What Is Restless Legs Syndrome?

Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a neurologic condition that causes uncomfortable sensations in the limbs (especially the legs) and an intense need to move the affected limb. It affects 7 to 10 percent of Americans and seems to be more common in women than men.

What Are the Symptoms?

Typical symptoms include a throbbing sensation or creeping discomfort or pain in the limbs and an irresistible urge to move them. The sensation occurs most often in the legs but also can occur in the arms and, more rarely, in the head and chest. Moving the limbs can relieve the uncomfortable feeling, so many affected patients toss and turn in bed, pace, rub, massage, or move their legs. Symptoms are usually worse at night, which can disrupt sleep. In more severe cases, symptoms can occur during the day (especially when seated and/or resting). Symptoms vary in frequency and severity and often worsen with age.  

What Are the Causes?

Neurologists suspect the condition is partly related to low levels of dopamine, a chemical in the brain that sends messages that control movements. Although no clear cause has emerged, researchers have identified risk factors, including low levels of iron; pregnancy (especially in the last trimester); end-stage kidney disease; alcohol, nicotine, or caffeine use; sleep deprivation or sleep apnea; nerve damage; and certain classes of medication including some that treat nausea, psychosis, depression, colds, and allergies. In some cases, restless legs syndrome may be hereditary, especially in people diagnosed before age 40.

How Is It Diagnosed?

Doctors ask about symptoms, take a medical history, and do a physical and neurologic examination. They may also order a blood test to check iron levels. To make a diagnosis, neurologists rely on five criteria:

1. An intense or uncontrollable urge to move the limbs, especially the legs, and/or strange sensations in the affected limbs
2. A more intense urge when sitting or lying down
3. An ease in sensation when stretching or walking
4. Worsening of symptoms at night
5. Ruling out other conditions that could account for the sensations

What Treatments Are Available?

The U.S. Food and Drug Administration (FDA) has approved three dopamine agonists often used to treat Parkinson’s disease—ropinirole (Requip), pramipexole (Mirapex), and rotigotine (Neupro)—as well as antiseizure medications such as gabapentin (Neurontin, Horizant) to treat restless legs syndrome. Since a co-occurring condition such as peripheral neuropathy, diabetes, or iron deficiency anemia can worsen RLS, treating the secondary disease can relieve or eliminate symptoms of RLS. Iron supplements may also help alleviate the unpleasant sensations. Lifestyle changes like avoiding or limiting alcohol and caffeine, quitting smoking, exercising, getting massages, taking warm baths, or using ice packs may reduce symptoms. The FDA also has cleared wraps that apply pressure to the limbs to ease the urge to move.

What Research is Being Done?

The National Institute of Neurological Disorders and Stroke conducts research and clinical trials related to restless legs syndrome, including studies on the genetics of the condition; the side effects of drugs to develop new and better therapies; changes in brain chemicals, which could lead to better research models; and ways to regulate iron in the brain.

Learn More About Restless Legs Syndrome

Where Can I Find More Information About Restless Leg Syndrome?

Information and resources on peripheral neuropathy and nerve disease are available from the following organizations: