Get Some Sleep: Is restless legs syndrome real?
January 11th, 2011
11:30 AM ET

Get Some Sleep: Is restless legs syndrome real?

One question that I am often asked is whether restless legs syndrome is a disorder made up by the pharmaceutical companies.  I can see why people might think that;  few people, including doctors, had heard of  it 20 years ago,  but media reports and ads for medications have put the term into common use.

But as someone who has treated hundreds of patients with this disorder, I can attest to its existence as well as its ability to seriously affect patients’ quality of life.

Restless legs syndrome (RLS) is not the same as foot tapping, nor is it the same as leg cramps.  Patients complain of strange and disturbing feelings usually in their lower legs that usually happen only  in the evening when they are sitting or lying down.  They move their legs voluntarily in an attempt to find relief.  Unfortunately, the minute they stop moving or rubbing their legs, the feeling returns, hence the repeated movement.  In severe cases, the symptoms can begin earlier in the day and can involve the arms or other body parts.  However, when people first develop this problem, it almost always starts in the evening and ends up preventing them from sleeping, which is why it's considered a sleep disorder.

This is a clinical diagnosis, meaning that there is no test that uncovers it.  Rather it is diagnosed based on the constellation of signs and symptoms that patients present.  However, we often do an overnight sleep test because there is a disorder that can go along with RLS which is called Periodic Limb Movement Disorder (PLMD) and this entails rhythmic kicking while asleep.  Sometimes people have PLMD without having RLS, and not all people with RLS will have significant limb movements during their sleep test.

There are population studies that show varying prevalence rates of 5-15%,  but only about 3% of adults and 0.5% of children have it often enough or severe enough to warrant treatment.  There appears to be a genetic component because 40% adults and 70% of children who have primary RLS report that at least one first-degree relative also suffers with this condition.  In most studies, it is approximately twice as common in women as compared to men.  One study found that 27% of pregnant women complained of RLS symptoms.

We do not understand what causes RLS but there seems to be a dysregulation of dopamine, a naturally occurring neurotransmitter.  RLS is greatly increased in patients with Parkinson’s disease, which involves a depletion of dopamine.  It should be noted that people with RLS do not have a depletion of dopamine, just a dysregulation, and there is no evidence that they are at increased risk of developing Parkinson’s disease.

 Iron deficiency can also be involved because in order to synthesize dopamine it is necessary to have sufficient amounts of stored iron in the central nervous system.  Therefore, we do see an increase in prevalence of RLS in people with anemia, end stage kidney disease and in pregnant women, all conditions that involve low levels of the storage form of iron, which is known as ferritin.  There is a simple blood test that can be checked in people with RLS symptoms and if the level is below 50 ng/ml, then oral iron replacement is indicated.  In fact, it is now recommended that all patients with RLS take extra iron each day.

We also know that certain medications can cause or aggravate RLS, medications such as antidepressants, over-the-counter antihistamines and nausea medications such as metoclopramide.  Substances such as caffeine, nicotine and alcohol can also worsen the symptoms of RLS.

If symptoms are very mild or infrequent, then people can try stretching exercises before the time that the symptoms  typically start or they can try doing mentally stimulating tasks such as crossword puzzles, which can help distract them. However, if RLS symptoms occur more than twice a week, most patients want treatment.  Besides adding more iron to the diet, there are several classes of prescription medications that can be used, the most common being dopamine agonists (i.e. synthetic dopamine replacement).  It is important that physicians have experience treating RLS because older dopamine agonists such as carbidopa/levodopa must be used with caution as they can actually worsen the RLS symptoms.

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She’ll blog on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.

Post by:
Filed under: Sleep

soundoff (973 Responses)
  1. AbdgEncox

    Eulexin https://canadianeve21.com/ canadian pharmacy online

    April 27, 2021 at 12:50 | Report abuse | Reply
  2. RfvbZisse

    cialis usa http://cileve.com/ side effects of cialis and grapefruits

    April 27, 2021 at 15:31 | Report abuse | Reply
  3. BbdfMile

    viagra for pulmonary hypertension [url=https://gensitecil.com/ ]is viagra covered by medicare[/url] womens viagra pill

