Restless Legs Syndrome and Sleep

There are two main movement disorders that are responsible for sleep problems: Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD). RLS afflicts between 9% and 15% of the general population. That’s not a small amount of people.

People with the disorder have an irresistible urge to move their legs. Some people will say they feel their skin crawling. If you ignore the urge to move your legs, you can start to feel discomfort in your legs that gets worse and worse. The urge to move your legs is usually worse at night and the leg movement can keep you awake or prevent you from getting into a deep sleep.

RLS mostly affects the legs, but it can also affect your feet, arms and chest.

Periodic limb movement disorder is slightly different. With this disorder, people experience movements of their lower extremities that last from half a second to a full five seconds and it occurs within the first few hours of sleep. Most often, you’re not aware of these movements but you still experience partial awakenings throughout the night. Most people with RLS have PLMD, but PLMD is also present in a number of other sleep-related conditions.

Primary RLS happens on it’s own and can run in families. Meaning you can inherit it. Secondary RLS can result from certain drugs, iron deficiency, pregnancy, anemia and peripheral neuropathy. Peripheral neuropathy is something you can get from diabetes.
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What can you do about RLS? Well, if you have RLS from another problem, you would treat the other problem first. Then there are some behavioral things you can do such as decreasing the things that make RLS worse like caffeine, alcohol and tobacco. Keeping a regular sleep pattern, regular exercise, taking a hot bath, massaging your legs or applying heat or ice to your legs.

Another intervention that has been studied is the use of pneumatic compression devices. If you have ever had major surgery, these are those inflatable wraps they put on your legs to keep your blood flowing until you are able to get up and walk. So it squeezes the legs, which offsets the urge to move the legs.

As for medication. Sometimes iron supplements will help with restless legs even if you don’t have an iron deficiency. Other medication choices are dopamine-enhancing agents such as Pramipexole and Ropinirole, benzodiazepines and anti-seizure medications.

Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.

[vivienwilliams]

I haven't checked out the rest of the messages here. But after suffering RLS for many, many years I was prescribed ROPINIROLE, (or equivalent) by my GP (ostensibly, a drug for treatment of Parkinson's disease). Oh. Bliss. No more restless legs! I can sleep without torture of the seemingly bone deep pain of Restless Legs. Thank you, thank you East Sussex NHS.

[torifgirl]

Thank you for another awesome vid Doc! Very informative! My hubby has RLS, and it's horrible. It used to be now and then, but after he had a stroke it is far more frequent. I'll show him this vid though as I am sure he'll like it 🤗🙏🏻

[bl]

Hi Dr. Marks. The doctor diagnosed me with PLMDS. I am in my early 30s and I haven't had a full nights rest since 2014. I also experience teeth grinding. When I first fall asleep, I usually wake up about 2-3 hours after. Generally after that, I fall back to sleep and wake up every 5-30 minutes. Some nights after I wake up, It can take me hours to fall back to sleep, Which I think, its due to becoming anxious, and the frustration of not receiving a full nights rest. Then towards the end of my cycle, I can sleep for the remaining 2-3 hours. I elected not to take any of the prescribed epileptic medication.

I have started natural ways to try to combat. I take magnesium and I drink Chamomile tea every night. I stopped caffeine after 12 and I curtail my sugars before 5pm. This combination at least allows me to wake up somewhat refreshed enough to carry out my day. I also found listening to a podcast in the background helps me fall asleep faster than silence. 

Can you think of any other suggestions? If not, I at least wanted to share my testimony.

[bojijeik]

I go in my bathroom and turn cold water and put my feet inside water for 1 to 5 minute. Works all time. Try it sometimes guys

[Healingfromtheroot]

I have it in my legs and arms. Sometimes it feels like I have to swim in bed and constantly move every 20-30 seconds. The relief is brief. Thank you for this video!

[mych_ain]

I have RLS. Whenever it attacks i had to wiggle my legs/feet as fast as i can til the exhaustion is unbearable. It was very effective to helped me fall asleep. Otherwise i had to get up and wet my legs and scalp with cold water from thigh to feet. The cold helped me fall asleep too. The worst solution i discovered was pull my hair to extreme pain. You see RLS is not just about the legs. It’s not even painful. It’s an unexplainable sensation of legs and brain. Like there was something tickling the inside of my legs and sending this tickle to the inside of the brain. I couldn’t stop it, I couldn’t just scratch or slap or touch and even massage couldn’t help. Only pain from exhaustion or hair pulling or cold water were the solution I learnt throughout the years.

