Restless Legs Syndrome - RLS

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-05-24 12:25

Restless Legs Syndrome (RLS)

Restless legs syndrome (RLS, restless legs syndrome, Ekbom syndrome) is manifested by excruciating abnormal sensations (e.g. pins and needles, tingling, burning, heat, pain, pulling, cold, etc.) of the legs, usually the lower legs. The suffering of those affected can sometimes be very high. Various therapy options are used to improve the quality of sleep. Sometimes measures such as exercise or taking a bath before going to bed bring relief.

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What are the symptoms?

The sleep-related movement disorders are manifested by symptoms with a circadian rhythm that mainly occur in the evening and at night and usually when lying down. In rare cases, the urge to move affects the arms.

Restless legs syndrome is also characterized by the urge to move (of the legs), which:

• often associated with sensitive disorders or pain,
• only occurs during rest and relaxation,
• improves or stops with movement.

The RLS is related to restlessness and sleep disorders. Falling asleep and falling asleep again can be severely disturbed. The symptoms can be improved through movement or stimuli such as rubbing the legs or cold (cold water).

The causes are not yet clear. It is believed that genetic components, iron deficiency, and dopamine disorders are related to RLS.

How is the diagnosis made?

The doctor takes an anamnesis for the diagnosis. In addition to information on medication intake, physical examinations with clarification of laboratory values (e.g. blood count, vitamins, iron metabolism, thyroid values, kidney values, glucose metabolism) are essential. Information on the laboratory values can be found in the laboratory values table.

Any underlying diseases will be clarified or excluded (e.g. kidney diseases, neurological diseases, depression, anxiety disorders, venous circulatory disorders, etc.) as well as any existing pregnancy. Certain drugs (e.g. dopamine antagonists, neuroleptics, antidepressants) can induce or intensify RLS. Possible substance abuse is also clarified.

In the course of the doctor-patient conversation, a sleep history is also carried out. A sleep diary or the recording of complaints can be helpful for the diagnosis.

In addition, depending on the individual requirements, further examinations are carried out (e.g. electromyography, electroneurography, polysomnography, L-dopa test).

Note In addition to the RLS, other movement disorders can also be a hindrance to sleep, e.g. periodic movement disorders of the limbs during sleep, nocturnal muscle cramps, sleep-related rhythmic movement disorders. You can find further information under Bruxism (teeth grinding) and in the brochure "RLS and periodic movement disorders of the limbs" of the DGSM.

How is the therapy carried out?

The therapy is based on the individual situation of the person affected and their complaints. The level of suffering plays an essential role. Exercising or taking a bath (before bed) can help some patients. An improvement can also be achieved by treating a possible underlying disease (e.g. iron deficiency).

In order to improve the quality of sleep, drug treatment can become inevitable. Dopamine preparations (L-dopamine, dopamine agonists) are used for this. In certain circumstances, preparations are also combined. Antiepileptic drugs are also used. In severe cases, opioids are also used. The dosage is individually tailored to the individual. The attending physician will provide information about the intake modalities and much more. Treatment can be lengthy.

Note Discuss your medication intake and dosage (also of non-prescription preparations) with your doctor!

Whom can I ask?

The family doctor is often the first point of contact. Doctors from various disciplines (e.g. neurology, internal medicine, etc.) and / or specializing in sleep medicine are involved in diagnosis and therapy processes. You can find sleep laboratories on the website of the ÖGSM (Austrian Society for Sleep Medicine and Sleep Research).

How are the costs going to be covered?

The costs of a visit to the doctor to clarify an RLS as well as the treatment are usually covered by the social security agencies.

For certain services (e.g. psychotherapy with resident psychotherapists), an application for a cost subsidy can be submitted by the health insurance. For more information, see Services & Costs.

For information on the respective provisions, please contact your health insurance provider, which you can find on the social security website.