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It was first accurately described in the 1940s by Swedish neurologist Dr Ekbom and has been called ‘Ekbom Syndrome’. It is a neurological rather than psychological condition in which the parts of the brain which control sensations and movements in the limbs, particularly the legs, are affected.
Some of all of the following will be true for people with Restless Legs Syndrome:
RLS is equally common in men and women, except for the additional incidence in women during pregnancy. It occurs in a mild form in up to 10% of the adult population but in around 2% causes troublesome symptoms on most nights of the week. It may worsen slightly with age but if it runs in the family it usually starts at a younger age than when it is due to a medical condition.
RLS is not a psychological or psychiatric disorder but is due to an abnormality of the control of sensation of movements in specific areas of the brain. It is thought that it is the result of a lack of dopamine in these parts of the brain. It is usually an isolated complaint with no other underlying illness but in a few patients RLS is related to:
RLS is often mistaken for other conditions partly because the symptoms are difficult to describe and also because there is usually nothing abnormal to find during a physical examination. Some important questions to be asked to confirm the diagnosis are shown in Table 3.
There are no specific tests for RLS but movement monitoring (actigraphy) can be useful and occasionally admission to hospital for sleep studies (polysomnography) may be needed. Polysomnography [link to] may show repetitive movements of the limbs (Periodic Limb Movement Disorder) even when you do not have symptoms of the restless legs syndrome during the day. These periodic limb movements may break up your sleep sufficiently to cause either insomnia or excessive sleepiness during the day. They often require the same treatment as the restless legs syndrome.
TGQ, aged 37
TGQ went to see his GP because he had not been meeting his targets at work. His line manager had noticed that he had been making more mistakes than usual and had been working more slowly than his colleagues. He found it difficult to stay awake in meetings and felt that he had less energy generally than previously. He told his GP that he tried to get more sleep at night but found it difficult to fall asleep. After about 0300 he would sleep soundly but woke feeling unrefreshed in the mornings. He denied feeling stressed by his problems at work but mentioned that he found it difficult to relax his legs, both while he was in bed and also in the evenings before he went to bed. He did not have any pains in his legs and found it difficult to explain why he could not lie still for long in bed.
TGQ had not had any other medical problems except for heartburn. He had started drinking more coffee during the day in order to try to keep himself awake but this did not seem to work.
His GP recognised his description of his sensations in his legs as being due to the Restless Legs Syndrome and checked his body's iron stores in view of his heartburn, which can lead to bleeding into the oesophagus. He was found to be iron deficient and was given iron tablets and advised to stop drinking coffee. Within 6 weeks he was aware that he was able to fall asleep more easily, his legs no longer felt restless and he was able to meet his targets at work.