Restless legs fidgety legs in bed

When the legs tingle, ache or twitch at night, sleep is out of the question. It's more than unpleasant, it's draining. But usually simple home remedies are enough to solve the problem.

Shortly before falling asleep it starts: there is a rumbling in the calves, an almost painful feeling of wanting to move spreads. A dull urge fills the lower legs, as if asking the muscles to do something. The feeling is very unpleasant, some describe it as tingling, others more as twitching, some even as pain. The result is the same for everyone: you are tired, but you cannot fall asleep. Occasionally, sufferers even wake up from the compulsion to move again.

This phenomenon is what doctors call restless legs syndrome, or RLS for short. Restless legs – the translation – feel good again as soon as they are allowed to move. Treatment is needed in only a few cases, in no more than one to three percent of the population. Women suffer from fidgety legs twice as often as men, and older people are affected more often than younger people. But even children know the agony.

The tingling sensation is still a mystery to doctors

Why the legs do not give rest in the evening is still largely unknown. Presumably, predisposition plays a role. Some researchers suspect that certain nerve signals are not properly transmitted from the brain to the legs. It is possible that the brain metabolism, which is responsible for movement patterns and which is mainly regulated by the neurotransmitter dopamine, is disturbed in those affected. Because medications with dopamine calm the legs.

However, other reasons can also cause the legs to wriggle: These include iron deficiency and certain medications. Some women also know the phenomenon from their time during pregnancy. After giving birth, the symptoms improved or even disappeared again.

Symptoms and diagnosis

The classic sign of restless legs syndrome is legs that feel like they want to fidget. The strange sensations in the legs start or worsen when you are sitting or lying down. The symptoms occur mainly in the evening and at night and disturb your sleep. You feel the need to move to get rid of the uncomfortable feeling in your legs. Your symptoms improve or disappear as soon as you move around. Only if these four symptoms occur, you suffer from restless legs syndrome.

Appointment with a neurologist

Restless legs syndrome is a nerve problem, therefore the right contact person is a neurologist. You don't need to go to the sleep lab for a diagnosis.

The neurologist will ask you to describe your symptoms. If she finds that you have all four typical symptoms, she will diagnose you with restless legs syndrome. Before that, however, she should rule out other causes: iron deficiency, diabetes or severe kidney disease can also cause the legs to wriggle.

In addition, certain medications can trigger something very similar to restless legs syndrome. These include, for example, drugs for depression and psychosis – so-called neuroleptics -, drugs for Parkinson's disease, drugs to help you quit smoking, or drugs for nausea.

Therapy and research

Try simple remedies first: Often it's enough to give up coffee and alcohol. Maybe a cold footbath before bedtime or a walk in the evening will help you. Stretching exercises can also calm legs. Magnesium tablets reduce the unpleasant feeling.

If your legs are very restless, the doctor may prescribe you medication. However, they do not cure, but only dampen the symptoms. Such drugs usually contain substances that resemble the body's own neurotransmitter dopamine. They are also used to treat Parkinson's disease, a disorder of the nervous system also known as shaking palsy.

Heavy chemical load: opiates and epilepsy drugs

Three drugs are now specifically approved for the treatment of restless legs syndrome. However, these drugs have numerous serious side effects. For example, one in three to one in five suffer from nausea. In addition, the substances can even worsen the symptoms.

If these medications don't help you or you can't tolerate them, the neurologist may also prescribe opioid-like substances or epilepsy medicines. These chemical clubs have strong side effects. Therefore, such heavy artillery should be brought up only if you suffer very badly and all other methods have failed.

Genes for fidgety legs discovered

Restless legs can be inherited: People with certain genetic changes have an increased risk of suffering from restless legs syndrome. Researchers have recently identified several genes that are likely to play a role in restless legs syndrome.

One of these genes determines how much dopamine the body makes. This neurotransmitter determines whether we can move well and fluidly. For example, people with Parkinson's disease lack this neurotransmitter. Apparently, people with restless legs syndrome also suffer from a lack of dopamine. However, the specific mechanisms by which the disorder develops are still unknown.

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