In other words, it’s still not all that clear why RLS happens to begin with. We do know it’s about twice as common in women than in men, and while RLS can affect anyone, symptoms usually get worse with age. Raizen says researchers have also identified a handful of genes that can carry mutations that seem to be associated with RLS. “We have our foot in the door,” he says. “There’s a lot of research to be done to understand how these variations in gene activity might result in the syndrome.”
While we wait on science to sort that out, here are some important things we do know.
It’s a real health problem.
Without a doubt, Raizen says. If RLS is keeping people from sleep, not only will they be constantly exhausted, they’ll also face an increased risk of heart disease, high blood pressure, and overall poor health. There’s even preliminary research suggesting severe RLS may be linked to a higher incidence of stroke. Typically, when diagnosing RLS, a doctor will look for four major criteria, according to the National Institutes of Health:
- The symptoms are worse at night than in the morning.
- The urge to move the limbs is a powerful one.
- The symptoms seem to be triggered by resting or sleeping.
- The symptoms seem to be relieved by moving the limbs.
Meds can help.
For some people, movement is the only thing that provides any relief—and only momentary relief at that. When they again become stationary, the sensation often immediately returns. For others, prescription medications might help, Raizen says. Several act on the receptors in our brains for the neurotransmitter dopamine, others affect calcium entering our cells, and still others, used off-label, are narcotics like oxycodone or codeine. It’s not really clear in any of these cases why the medications work, he says.
…But not everyone needs meds.
People with mild RLS may benefit from simple lifestyle changes like getting more exercise and limiting caffeine. Sometimes the legs need some other sort of sensory stimulation, like daily stretching or even just a good rubdown, Raizen says. Some people resort to a warm bath or a whirlpool tub for the same reason, while others use a recently FDA-approved vibrating device that does the rubbing for them. Still others swear by a straightforward home remedy: 6 ounces of tonic water before bed. The quinine is thought to help stop muscle contractions.
It screws with your emotions.
“It’s a disease that’s really defined by nothing more than a patient’s symptoms, and patients will tell me, ‘My family says I’m crazy that I have to start pacing at night. Why can’t I just sit still?’ There’s a social aspect to this disease that’s very disruptive to quality of life.” Going to a movie or even a restaurant is often out of the question. There’s no way to measure or test for RLS, and it’s often very hard to explain to people who don’t have it, further contributing to patients’ frustrations, he says. “People with a headache know to say, ‘I have a headache,’ and others will understand them. Many people with RLS don’t know how to express these symptoms.”