Restless Leg Syndrome Restless Leg Syndrome (RLS) is often described as irresistible leg jerks or movements accompanied by a crawling, tingling or prickling sensation deep in the limbs. Patients with RLS have difficulty falling asleep, often laying in bed vigorously stretching, flexing, crossing or rubbing their legs. The intensity of these leg movements and sensations can vary from one individual to the next.

RLS occurs in roughly 5% of the general population, although the incidence may be even higher and unreported. The severity of RLS can vary throughout an individual’s lifetime with sudden remissions lasting for months and sometimes years.

Cause
The cause of restless legs syndrome is unknown. It can run in families, and thus there is likely a genetic base to some cases. RLS can also be related to low iron (anemia). In addition, some children with chronic diseases, such as kidney disease and diabetes, are at incrased risk for developing RLS.

Symptoms
The symptoms of RLS include:

• Leg Discomfort
  Children or adolescents often describe these uncomfortable leg sensations as creepy, crawly, painful or tingling. These sensations occur at bedtime but also can occur at other times of inactivity, such as during long car rides or while watching a movie.
• Leg Movements
  To relieve the leg discomfort, children and adolescents often have an irresistable urge to move their legs, whether by tossing and turning while lying in bed, or by walking or running about at bedtime.
• Sleep Disruption
  Children iwht RLS often take a long time to fall asleep because of the leg discomfort and need to move. They not only have problems falling asleep but also may have trouble staying asleep.
• Bedtime Behavior Problems
  Because of the difficulty with falling asleep, parents may report that their child is a problem at bedtime due to not staying in bed.
• Daytime Sleepiness
  The difficulties falling and staying asleep result in significant daytime sleepiness.
• Behavior and Academic Problems
  Children with RLS may have daytime behavior and academic problems, such as hyperactivity, impulsivity and irritability, as a result of sleep disruption.

Diagnosis
There is no definitive test for RLS, so diagnosis is made based on the description of symptoms. A medical history and physical examination will also be done to exclue other problems. Finally an overnight sleep study may be recommended to evaluate for other sleep disorders, such as PLMD (Periodic Limb Movement Disorder, a variation of RLS).

Treatment
Treatment for RLS may involve any of the following:

• Changing of Bedtime Habits
  Given that the leg discomfort gets worse when an individual is lying in bed, it is usually better for a person to wait until the lights are turned off to get into bed. Therefore, bedtime routines, such as watching television, reading, etc should all occur out of bed.
• Caffeine Avoidance
  Caffeine can makes RLS symptoms worse. Don't forget, while caffeine is found in soda, tea and coffee, it is also in chocolate and some medications (Excedrine, Midol, etc.)
• Reduce the Discomfort
  Massage, cold compresses or a heating pad may provide temporary relief.
• Rule out Iron Deficiency
  Low levels of iron or folic acid can contribute to RLS. An iron or folic acid supplement may be prescribed.
• Medication
  Medication may be recommeded when significant sleep disruption is occuring. There are a number of sleep medications that can help. Consult with the SleepCenter to determine what is best.