[mrmalik]

Ive had this as far back as i can remember, when i was child. Im 40 now and only discovered this is an actual condition. My siblings have it too.

[maryu]

Just learned tonight that antihistamines can also make it act up. I got a bunch of mosquito bites on my feet (100ish) and put on topical Benadryl. I’m also low iron (another cause) and heard quinine (in tonic water) and magnesium can help. Also running hot as I can stand water on the backs of my knees, and stretch like you think they’re on the verge of breaking. Good luck all

[majorharmonic]

Paracetamol has helped me, strangely enough.
A doctor once mentioned it to my dad, and he told me. I don't know if there is much, if any research into this.
But I have known 3 people, myself included, who have found paracetamol helpful.
It could be worth a try for anybody who suffers from RLS, provided it is safe for them to take.
It is over the counter, and has far fewer side effects than any other medication used for RLS.

[kxxuxju]

my parents wont take me to get diagnosed but i am in pain from this help

[Cathy-xicb]

PLMS can progress to REM sleep behavior disorder. And that is astonishingly predictive of Parkinson's and Alzheimer's. Bottom line: get your sleep issues treated. Do it today.

[NobleWolf]

So I tried to stop moving my legs while having RLS and trust me it was the hardest 30 secs of my life! My legs started twitching ALOT and the pain only amplified to my arms....

[dopetype]

Can you make a video on periodic limb movement disorder? In detail

[beachgirrl]

Low ferritin. Check your ferritin levels first, then check iron. If you have low ferritin (iron stores) you may still have normal iron blood levels. However when your iron levels drop, your body turns to its’ ferritin stores to make up for it. If the ferritin pantry is empty, there is no iron available. It is also linked to exhaustion levels. Taking an iron supplement daily solved the problem for me almost instantly. Remember, you don’t just need to get your iron levels up, you want to fully stock your ferritin pantry. Taking iron with vitamin c and folic acid, help with absorption. It’s important to have your levels monitored so you don’t get too much :)

[royalskyeofficial]

I’m so tired ready to go to sleep but my legs just won’t give up. I constantly have to move my leg or shake my leg and if I try to stay still my legs will start twitching like crazy and the urge to want to move gets worst then I’ll keep moving my leg every other second I’ll deal with it Untill I eventually fall asleep. But it’s so irritating and annoying. My whole body and mind is tired except my legs. What helps if you lay down and rock back and forth and try to not think about it, it’s extremely exhausting

[illiabright]

During puberty I would get severe restless leg during the mornings. I would wake up in severe pain and cramps in the left leg. I did also break the leg at ~age 4-5 as a result of a bouncy castle accident. The cast was from the ankle to the thigh and was for approximately 2 months. Additionally I did break my right kneecap by slamming my knee into a “brick wall” age 9. I was told at first by the brother that I was being a “p****y” and a liar, then I had a X-ray and I was told that I would require surgery and that the right leg would not grow after the surgery and that I would have one leg shorter than the other. I also have Osgoode Schlatter in the left knee, my current hypothesis is that the left leg had to compensate for the right leg. I still have osgoode schlatter and because of that making me kneel causes extreme pain.

[queenlioness]

Its in my feet legs arms and back ive had it since 15yrs old

[martine]

I have RLS, but what usually triggers mine isn't mentioned, and that's if I'm having lower back and hip problems. I'd also like to note I have Fibromyalgia as well.I can't afford to see a massage therapist but fortunately my chiropractor incorporates muscle massage techniques. Then my RLS goes away. It's not ALWAYS due to hip issues though. I will also use a massage gun, gently, on trigger points in my legs and arms which calms it temporarily. And interesting enough, once my leg starts acting up, my arms are sure to follow! What I find bizarre is that, since I am a finger picker, and if I have a jagged piece of skin sticking out, picking at it can trigger arm RLS! I don't drink, smoke, or ingest caffeine in the PM. Benzos and antipsychotics don't help. (Lamotrigine for BP II.) Just thought I'd throw the 1st few lines in there as maybe someone else has this problem and the info might help.

[drgreenjuice]

No mention of the EASY nutritional fixes for RLS?

[colinfidgeon]

Hi Dr Marks. Another excellent video. Thank you so much for putting this information online. Do you know if Gabapentin is effective for secondary PLMS? I have restless legs from use of Effexor.