Restless legs syndrome

The exact cause of restless legs syndrome is uncertain. There may be a genetic link as it runs in families.

Several medical conditions are associated with it, including:

• low iron and iron deficiency anaemia
• hypothyroidism or hyperthyroidism
• rheumatoid arthritis
• type 2 diabetes
• obstructive sleep apnoea
• chronic kidney disease
• Parkinson disease
• varicose veins
• nerve damage, such as neuropathy, spinal cord disease or multiple sclerosis.

Pregnancy can also be linked with restless legs syndrome. It usually gets better after your pēpi is born. Some women also experience symptoms of restless leg syndrome during perimenopause and menopause.

Some medicines may cause it, for example:

• some antidepressants
• sedating antihistamines
• antipsychotics such as haloperidol, quetiapine and olanzapine.

Restless legs syndrome is more common in women than men, and it often gets worse as you get older.

The most common symptom is a strong urge to move your legs and sometimes other parts of your body.

Symptoms occur most often at night. They might only happen some evenings, or they might happen every evening and night, disturbing your sleep.

You may also get unpleasant sensations in your legs, such as pins and needles or prickling.

The feelings start or worsen when you rest, lie down to sleep, or have not moved for a while, such as when you are in a car. Moving, walking or stretching will usually make you feel better and relieve your symptoms.

Restless legs syndrome is different from leg cramps or periodic limb movements of sleep, where you have regular repeated movements in your sleep.

Periodic limb movements of sleep — SleepHealth Foundationexternal link

Your healthcare provider will usually diagnose restless legs syndrome from your symptoms.

They may ask you to have a blood test to check for a contributing problem, such as low iron or a problem with your thyroid.

Treatment for restless legs syndrome focuses on lifestyle changes.

If you have a medical condition causing or aggravating restless legs syndrome, such as iron deficiency, treating it may make your restless legs syndrome go away. Your healthcare provider may advise a change of medication if they think a side effect from a medication is responsible.

If your symptoms are severe or are interfering with your quality of life, your healthcare provider may suggest medication for restless legs syndrome.

Restless legs syndrome is most often a lifelong condition. It is important to develop some ways to try to manage it.

• Stretching, a warm bath and massaging the affected arms or legs can relax the muscles.
• Using a heat or cool pack, or alternating between them, may lessen the leg sensations.
• Keep your sleeping environment cool, quiet and comfortable. Create good routines and try to go to bed and get up at the same time every day. Aim for a good sleep but recognise that having restless legs may make it difficult to fall and stay asleep.
• Moderate, regular exercise may relieve symptoms. Overdoing it or working out too late in the day may make symptoms worse. Try a gentle walk or some stretching before bed instead.
• Cutting back on nicotine, alcohol and caffeine may help restless legs. Try to avoid caffeine-containing products and alcohol for a few weeks to see if this helps — this includes chocolate, coffee, tea and caffeinated soft drinks.
• Distract yourself with an activity such as reading, so you are less aware of your symptoms.
• Keep a diary to track your medicines, food and strategies that help your symptoms, and those that make them worse.