    April 27, 2021 at 19:10 | Report abuse | Reply
  4. RfvbZisse

    rhino laboratories cialis https://cileve.com/ online buy cialis

    April 28, 2021 at 13:40 | Report abuse | Reply
  5. avanafil

    avana canada buy avanafil online

    April 28, 2021 at 19:04 | Report abuse | Reply
  6. FbsfEncox

    canadian drugs without prescription https://uspharmus.com/ Vermox

    April 28, 2021 at 20:01 | Report abuse | Reply
  7. how can i order cialis from a canadian pharmacy

    buying canadian cialis https://canadacialisstore.com/ cialis canadian

    April 29, 2021 at 04:50 | Report abuse | Reply
  8. LhdvZisse

    cialis soft tabs [url=http://asciled.com/ ]cialis dapoxetine[/url] viagra vs cialis side effects

    April 29, 2021 at 06:37 | Report abuse | Reply
  9. Anahi

    Does anyone know what happened to Dime Piece LA celebrity streetwear brand? I am unable to proceed to the checkout on Dimepiecela site. I've read in Teen Vogue that the brand was acquired by a UK hedge fund for $50 m. I've just bought the Dimepiece Babygirl Unisex Heavy Blend™ Crewneck Sweatshirt from Ebay and absolutely love it xox


    April 29, 2021 at 13:15 | Report abuse | Reply
  10. LrbsEncox

    levitra online pharmacy http://uslevitraanna.com/ levitra from india

    May 1, 2021 at 03:05 | Report abuse | Reply
  11. AbdgEncox

    canadian drug stores online http://canadianeve21.com/ Advair Diskus

    May 2, 2021 at 23:48 | Report abuse | Reply
  12. LrbsEncox

    levitra coupon walgreens [url=https://uslevitraanna.com/ ]viagra versus cialis versus levitra[/url] levitra generico on line

    May 3, 2021 at 02:48 | Report abuse | Reply
  13. priligy

    buy priligy usa buy avanafil

    May 3, 2021 at 03:54 | Report abuse | Reply
  14. 黑金推薦

    Great blog you've got here.. It's hard to find high quality writing like
    yours nowadays. I honestly appreciate people like you!

    Take care!!

    May 3, 2021 at 05:36 | Report abuse | Reply
  15. RebfZisse

    viagra cialis melbourne site:au https://rcialisgl.com/ cialis drug

    May 3, 2021 at 11:51 | Report abuse | Reply
  16. LbsoZisse

    cialis 20mg online http://ucialisdas.com/ female cialis no prescription

    May 4, 2021 at 06:36 | Report abuse | Reply
  17. avana

    avana tabs buy avanafil canada

    May 4, 2021 at 07:25 | Report abuse | Reply
  18. LebnEncox

    drugstore makeup https://xlnpharmacy.com/ canada pharma limited

    May 4, 2021 at 11:27 | Report abuse | Reply
  19. GtnbCrulk

    is viagra a blood thinner https://jokviagra.com/ is sildenafil 20 mg the same as viagra?

    May 4, 2021 at 15:37 | Report abuse | Reply
  20. dapoxetine

    dapoxetine for sale dapoxetine 100 mg

    May 5, 2021 at 00:16 | Report abuse | Reply
  21. GtnbCrulk

    i am a woman and i took viagra [url=http://jokviagra.com/ ]how long does it take for a 100mg viagra to kick in?[/url] is viagra bad for you

    May 5, 2021 at 10:00 | Report abuse | Reply
  22. AnooEncox

    viagra 100mg dauer https://llviagra.com/ can you ejaculate after taking viagra

    May 6, 2021 at 01:02 | Report abuse | Reply
  23. LebnEncox

    best canadian prescription prices http://xlnpharmacy.com/ legitimate online pharmacy usa

    May 6, 2021 at 15:41 | Report abuse | Reply
  24. FmrfEncox

    cialis quick ship https://cialisee.com/ cialis cost

    May 6, 2021 at 21:28 | Report abuse | Reply
  25. BbshMile

    when do you take viagra [url=https://loxviagra.com/ ]best viagra pills[/url] super viagra

    May 7, 2021 at 12:24 | Report abuse | Reply
  26. JebgEncox

    usa pharmacy https://pharmacylo.com/ ed meds online without doctor prescription

    May 7, 2021 at 18:03 | Report abuse | Reply
  27. JebgEncox

    cheapest pharmacy canada http://pharmacylo.com/ pharmacy today

    May 7, 2021 at 20:28 | Report abuse | Reply
  28. LbsoZisse

    cialis prices walmart [url=http://ucialisdas.com/ ]cialis 10mg vs 20mg[/url] cialis cheap buy

    May 8, 2021 at 17:47 | Report abuse | Reply
  29. AnooEncox

    beber e usar viagra http://llviagra.com/ ban thuoc kich duc viagra

    May 8, 2021 at 18:41 | Report abuse | Reply
  30. RebfZisse

    where to buy cialis in singapore [url=https://rcialisgl.com/ ]where to find cheap cialis[/url] generic cialis for sale

    May 8, 2021 at 21:57 | Report abuse | Reply
  31. FmrfEncox

    cialis without prescription overnight [url=http://cialisee.com/ ]cialis extra[/url] viragecialis

    May 9, 2021 at 19:51 | Report abuse | Reply
  32. RebfZisse

    viagra/cialis black and gold 800 http://rcialisgl.com/ viagra and cialis

    May 10, 2021 at 10:36 | Report abuse | Reply
  33. LbsoZisse

    cheap cialis professional https://ucialisdas.com/ inexpensive real cialis

    May 11, 2021 at 04:17 | Report abuse | Reply
  34. GtnbCrulk

    reddit viagra [url=http://jokviagra.com/ ]viagra how long does it last[/url] girls viagra

    May 11, 2021 at 21:51 | Report abuse | Reply
  35. BbshMile

    can i take 2 viagra 100mg https://loxviagra.com/ viagra benefits

    May 12, 2021 at 09:05 | Report abuse | Reply
  36. LebnEncox

    Aciphex [url=https://xlnpharmacy.com/ ]Zudena[/url] pharmacy no prescription required

    May 12, 2021 at 13:13 | Report abuse | Reply
  37. GtnbCrulk

    viagra vitamins [url=https://jokviagra.com/ ]viagra by mail[/url] cialis or viagra

    May 12, 2021 at 21:14 | Report abuse | Reply
  38. AnooEncox

    tester le viagra http://llviagra.com/ is viagra good for recreation

    May 13, 2021 at 04:46 | Report abuse | Reply
  39. stornobrzinol

    Wow! Thank you! I continually wanted to write on my blog something like that. Can I include a fragment of your post to my website?


    May 13, 2021 at 17:31 | Report abuse | Reply
  40. stornobrzinol

    Way cool, some valid points! I appreciate you making this article available, the rest of the site is also high quality. Have a fun.


    May 13, 2021 at 19:00 | Report abuse | Reply
  41. FmrfEncox

    best price on cialis 20mg https://cialisee.com/ us cialis purchase

    May 13, 2021 at 20:39 | Report abuse | Reply
  42. stornobrzinol

    Keep working ,terrific job!


    May 14, 2021 at 00:14 | Report abuse | Reply
  43. LebnEncox

    prescription drug price comparison http://xlnpharmacy.com/ discount prescription drug

    May 14, 2021 at 16:04 | Report abuse | Reply
  44. BbshMile

    tadalafil vs viagra https://loxviagra.com/ viagra connect walgreens

    May 14, 2021 at 23:43 | Report abuse | Reply
  45. cyclomune

    cyclomune eye drop cyclosporine eye drops

    May 15, 2021 at 05:58 | Report abuse | Reply
  46. AnooEncox

    la viagra dj pablito https://llviagra.com/ problemas com viagra

    May 15, 2021 at 13:00 | Report abuse | Reply
  47. JebgEncox

    online pharmacy no rx http://pharmacylo.com/ best ed medication

    May 15, 2021 at 16:49 | Report abuse | Reply
  48. storno brzinol

    I have not checked in here for a while as I thought it was getting boring, but the last several posts are good quality so I guess I will add you back to my daily bloglist. You deserve it my friend 🙂


    May 15, 2021 at 18:10 | Report abuse | Reply
  49. JebgEncox

    canadian viagra generic pharmacy [url=http://pharmacylo.com/ ]pharmacy wholesalers canada[/url] canadian neighbor pharmacy

    May 15, 2021 at 18:42 | Report abuse | Reply
  50. LbsoZisse

    i want to buy cialis in australia https://ucialisdas.com/ buy cialis through pay pal

    May 15, 2021 at 19:57 | Report abuse | Reply
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Leave a Reply to Ultimate Cynic


CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.

Recent Comments
January 2011
  • An error has occurred, which probably means the feed is down. Try again later.