.
However, the pain usually is more of an ache than
a sharp, stabbing pain.
Children may describe RLS symptoms
differently than adults. In children, the condition
may occur with
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26. Symptoms
hyperactivity. However, it's not fully known how
the disorders are related.
The unpleasant feelings from RLS often
occur in the lower legs (calves). But the feelings
can occur at any place in
the legs or feet. They also can occur in the arms.
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27. Symptoms
The feelings seem to come from deep within
the limbs, rather than from the surface. You usually
will have the feelings in
both legs. However, the feelings can occur in one
leg, move from one leg to the
other, or affect one leg more than the other.
26

28. Symptoms
People who have mild symptoms may notice
them only when they're still or awake for a long
time, such as on a long
airplane trip or while watching TV. If they fall
asleep quickly, they may not
have symptoms when lying down at night.
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29. Symptoms
The unpleasant feelings from RLS aren't the
same as the leg cramps many people get at night.
Leg cramps often are limited
to certain muscle groups in the leg, which you can
feel tightening. Leg cramps
cause more severe pain and require stretching the
affected muscle for relief.
28

30. Symptoms
Sometimes arthritis or peripheral
arterial disease (P.A.D.) can cause pain or
discomfort in the legs.
Moving the limbs usually worsens the discomfort
instead of relieving it.
29

31. Symptoms
**Periodic Limb Movement in Sleep**
Many people who have RLS also have a
condition called periodic limb movement in sleep
(PLMS). PLMS causes your legs
or arms to twitch or jerk about every10 to 60
seconds during sleep. These
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32. Symptoms
**Periodic Limb Movement in Sleep**
movements cause you to wake up often and get
less sleep.
PLMS usually affects the legs, but it also
can affect the arms. Not everyone who has PLMS
also has RLS.
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33. Symptoms
**Related Sleep Problems**
RLS can make it hard to fall or stay
asleep. If RLS disturbs your sleep, you may feel
very tired during the day.
Lack of sleep may make it hard for you to
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34. Symptoms
**Related Sleep Problems**
concentrate at school or work. Not enough sleep
also can cause depression, mood
swings, and other health problems such as
diabetes or high blood
pressure.
33

35. Diagnosis
Your doctor will diagnose restless legs
syndrome (RLS) based on your signs and
symptoms, your medical and family
histories, a physical exam, and test results.
Your doctor will use this information to
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36. Diagnosis
rule out other conditions that have symptoms
similar to those of RLS.
**Specialists Involved**
Your primary care doctor usually can
diagnose and treat RLS. However, he or she also
may suggest that you see a
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37. Diagnosis
sleep specialist or neurologist.
**Signs and Symptoms**
You must have the four
key signs of RLS to be diagnosed with the disorder.
Your doctor will want to know how your
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38. Diagnosis
symptoms are affecting your sleep and how alert
you are during the day.
To help your doctor, you may want to keep a
sleep diary. Use the diary to keep a daily record of
how easy it is to fall and
stay asleep, how much sleep you get at night, and
how alert you feel during the
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39. Diagnosis
day.
For a sample sleep diary, go to the
National Heart, Lung, and Blood Institute's"Your
Guide to Healthy Sleep."
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40. Diagnosis
**Medical and Family Histories**
Your doctor may ask whether you have any of
the diseases or conditions that can trigger RLS.
These include kidney failure,
Parkinson's disease, diabetes, rheumatoid arthritis,
pregnancy, and iron
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41. Diagnosis
**Medical and Family Histories**
deficiency.
Your doctor also may want to know what
medicines you take. Some medicines can trigger or
worsen RLS.
The most common type of RLS tends to run in
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42. Diagnosis
**Medical and Family Histories**
families. Thus, your doctor may ask whether any of
your relatives have RLS.
**Physical Exam**
Your doctor will do a physical exam to
check for underlying conditions that may trigger
RLS. He or she also will check
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43. Diagnosis
**Medical and Family Histories**
for other conditions that have symptoms similar to
those of RLS.
**Diagnostic Tests**
Currently, no test can diagnose RLS. Still,
your doctor may recommend blood teststo
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44. Diagnosis
**Medical and Family Histories**
measure your iron levels. He or she also may
suggest muscle or nerve tests.
These tests can show whether you have a
condition that can worsen RLS or that
has symptoms similar to those of RLS.
Rarely, sleep
43

45. Diagnosis
**Medical and Family Histories**
studies are used to help diagnose RLS. A sleep
study measures how much
and how well you sleep. Although RLS can cause a
lack of sleep, this sign isn't
specific enough to diagnose the condition.
Researchers continue to study new ways to
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46. Diagnosis
**Medical and Family Histories**
diagnose RLS.
**Drug Therapy Trial**
If your doctor thinks you have RLS, he or
she may prescribe certain medicines to relieve
your symptoms. These medicines,
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47. Diagnosis
**Medical and Family Histories**
which are used to treat people who have
Parkinson's disease, also can relieve
RLS symptoms. If the medicines relieve your
symptoms, your doctor can confirm
that you have RLS.
46

48. Treatment
Restless legs syndrome (RLS) has no cure.
If a condition or medicine triggers RLS, it may go
away or get better if the
trigger is relieved or stopped.
RLS can be treated. The goals of treatment
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49. Treatment
are to:
-- Prevent or relieve symptoms
-- Increase the amount of sleep you're getting
and improve the quality of your sleep
-- Treat or correct any underlying condition
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50. Treatment
that may trigger or worsen RLS
Mild cases of RLS often are treated with
lifestyle changes and sometimes with periodic use
of medicines. More severe RLS
usually is treated with daily medicines.
49

