Restless legs syndrome

definition

"Restless Legs" (RLS) is an English expression which literally means: "Restless legs". With this disease there is an almost uncontrollable urge to move and furthermore sensory disorders in the legs.

Epidemiology

There are estimates that between 5-8 million people are at Restless Legs Syndrome Suffer. However, it should be emphasized here that in well over 2/3 of the patients the symptoms are only weakly pronounced and therefore do not require treatment.

Overall, it is assumed that 4-6% the over 30 year olds suffers from RLS (Restless Legs Syndrome). With the over 60 year olds it is probably even more than 11%.

Women are affected slightly more often than men.

Today it is assumed that the disorder inheritable is.

Nearly 1/6 all serious sleep disorders are probably triggered by restless legs.

Symptoms of Restless Legs

Especially in phases of relaxation and rest, there is a multitude of abnormal sensations (tingling, pulling, pins and needles, tearing, etc.). This leads to the fact that the patients develop a tremendous urge to move their legs (= restless legs) in order to make the muscular tension disappear. (In rare cases the arms can also be affected by this urge to move). lead to problems in relationships, as a “stepping” neighbor or partner naturally needs a lot of space in bed. Patients occasionally feel as if they are "out of their skin".
People who are not affected can often not fully understand the symptoms because they are not easy to describe. This lack of understanding can lead to patients isolating themselves with their suffering, since “nobody wants to listen or help anyway”. It is not uncommon for patients with restless legs to get the “psycho or simulant stamp”.

Since the classic Relaxation situation night is sleep during the day, it comes to you right here frequent occurrencewith the consequence that it regularly becomes heavier Sleep disorder comes.

Often the patients with restless legs also suffer involuntary twitching in the legs. These occur mainly during sleep and have the unpleasant side effect that they can wake the patient up for a short time, which was previously mentioned Sleep disorder reinforced.

As already mentioned, a restless leg disorder of this type often results in a chronic sleep disorder which in turn can lead to further symptoms. It comes to one physical exhaustion, rapid exhaustion, listlessness, difficulty concentrating and occasionally even to develop one depression.
In addition, a pronounced RLS (Restless legs syndrome) can lead to loneliness (social isolation), since the patients e.g. are no longer invited, as they are e.g. it is not possible to endure a visit to the cinema in silence or to sit in a restaurant.
It is not uncommon for patients to report one Worsening of the leg restlessness following physical activity (e.g. sport).

Another symptom is an accumulated, comprehensive feeling of the patient "Tight" described. Patients feel just as uncomfortable in tight clothing as they do under the overly tight duvet.

diagnosis

This is usually provided by an experienced family doctor or a neurologist (specialist in neurology).

It is not uncommon for a few years to pass before the diagnosis is made, since the leg restlessness is often seen as a symptom of "physical restlessness", as it is e.g. can occur in the case of depression or other psychosomatic disorders.

therapy

The therapy of the RLS (Restless legs) is primarily medicated.

Here, the patient and doctor first clarify the The severity of the symptoms and then determine a therapy plan.

If, for example, there are more nocturnal (unconscious) twitches and thus sleep disorders, it may be sufficient to treat the sleep disorder.

At moderate leg restlessness is first and foremost the first choice L-Dopa (e.g. Restex). This agent, which is also used in the treatment of Parkinson's disease, is a chemical precursor to the actual messenger substance "dopamine". In the body, L-Dopa is "converted" into dopamine, so to speak, and then takes over the tasks of this messenger substance.

It can often take away the discomfort and within a very short time over 80% of the patients react very positively.

Overall, the use of L-Dopa, especially over a longer period of time, is not without problems, since it increases numerous side effects can come. (See topic L-Dopa / Dopamine [in brief]).

In the severe leg restlessness, a different class of active ingredients is used today. This is the so-called. "Dopamine agonists".

In its original form, dopamine as a messenger substance settles on a receptor and causes a reaction there. This can be compared to a key and a lock.
Actually, only dopamine “fits” into this receptor lock. The "dopamine agonists" are drugs that can also trigger a reaction at the dopamine receptors. They act a bit like a counterfeit key or a lockpick.

Typical agonists, i.e. substances that act on the receptor such as dopamine, are e.g. Cabergoline (Trade name e.g. Cabaseril) or also Pramipexole (Trade name e.g. Sifrol).

Similar to L-Dopa, on the one hand there can be a rapid improvement, but here, too, you have to partially significant side effects calculate.

If the therapeutic approaches mentioned above remain unsuccessful and there is still a strong and strong urge to move and this may is even associated with pain, you can try the so-called "Opioids" start.

Opioids are drugs commonly used in pain medicine, which only very limited should be used as it is a high addictive potential and it becomes one relatively quickly Tolerance development comes.
This means that in order to achieve a certain effect, one constantly needs larger doses of such a substance.

So you have to carefully weigh up Benefit and risk weigh up.

There are a few non-drug approachesthat can complement RLS therapy (Restless legs syndrome).

Here comes e.g. the so-called Sleep hygiene (see also topic Sleep disorder) is of great importance.

Other approaches vary from patient to patient and can therefore only be used as therapeutic stimulation be understood.

Measures that have helped individual patients were e.g.

• Hot or cold bathing or showering
• Light movement (no excessive exertion)
• Gymnastics / stretching
• Thai chi
• Massages

In any case, it is not advisable to use any type of "Passive" artificial relaxation (e.g. Progressive Muscle Relaxationautogenic training, etc.), as this can worsen the symptoms.

Visiting a support group can, as with many other diseases, also be very helpful.