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Restless legs syndrome and periodic limb movements of sleep

Lookup NU author(s): Dr Kirstie Anderson

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Abstract

Restless legs syndrome describes a curious need to stretch and move in response to an unpleasant feeling in the legs. For most people who have this, as they are drifting off to sleep there is a twitch of the toe, foot and ankle followed by another and then another. The limb movements are strikingly periodic and are described as such by frustrated bed partners. The pathophysiology remains debated but is likely to involve dopaminergic dysfunction and ascending arousal systems. Despite a prevalence of 5-10% in the general population, the variable nature of symptoms and difficulty describing the dysaesthesia often leads to delay in treatment. This article outlines the diagnostic criteria, medication and comorbidities that modify symptoms, the impact of restless legs syndrome on health, and symptomatic management. Several licensed therapies are effective but the dopamine agonists in particular can cause challenging side effects and paradoxically worsen symptoms over time. Case histories are reviewed to guide physicians.

Publication metadata

Author(s): O'Regan D, Anderson KN

Publication type: Article

Publication status: Published

Journal: British Journal of Hospital Medicine

Year: 2020

Volume: 81

Issue: 1

Pages: 1-8

Online publication date: 28/01/2020

Acceptance date: 09/10/2019

ISSN (print): 1750-8460

ISSN (electronic): 1759-7390

Publisher: Mark Allen Healthcare

URL: https://doi.org/10.12968/hmed.2019.0319

DOI: 10.12968/hmed.2019.0319

PubMed id: 32003620

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