Restless legs syndrome: how it affects quality of life


The disease Willis-Ekbom , also called restless leg syndrome (RLS) is a neurological disorder that triggers involuntary movement of the legs , especially at rest and during the night, making it difficult to sleep. Consequently, without proper treatment it ends up leading to other pathologies such as metabolic problems, depression , obesity , diabetes and cardiovascular problems .

That is without taking into account the disorders that it entails on the patient’s quality of life: it complicates certain nighttime activities such as going out to dinner, going to the cinema or long trips. It can even undermine the couple’s relationship since in the moments of sleep, it produces periodic shocks that usually wake up both the patient and whoever is close to him, forcing the other person to sleep in another space. This is stated by Óscar Larrosa, member of the Movement and Behavior Disorders During Sleep working group of the Spanish Sleep Society (SES) .

According to Marta Fernández, a specialist at the Sleep Unit at the University of Navarra Clinic , in most patients it appears suddenly without showing a specific cause. “There may be a component of genetic predisposition , since at least a third of patients have a family history,” he explains. In these cases, Larrosa recommends constant vigilance in the hands of the specialist, “and as soon as the first symptoms appear, apply the corresponding treatment.”

However, it points out that in some cases it may be due to an injury to the peripheral nerves , which link the brain and spinal cord with the rest of the body; by the decrease in iron deposits ; or by increased uric acid in the blood. “It is believed that the origin of this syndrome may be related to a decrease in dopamine , which is a brain neurotransmitter necessary for the performance and coordination of movements,” says Fernández.

Symptoms and diagnosis of restless legs syndrome
The specialist at the University of Navarra Clinic assures that patients suffer, in addition to involuntary movement, an “unpleasant sensation” in the legs during moments of rest that temporarily improves when moving them. It can appear at any age, although the higher the genetic load, the sooner the pathology appears, even in children. “The most frequent age of onset is between 30 and 40 years old , and in these adult ages it is much more common in women, practically double,” calculates Larrosa.

When giving a clinical diagnosis , specialists take into account the symptoms. “In addition, tests are carried out to observe the levels of vitamin B12, folic acid , iron metabolism or vitamin D , which greatly influences sleep and the metabolism of neurotransmitters. On the other hand, it helps a lot to do a sleep study with a nocturnal polysomnography ”, indicates the SES specialist.

This is a test in which brain waves, blood oxygen levels, heart rate, and respiration are recorded. And also the movements of the eyes and legs. “It helps us to see what happens during the night , whether the patient is awake or asleep: if he moves his legs, how he does it and how it influences the quality of sleep”, explains Larrosa.

Restless leg syndrome treatment
To put a patient in treatment, the specialist mainly values ​​the intensity of the movement. If it is moderate to significant and is repeated at least two days a week, significantly altering the quality of sleep, drug therapy should be started . “It is a chronic problem that, at the moment, has no cure, so we are looking for the most effective formula to alleviate the symptoms and that must be controlled by the doctor to prevent the disease from worsening,” says the SES spokesman.

The most widely used drugs are those that modulate brain dopamine receptors, but if used in very high doses for a long time they can worsen the disease and increase its symptoms.

He explains that in milder cases, other types of therapies can be applied without having to resort to medications: regular sleep schedules, leg massages with hot or cold creams, depending on the case, showers with cold water or to exercise legs moderately midafternoon they may make symptoms more bearable. Mental entertainment activities are also recommended : chess, painting, video games, cross stitch… to keep your head occupied in the most difficult moments.

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