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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Ask Dr. K: Poor sleep a consequence of RLS

Anthony L. Komaroff Universal Uclick

DEAR DOCTOR K: My doctor says I have restless leg syndrome. What is it, and how is it treated?

DEAR READER: Restless legs syndrome is a brain and nervous system disorder that causes uncomfortable sensations in the legs. The discomfort is usually accompanied by an overwhelming urge to move the legs. Doing so can temporarily relieve the discomfort.

The odd sensations are usually worst below the knees and usually felt in both legs. In people with more severe symptoms, similar sensations can affect the arms.

The uncomfortable sensations caused by RLS are worse during periods of rest, especially just before sleeping or during sleep.

Because RLS symptoms are worse at night – or, in many cases, occur only at night – sleep deprivation can be a major problem for people with RLS. Symptoms may make it difficult to fall asleep, or they may compel a person to get in and out of bed many times. Even asleep, patients typically shift position every 15 to 30 minutes.

During the day, symptoms are worse when sitting still. The condition can make it difficult to take car or plane trips, enjoy a movie or even hold a desk job.

Alcohol, nicotine and caffeine can aggravate the condition. So can several medications; the SSRI anti-depressants, amitriptyline and anti-psychotic medicines may be the most common culprits.

Treatment depends on the severity of symptoms. For mild symptoms, exercising, stretching, doing knee bends or massaging your legs can help.

A number of medications, taken individually or in combination, can help relieve symptoms:

• Dopaminergic agents. These drugs relieve discomfort and improve sleep quality.

• Benzodiazepines. These sedatives improve sleep quality.

• Anti-convulsants. These medicines are especially useful in patients who experience pain.

• Opioids. These narcotic drugs are used to relieve pain and suppress RLS in people with severe, unrelenting symptoms that do not respond to other treatments. They can be habit-forming.