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October 19 2017
 

What to do when your legs are too restless for sleep

By Brittany Schultz, MD

Sleep disorders vary and can include obstructive sleep apnea, insomnia, sleep walking and other problems that cause tiredness during the day. One of the more common disorders is restless legs syndrome, or RLS, which affects up to 7 percent of the population.

RLS is described as a crawling sensation or aching discomfort that can feel like your legs are being squeezed or pulled. The result is a continual urge to move your legs.

Most people with RLS have irresistible urges to move their legs at rest, on airplanes and when they simply want to sit and watch TV. For some people, the tingling and twitchiness can be felt in the arms.

When these symptoms occur, a normal reaction is to twist, turn and move. These movements can pause the annoying – and sometimes agonizing – sensations. However, counteractive movements help only temporarily, with sensations starting again once you stop the movement. The constant need to move your legs leads to more wakefulness because you cannot relax enough to fall asleep.

Restless limbs and related sleeplessness can afflict anyone – children, adults, men and women. Children who have leg cramps or “growing pains” are more prone to RLS. People who do not eat red meat are also more susceptible because of a lack of iron in their diets. Some women develop RLS during pregnancy.

People often live with RLS, also known as Willis-Ekbom disease, for a lifetime. More than one exasperated spouse has led an RLS-plagued partner to a doctor. Unfortunately, RLS results in poor sleep that compromises health and may ultimately lead to heart disease, hypertension, obesity or other serious medical problems.

You don’t have to wait for relationships and daily life to be adversely affected by the syndrome. A sleep specialist can work with you to diagnose and help resolve RLS. The goal of treatment is to suppress or extinguish the restlessness so you can get the rest you need.

Common causes of RLS are genetics, iron deficiency or certain medications that have been shown to cause the syndrome. RLS not associated with another medical condition can be confirmed by a consultation with a sleep specialist, who may order a blood test or a sleep study.

A sleep specialist can evaluate your symptoms and medications to determine what may be contributing to your RLS. In addition, a blood test for ferritin can help show whether an oral iron supplement, change in diet or iron transfusion is needed.

The specialist can also recommend lifestyle changes and strategies for easing RLS symptoms, including playing games, knitting, stretching and walking when trying to relax or having to sit for periods of time.

If a sleep study is warranted, it’s best to have the study performed in a sleep center so the following can be monitored and scientifically evaluated:

  • Frequency of leg movements and responses

  • Brain activity

  • Breathing

  • Respiratory flow in the mouth and nose

  • Muscle tone

  • Heart activity

  • Efforts to breathe in the body

  • Oxygen level

A sleep study can help reveal the causes of the restlessness, including whether RLS is a side effect of another disorder such as obstructive sleep apnea. A complete study allows you and the doctor to target treatments to address the specific problem or problems. In some cases, RLS symptoms may subside when another sleep disorder is treated.

If tests determine that more targeted treatment is needed, the sleep specialist will provide treatment options. Some options include oral medication, a medication patch or a special vibrational device for the legs with individual comfort settings.

Everyone in the family can improve sleep by:

  • Getting regular exercise

  • Eating healthy foods

  • Turning off electronic devices and TVs at least one hour before bedtime

  • Sleeping in dark, quiet, cool and comfortable surroundings.

RLS can affect anyone. Take note of the symptoms, ask loved ones whether restless legs run in the family, and consult a doctor about jumpy legs and sleep problems. Take care of your sleep and your long-term health by seeking effective solutions to restlessness.

ProHealth’s team of board certified physicians specializing in sleep disorders sees patients at ProHealth Care’s Sleep Center in Delafield, ProHealth Medical Group in Pewaukee and both ProHealth Oconomowoc Memorial Hospital and ProHealth Waukesha Memorial Hospital. Information about the Sleep Center is available at ProHealthCare.org/Sleep or by calling 262-928-4043.

Brittany Schultz, MD, is a sleep specialist with ProHealth Medical Group. She sees patients at ProHealth Care’s Sleep Center in Delafield. Dr. Schultz is board certified in family medicine. She completed her fellowship in sleep medicine at Stanford Health Care in California and has special interests in obstructive sleep apnea, central sleep apnea, narcolepsy, restless leg syndrome, hypoventilation syndrome and insomnia.

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For more than a century, ProHealth Care has been the health care leader in Waukesha County and surrounding areas, providing outstanding care across a full spectrum of services. The people of ProHealth Care strive to continuously improve the health and well-being of the community by combining skill, compassion and innovation. The ProHealth family includes ProHealth Waukesha Memorial Hospital, ProHealth Oconomowoc Memorial Hospital, ProHealth Rehabilitation Hospital of Wisconsin, ProHealth Medical Group, the UW Cancer Center at ProHealth Care, Moreland Surgery Center, ProHealth AngelsGrace Hospice, ProHealth Home Care, ProHealth West Wood Health & Fitness Center and ProHealth Regency Senior Communities. Learn more at ProHealthCare.org.