51. Treatment
**Lifestyle Changes**
Lifestyle changes can prevent or relieve
the symptoms of RLS. For mild RLS, lifestyle
changes may be the only treatment
needed.
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52. Treatment
**Preventing Symptoms**
Many common substances, such as alcohol and
tobacco, can trigger RLS symptoms. Avoiding these
substances can limit or
prevent symptoms.
Some prescription and over-the-counter
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53. Treatment
**Preventing Symptoms**
medicines can cause or worsen RLS symptoms. Tell
your doctor about all of the
medicines you're taking. He or she can tell you
whether you should stop or
change certain medicines.
Adopting good sleep habits can help you
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54. Treatment
**Preventing Symptoms**
fall asleep and stay asleep—a problem for many
people who have RLS. Good sleep habits
include:
-- Keeping the area where you sleep cool,
quiet, comfortable, and as dark as possible.
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55. Treatment
**Preventing Symptoms**
-- Making your bedroom sleep-friendly. Remove
things that can interfere with sleep, such as a TV,
computer, or phone.
-- Going to bed and waking up at the same time
every day. Some people who have RLS find it
helpful to go to bed later in the
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56. Treatment
**Preventing Symptoms**
evening and get up later in the morning.
-- Avoiding staying in bed awake for long
periods in the evening or during the night.
-- Doing a challenging activity before
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57. Treatment
**Preventing Symptoms**
bedtime, such as solving a crossword puzzle, may
ease your RLS symptoms. This
distraction may make it easier for you to fall
asleep. Focusing on your
breathing and using other relaxation techniques
also may help you fall asleep.
-- Regular, moderate physical activity also can
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58. Treatment
**Preventing Symptoms**
help limit or prevent RLS symptoms. Often, people
who have RLS find that if
they increase their activity during the day, they
have fewer symptoms.
-- Relieving Symptoms
Certain activities can relieve RLS
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59. Treatment
**Preventing Symptoms**
symptoms. These include:
-- Walking or stretching
-- Taking a hot or cold bath
-- Massaging the affected limb(s)
-- Using heat or ice packs on the affected
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60. Treatment
**Preventing Symptoms**
limb(s)
-- Doing mentally challenging tasks
-- Choose an aisle seat at the movies or on
airplanes and trains so you can move around, if
necessary.
59

61. Treatment
**Medicines**
You may need medicines to treat RLS if
lifestyle changes can't control symptoms. Many
medicines can relieve or prevent
RLS symptoms.
No single medicine works for all people who
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62. Treatment
**Medicines**
have RLS. It may take several changes in medicines
and dosages to find the best
approach. Sometimes, a medicine will work for a
while and then stop working.
Some of the medicines used to treat RLS
also are used to treat Parkinson's disease. These
medicines make dopamine or
61

63. Treatment
**Medicines**
mimic it in the parts of the brain that control
movement. (Dopamine is a chemical
that helps you move properly.)
If medicines for Parkinson's disease don't
prevent or relieve your symptoms, your doctor
may prescribe other medicines.
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64. Treatment
**Medicines**
You may have to take more than one medicine to
treat your RLS.
Always talk with your doctor before taking
any medicines. He or she can tell you the side
effects of each RLS medicine.
Side effects may include nausea (feeling sick to
your stomach), headache, and
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65. Treatment
**Medicines**
daytime sleepiness.
In some cases, RLS medicines may worsen
problems with excessive gambling, shopping, or
sexual activity. Sometimes,
continued use of RLS medicines may make your
RLS symptoms worse.
64

66. Treatment
**Medicines**
Contact your doctor if you have any of
these problems. He or she can adjust your
medicines to prevent these side
effects.
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67. Living and coping
Restless legs syndrome (RLS) often is a
lifelong condition. Symptoms may come and go
often or go away for long periods.
Symptoms often get worse over time.
If a condition or medicine triggers RLS,
66

68. Living and coping
the disorder may go away if the trigger is relieved
or stopped. For example,
RLS that occurs due to pregnancy tends to go away
after giving birth.
Although RLS has no cure, treatments can
relieve or prevent RLS symptoms. Mild cases of RLS
often are treated with
67

69. Living and coping
lifestyle changes and sometimes with periodic use
of medicines. More severe RLS
usually is treated with daily medicines. (For more
information, go to "How
Is Restless Legs Syndrome Treated?")
68

70. Living and coping
**Ongoing Medical Care**
If you have RLS, see your doctor regularly
so he or she can watch for changes in your
symptoms. This will show whether
your treatment is working and whether it will
continue to work over time.
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71. Living and coping
**Ongoing Medical Care**
Call your doctor if you notice your
treatment is no longer working or if you have new
symptoms.
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72. Living and coping
**Other Considerations**
Try to plan long car trips and other long
periods of inactivity at the times of day when your
symptoms are least severe.
Give yourself time to stretch or take walking
breaks.
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73. Living and coping
**Other Considerations**
Choose an aisle seat at the movies or on
airplanes and trains so you can move around if
needed.
Consider finding a work setting where you
can stand or walk around.
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74. Living and coping
**Emotional Issues and Support**
Living with RLS may cause anxiety and
stress. It's important to talk about how you feel
with your health care team.
Joining a patient support group may help
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75. Living and coping
**Emotional Issues and Support**
you adjust to living with RLS. You can see how
other people who have the same
symptoms have coped with them. Talk with your
doctor about local support groups
or check with an area medical center.
Support from family and friends also can
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76. Living and coping
**Emotional Issues and Support**
help relieve stress and anxiety. Let your loved ones
know how you feel and what
they can do to help you.
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