Symptoms and treatment for restless legs syndrome

“The main symptom of this syndrome is a strong need to move the legs, a need that can become uncontrollable. Symptoms occur or intensify when the person is at rest, mainly during the night. This causes the vast majority of people suffering from this syndrome to have difficulty maintaining sleep because of the need to move their legs.

The degree to which these symptoms can be tolerated varies from person to person and the level of severity, but they can become unbearable and interfere with daily life,” explains Dr. Bassi. “In fact, chronic sleep deprivation negatively affects the ability to concentrate during the day, participation in social activities, and can promote depression of mood. 

“The causes of this syndrome have not yet been well identified, but it is believed that genetic predisposition may play a central role. In fact, it often affects people in the same family: in this case it is called primary syndrome. 

If, on the other hand, the symptomatology is caused by another concomitant disorder then it is referred to as a secondary syndrome; if, on the other hand, there is no positive family history or other related diseases or conditions, then it is called idiopathic,” the specialist specifies. 

From a biochemical point of view, restless legs syndrome is related to a decrease in the availability of dopamine, which is a key neurotransmitter in the Central Nervous System”. 

Then there are some conditions that can be related to the onset of restless legs syndrome symptoms such as:

• anemia and iron deficiency in the blood;
• renal failure;
• chronic peripheral neuropathy with peripheral nerve suffering;
• pregnancy, especially in the final trimester.

Restless legs syndrome is diagnosed by the specialist based on a description of the sensations experienced by the patient, after blood tests to check for anemia or iron deficiency and possibly a sleep examination.

“The goals of the therapy are: 

• reduce or eliminate symptoms;
• improve daytime function, sleep and quality of life.

The choice of therapy depends on a number of factors, including the severity of the disease, the patient's age, and comorbidities. The good news is that restless legs syndrome is a treatable condition that generally responds well to drug therapy”, the specialist continues.

In cases of mild and infrequent symptoms that are not associated with other diseases, it is suggested to intervene mainly on lifestyle. Among the recommendations:

• maintain a good sleeping habit;
• reduce or better eliminate smoking;
• reduce alcohol consumption;
• engage in moderate and regular exercise;
• follow an adequate diet. 

In general, the symptoms are relieved by movement of the affected extremities,” Dr. Bassi continues.

Drug therapy

"In cases, on the other hand, where the disorder is disabling, after a neurological examination, the specialist may decide to intervene pharmacologically through the use in the first instance of: 

• dopaminergic drugs: increase available CNS dopamine;
• tranquilizing drugs: improve sleep disturbances associated with restless legs syndrome and are taken at bedtime.

In general, it is crucial to proceed cautiously to find the most appropriate medication and dose for each patient's needs because there is no universal treatment”,  Dr. Bassi concludes.