Restless Legs Syndrome (RLS) is a sensory-motor neurological disorder that causes an irresistible urge to move the legs. It often begins at a very young age but is mostly diagnosed in the middle or later years.
When an involuntary twitching or jerking of the legs occurs during sleep, it is known as Periodic Limb Movements in Sleep (PLMS).
The prevalence of RLS in the U.S and Europe is quoted to be around seven to 10 percent, whereas in Asia, it is reported to be around one to four percent. A local study done in Singapore showed a RLS prevalence of less than one percent. It is more common in women.
80 percent of RLS patients have PLMS. PLMS is usually picked up incidentally on overnight sleep studies. It is only clinically significant if it causes symptoms.
RLS can affect your quality of life. Both RLS and PLMS can disturb sleep by causing sleep initiation insomnia and sleep maintenance insomnia respectively.
In the majority of cases, the underlying cause is unknown. Iron metabolism and dopamine, a neurochemical in the brain, are believed to play a role in causing RLS/PLMS.
RLS are often seen in patients with low iron levels, kidney failure, diabetes mellitus and low thyroid hormone.
About one in five pregnant women suffer from RLS in the last three months of pregnancy. The symptoms usually disappear after delivery. Some medications, for example, antidepressants, can trigger and worsen RLS/PLMS.
The diagnosis of RLS lies entirely on clinical features. An overnight sleep study is occasionally used to diagnose PLMS.
First, to treat the underlying cause, if any. This includes stopping any medications that can trigger RLS/PLMS, if possible.
It is important to maintain good sleep hygiene, quit smoking and exercise regularly during the day.
The drug treatment includes: dopamine agonists, alfa-2 delta ligands (gabapentin, pregabalin) and opioids.
