Restless legs syndrome is a common, often debilitating disorder, which is under-recognised and under-diagnosed. Patients typically describe an uncomfortable urge to move their legs, this occurs mainly at night. It often has a significant impact on the quality of sleep, and hence, daily functioning. The pathophysiology of the disorder is well known, it relates to iron depletion and dopaminergic receptors in the brain, and this has aided the development of effective treatment. This article will cover the recognition, pathophysiology and management of the condition.
Get full access to this article
View all access options for this article.
References
1.
AllenR (2004) Dopamine and iron in the pathophysiology of restless legs syndrome (RLS). Sleep Medicine5(4): 385–391. DOI: 10.1016/j.sleep.2004.01.012.
2.
AllenRPicchiettiDGarcia-BorregueroD, et al.(2014) Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: Updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria-history, rationale, description, and significance. Sleep Medicine15(8): 860–873. DOI: 10.1016/j.sleep.2014.03.025.
3.
AllenRPAuerbachSBahrainH, et al.(2013) The prevalence and impact of restless legs syndrome on patients with iron deficiency anemia. American Journal of Hematology88(4): 261–264. DOI: 10.1002/ajh.23397.
4.
BayardMAvondaTWadzinskiJ (2008) Restless legs syndrome. American Family Physician78: 235–240.
5.
ByrneRSinhaSChaudhuriKR (2006) Restless legs syndrome: Diagnosis and review of management options. Neuropsychiatric Disease and Treatment2: 155–164.
6.
CesnikECasettaITurriM, et al.(2010) Transient RLS during pregnancy is a risk factor for the chronic idiopathic form. Neurology75(23): 2117–2120. DOI: 10.1212/WNL. 0b013e318200d779.
7.
EarleyCConnorJGarcia-BorregueroD, et al.(2014) Altered brain iron homeostasis and dopaminergic function in restless legs syndrome (Willis-Ekbom disease). Sleep Medicine15(11): 1288–1301.
8.
EarleyCJHylandKAllenRP (2006) Circadian changes in CSF dopaminergic measures in restless legs syndrome. Sleep Medicine7(3): 263–268.
9.
EkbomKA (1960) Restless legs syndrome. Neurology10: 868–873.
10.
Garcia-BorregueroDCano-PumaregaI (2017) New concepts in the management of restless legs syndrome. BMJ356: j104DOI: 10.1136/bmj.j104.
11.
Garcia-BorregueroDKohnenRSilberM, et al.(2013) The long-term treatment of restless legs syndrome/Willis-Ekbom disease: Evidence-based guidelines and clinical consensus best practice guidance: A report from the International Restless Legs Syndrome Group. Sleep Medicine14(7): 675–684. DOI: 10.1016/j.sleep.2013.05.016.
12.
Garcia-BorregueroDStillmanPBenesH, et al.(2011) Algorithms for the diagnosis and treatment of restless legs syndrome in primary care. BMC Neurology11: 28DOI: 10.1186/1471-2377-11-28.
13.
GigliGLAdoratiMDolsoP, et al.(2004) Restless legs syndrome in end-stage renal disease. Sleep Medicine5(3): 309–315.
14.
HeningWWaltersASAllenRP, et al.(2004) Impact, diagnosis and treatment of restless legs syndrome (RLS) in a primary care population: The REST (RLS epidemiology, symptoms, and treatment) primary care study. Sleep Medicine5(3): 237–246.
15.
Joint Formulary Committee (2018) British National Formulary, 76th edition, London: BMJ Group and Pharmaceutical Press.
16.
KaratasM (2007) Restless legs syndrome and periodic limb movements during sleep: Diagnosis and treatment. Neurologist13(5): 294–301.
17.
LeschzinerGGringasP (2012) Restless legs syndrome. British Medical Journal344: e3056DOI: 10.1136/bmj.e3056.
18.
Maheswaran M and Kushida C (2006) Restless legs syndrome in children. Medscape General Medicine 8(2): 79.
19.
ManconiMGovoniVde VitoA, et al.(2004) Pregnancy as a risk factor for restless legs syndrome. Sleep Medicine5(3): 305–308.
20.
NagandlaKDeS (2013) Restless legs syndrome: Pathophysiology and modern management. Postgraduate Medicine Journal89(1053): 402–410. DOI: 10.1136/postgradmedj-2012-131634.
OhayonMO'HaraRVitielloM (2012) Epidemiology of restless legs syndrome: A synthesis of the literature. Sleep Medicine Reviews16(4): 283–295. DOI: 10.1016/j.smrv.2011.05.002.
23.
OndoW (2002) Epidemiology of restless legs syndrome. Sleep Medicine3: S13–S15.
24.
PicchiettiDStevensH (2008) Early manifestations of restless legs syndrome in childhood and adolescence. Sleep Medicine9: 770–781.
25.
SunERChenCAHoG, et al.(1998) Iron and the restless legs syndrome. Sleep21(4): 371–377.
26.
The Restless Legs Syndrome Society – RLS-UK. www.rls-uk.org.
27.
WaltersASLeBrocqCDharA, et al.(2003) Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Medicine4(2): 129–130. DOI: 10.1016/S1389-9457(02)00258-7.
28.
WijemanneSOndoW (2017) Restless legs syndrome: Clinical features, diagnosis and a practical approach to management. Practical Neurology17(6): 444–452. DOI: 10.1136/practneurol-2017-001762.
29.
WillisTEugeniusP (1692) The London Practice of Physick, London: Bassett, Dring, Harper, and Crook.
30.
XiongLMontplaisirJDesautelsA, et al.(2010) Family study of restless legs syndrome in Quebec, Canada: Clinical characterization of 671 familial cases. Archives of Neurology67(5): 617–622. DOI: 10.1001/archneurol.2010.67.
