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Researchers believe that Restless Legs Syndrome is commonly unrecognized or misdiagnosed

Approximately 50% of patients with RLS have a family history of the condition, suggesting that genetics is a major risk factor.

Caffeine, alcohol, and tobacco may aggravate or trigger symptoms in predisposed individuals.

Restless legs syndrome (RLS) is a common neurological disorder. It is characterized by unpleasant sensations in the legs and an uncontrollable urge to move the legs in an effort to relieve these feelings.

The symptoms are worse during rest or inactivity. Sleep is often interrupted by involuntary periodic limb movements (PLM), which are generally considered to be a hallmark of RLS.

Researchers believe that RLS is commonly unrecognized or misdiagnosed as insomnia or another neurological, muscular, or orthopedic condition. Despite a high number of people affected by RLS in North America and Europe (5% to 15%), the cause is still not clear. Over-indulgent healthcare systems in affluent parts of the world may be more likely to diagnose RLS, and thereby could account for differences in the number of cases reported.

Hereditary factors contribute significantly to the etiology of RLS and four genetic variants have been found that increase the risk of developing RLS. One variant is located in or near the BTBD9 gene on chromosome 6, another in the Meis1 gene on chromosome 2, a third in the region of the MAP2K5/LBXCOR1 gene on chromosome 15 and the fourth in the PTPRD gene on chromosome 9.

The prevalence of RLS is lower in Asia than in North America and Europe and risk variants at all the three RLS loci are also found in lower frequencies in Asian than populations of European descent. The three variants associating with RLS in Europe have not been tested for association with RLS in Asian populations. The lower reported prevalence of RLS in Asia is though most likely a reflection of ethnic differences in frequencies of these risk variants.

The deCODEme Complete Scan identifies the variants listed above and provides interpretation of their associated risk for the development of RLS in customers of northern European descent. Currently, apart from differences in prevalence of the disorder and frequencies of the variants mentioned above, no data are available for people of Asian or African ethnicities, for the three variants listed above.

Risk factors

• Age: Although the symptoms of RLS may begin at any age, the syndrome is more common with increasing age.
• Genetics: Approximately 50% of patients with RLS have a family history of the condition, suggesting that genetics is a major risk factor. People with familial RLS tend to be younger when symptoms start and have a slower progression of the condition.

Prevention and treatment

Although family history is evident in about 50% of RLS cases, other cases appear to be related to the factors or conditions listed below. Researchers do not yet know if these factors actually cause RLS, although reversing these conditions may improve the symptoms of RLS.

• Low iron levels or anemia may increase the likelihood of developing RLS. Once iron levels are corrected, patients may experience a reduction in signs and symptoms.
• Chronic diseases such as kidney failure, diabetes, Parkinson’s disease, and peripheral neuropathy are associated with RLS. Treating the underlying condition often provides relief from RLS symptoms.
• Pregnancy: some pregnant women experience RLS, especially in their last trimester. For most of these women, symptoms usually disappear within 4 weeks after delivery.
• Certain medications, such as antinausea drugs, antiseizure drugs, antipsychotic drugs, and some cold and allergy medications, may aggravate the disease.
• Researchers have also found that caffeine, alcohol, and tobacco may aggravate or trigger symptoms in patients who are predisposed to develop RLS. Some studies have shown that a reduction or complete elimination of such substances may relieve symptoms, although it remains unclear whether elimination of these substances can prevent RLS symptoms from occurring.

Individuals with higher than average risk for RLS and who are experiencing sleep disturbances may benefit from seeking advice from their doctor. Medications such as dopamine agonists may not always be recommended for RLS, particularly if the symptoms are mild. However, important lifestyle changes and activities such as regular sleep habits, relaxation techniques, and moderate exercise during the day, can, in some cases, help reduce symptoms.

More information

You can find out more information about RLS by talking with your doctor and visiting these Web sites:

• MedlinePlus Article on Restless Legs Syndrome
• National Institute of Neurological Disorders and Stroke
• National Sleep Foundation
• The Restless Legs Syndrome Foundation
• WeMove – Worldwide Education and Awareness for Movement Disorders

This content was last reviewed on February 23, 2011.

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