What is restless legs syndrome?

Restless legs syndrome (“RLS”) is a condition that causes strange sensations in your legs. If you have RLS, you probably have the urge to move your legs at night. This can make it hard to get comfortable and fall asleep.

In some cases, RLS happens on its own and seems to run in families. In other cases, the condition seems to be linked to other medical problems. For instance, a condition called “iron deficiency anemia,” in which there is too little iron in the blood, seems to increase the risk of RLS. Other conditions that increase the risk of RLS include kidney disease, diabetes, and multiple sclerosis. Pregnancy seems to increase a person’s risk of developing RLS, too.

What are the symptoms of RLS?

People who have RLS get an uncomfortable urge to move their legs when they are at rest. They describe the feeling as crawling, creeping, pulling, or itching. And they say that the feeling is deep in the legs (not on the skin), usually below the knees. These symptoms usually get worse as the day moves on, and they are worst at night. The symptoms can be especially bad when trying to stay still to read a book, watch TV, or fall asleep. It can be hard to do things that require sitting still for a long time. For example, symptoms can get worse if you take a long drive, fly in an airplane, or go to the theater.

People with RLS can make the feeling go away temporarily if they walk around or move their legs. Some people find that their legs move on their own while they are asleep.

In short, the symptoms:

• Happen when you are at rest
• Go away if you move your legs on purpose
• Are worst at night
• Sometimes include the legs moving on their own during sleep

Together, the symptoms of RLS can make it hard to get a good night’s sleep. People with the condition often have insomnia. This means that they have trouble falling or staying asleep, or they do not feel rested when they wake up.

Is there a test for RLS?

No, there is no test. Your doctor or nurse should be able to tell if you have RLS by asking about your symptoms and doing an exam. They might do blood tests to see whether you have enough iron in your blood.

Your doctor or nurse might also do other tests if they think that something else could be causing your symptoms.

Is there anything I can do on my own to feel better?

Yes. There are some things you can do that might help (table 1).

For example, you can:

• Practice good “sleep hygiene” – This means following certain habits to improve your sleep. For example, avoid caffeine and alcohol, especially near bedtime. It also helps to avoid looking at screens before bed.
• Do activities that keep your mind alert during the day, such as puzzles.
• Stay physically active – Any activities that involve moving your body are good for you. Even gentle forms of exercise, like walking or yoga, can help.
• Massage your legs – You can also have someone massage them, if possible. Some people also feel better if they use “pneumatic compression devices.” These are special sleeves that fill with air and squeeze your legs.
• Apply heat to your legs – You can do this by using a heating pad or taking a hot bath or shower.
• Avoid taking medicines that can make RLS worse – These include antihistamines like diphenhydramine (sample brand name: Benadryl). Some over-the-counter sleep aids also contain diphenhydramine, and can make RLS worse if people try them to help with sleep. It also includes some medicines used to treat depression and other mental health problems. If you take any medicines regularly, talk to your doctor before stopping. They might recommend trying a different medicine instead.

Should I see a doctor or nurse?

See your doctor or nurse if your condition bothers you, or if it keeps you from getting a good night’s sleep.

Some people with RLS have another condition that affects their sleep, such as sleep apnea. People with sleep apnea stop breathing for short periods while they are asleep. If your doctor thinks that you might have this or another condition, they can order tests. They can also recommend treatment if needed.