2024-01-09 06:00:00
Constantly changing positions, moving your legs, getting up and having the need to walk are direct consequences of suffering from Restless Legs Syndrome (RLS). In addition to affecting our sleep, this disorder prevents those who suffer from it from enjoying a theater performance, a movie, or simply a relaxed, relaxed chat.
This sensation seriously impacts our daily lives, but a comprehensive approach and individualized treatment can significantly improve the quality of life of those affected. The neurologist specialized in sleep at the Neurology Service of the Ruber International HospitalDr. Laura Lillo Triguero, states that “it is a disorder that goes beyond the simple need to move the legs,” mainly in the late afternoon and first third of the night.
“This discomfort, although not painful in itself, becomes so unbearable that the person feels the need to get up and walk, interrupting the activity in progress,” explains Lillo. Specifically, it is an uncomfortable, annoying and difficult to describe internal sensation, with restlessness centered in the legs that cannot be ignored by the person who suffers from it.
“This discomfort becomes so unbearable that the person feels the need to get up and walk”
The specialist details that this discomfort in the legs “thus creates a disruptive cycle, where the lack of night rest negatively affects energy and general well-being during the day.” Its impact, therefore, extends its influence to the emotions of those who suffer from it and has a direct impact on “fundamental aspects of daily life.”
Main causes
This condition affects between 5% and 12% of the population, being more common in women and increasing in incidence after age 50. The general lack of awareness about this condition and the mildness of the symptoms in many cases make RLS an underdiagnosed disease.
“There is evidence of a hereditary predisposition to the disorder”
“Iron plays an essential role in the production of dopamine, and low levels of iron at the systemic level and brain level have been related to the appearance of RLS symptoms,” says the expert. Likewise, during pregnancy, risk factors related to RLS have also been identified, “possibly related to hormonal changes” and relative iron deficiencies linked to the pregnancy itself. Likewise, substances such as alcohol, tobacco and caffeine “have the potential to alter sleep and neuronal activity, thus contributing to the intensification of symptoms.”
Clinical approach and treatment
The diagnosis of RLS is based on a clinical approach that involves a doctor specialized in sleep who is familiar with the disease and who can establish the diagnosis without resorting to other tests. In this process, physical and neurological examinations become fundamental elements, as well as the medical history, the patient’s symptoms, and the diagnostic criteria of the International RLS Study Group.
These parameters include the urge to move the legs, onset or worsening of symptoms at rest, nocturnal exacerbation of symptoms, and temporary relief with activity. Likewise, for Dr. Lillo it is very useful to perform a blood test as a complement to the clinical diagnosis. This aims to evaluate iron status at a general level and provides valuable data about possible deficiencies related to this disorder. A sleep study or polymnography may be considered if the presence of another sleep pathology is suspected.
For decades, the treatment consisted of the application of dopamine agonists in the form of tablets: “These treatments are very useful in the short term, but very dangerous in the long term because they cause a worsening of the situation,” details the specialist. Currently, there are safer treatment options, such as gabapentin and pregabalin, and intravenous iron treatments if necessary.
“The application of dopamine agonists is very useful in the short term, but very dangerous in the long term”
In cases resistant to gabapentin and pregabalin, the option of using opioids is considered. In addition, new antiepileptics are being explored, such as perampanel and other drugs such as dipyridamole, and research continues to advance to offer more treatment options in the future. However, each patient can adopt non-pharmacological measures to improve their quality of life, such as establishing adequate sleep hygiene with stable schedules, exercising regularly and moderately, maintaining a balanced diet and avoiding the consumption of stimulant substances.
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