Restless legs syndrome, a problem as common as it is rarely diagnosed

Maybe you are suffering from it and are not aware of it. Approximately one in ten European and North American adults suffers from restless legs syndrome, but it is greatly underdiagnosed.

In countries like Spain, for example, up to 90% of patients are unaware that they have it. And in most cases, diagnoses are very late.

An aggravating factor is that it is even more difficult to detect in children, since it can be associated with attention deficit hyperactivity disorder (ADHD). As shown by multiple studies, there is a close relationship between ADHD and sleep disorders in general.

Burning, bubbling, or tingling sensation
Pay attention, then, to the symptoms. As some research describes, those affected experience sensations described as “crawling”, “gas bubbles in the veins” or “burning” that force them to move their legs to temporarily relieve the anguish or anxiety that it produces.

In the most serious cases, the affected person has to get up and even start walking: it is the only way to alleviate their restlessness, which reappears as soon as they go to bed.

Also called Willis-Ekbom disease or periodic limb movement disorder, this abnormal and redundant movement is especially linked to sleep: more than 80% of episodes occur at night. Both the International Classification of Sleep Disorders (ISCD-3) and the International Classification of Diseases (ICD-11) include it within “sleep-related movement disorders.”

The symptoms (or sensations) cause it to take longer to fall asleep. In addition, movements cause a greater number of awakenings and make it difficult to access deep sleep (phases 3 and 4). During these stages, mainly, bodily and neurological restoration occurs.

Why does it occur?
As for the causes, they are multiple. For years it has been attributed to an iron deficiency, anemia (deficient oxygen delivery to the tissues) and alterations in the levels of the neurotransmitter dopamine. All of these factors are related to the regulation of movement.

Approximately 50% of cases would have a genetic origin, without associated diseases. However, the syndrome can appear as a secondary consequence of other pathologies, such as diabetes, Parkinson's or multiple sclerosis. Some studies also indicate that it is common in patients with head trauma.

What consequences can it have for health?
Restless legs syndrome is linked to other sleep-related problems, such as insomnia and excessive tiredness or daytime sleepiness. This can compromise the school performance of minors (problems with attention, memory, concentration, orientation and learning), cause accidents of various kinds and even deteriorate social relationships and the performance of daily activities.

In addition, it sometimes entails serious psychological consequences, linked above all to depression and anxiety.

Prevention and treatment
The practice of healthy habits contributes to the prevention of multiple pathologies, and mild cases of this disorder are no exception. Like any type of sleep disorder, it requires improving our nightly rest habits, including massages, stretching or specific muscle relaxation therapies.

In addition, any activity that promotes muscle relaxation and induces sleep is recommended, such as taking a warm or hot bath before going to sleep. The effectiveness of focusing on a cognitive task in a sustained manner has even been analyzed as a strategy to reduce symptoms. That is, carrying out mental activities that initiate behavior other than moving the legs.

It is also highly advisable to perform physical exercise during the day and reduce or eliminate the consumption of exciting substances, such as tobacco, caffeine or theine.

Finally, when restless legs syndrome has a neurological origin, various types of drugs are used. Among them, those that provide iron to the body and regulate dopamine levels. Nor can we ignore that some medications, such as antipsychotics, can worsen this syndrome.

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Source: The Conversation. Authorship:

Raul Quevedo-Blasco
Doctor in Psychology. Sleep and Health Promotion Laboratory (Mind, Brain and Behavior Research Center-CIMCYC), University of Granada

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