Could you have restless legs syndrome?

Nobody likes a fidget – but there might be a good reason why your partner can't keep still at night. Restless legs syndrome – which causes an irresistible urge to move the legs - is more common that you might think. It's estimated that one-in-10 people in the UK will suffer from the problem at some point in their lives. If you or your partner can't stop fidgeting at night, read on to discover the signs, symptoms and treatment options available.

Symptoms to watch for
People with restless legs syndrome, or Willis-Ekbom disease to give it its proper name, experience an overwhelming desire to move the legs along with an unpleasant feeling in the feet, calves and thighs – often described as a "creeping" or "crawling" sensation.

Periodic limb movement – an involuntary jerking and movement of the limbs - can also affect the arms in some people.

The severity of the symptoms can vary depending on the individual. Some people describe a mild "fizzing" feeling, while others experience a tingling or burning sensation and cramping of the calves and legs. Because the symptoms tend to be more intense at night, people with the condition often suffer from sleep deprivation. Periodic limb movement can be violent enough to wake the sufferer and his or her partner.

Are you at risk?
Willis-Ekbom disease can affect children as well as adults, but tends to be more common in middle age. Women are twice as likely to suffer from the condition as men. In the majority of cases, the cause remains unknown, although experts believe the condition may be linked to low levels of dopamine in the brain – which naturally decrease at night.

Restless legs syndrome can also occur as a secondary condition, particularly in those who are anaemic or suffering from chronic health conditions such as kidney disease, Parkinson's disease, diabetes or fibromyalgia. It sometimes affects pregnant women, but tends to ease after the first month or so.

The condition can be triggered or worsened by use of anti-depressants, anti-psychotic drugs, lithium, calcium channel blockers, some anti-histamines and metoclopramide (a drug used to relieve nausea). Other risk factors include smoking, being overweight or obese, having a sedentary lifestyle, being stressed and excessive alcohol and caffeine consumption.

Self-help and treatment options
Lifestyle changes may help ease the problem – cut back on or eliminate caffeine, tobacco and alcohol, especially in the evening. It can help to exercise regularly, but not just before bed as this can be too stimulating.

When symptoms arise, it can help to massage the legs, have a hot bath or apply a hot or cold compress to the legs. Some people find that relaxation exercises such as yoga or tai chi help.
If you are experiencing intense discomfort, your doctor may prescribe painkillers such as codeine or tramadol. Some sufferers have been found to benefit from a "dopamine agonist" medication, which raises the level of dopamine in the brain. These include ropinirole, pramipexole and rotigotine – and all three can cause sleepiness, so it is advised to avoid driving after taking them.

In acute cases, sleeping tablets may be prescribed and a drug called levodopa is sometimes offered to patients who experience isolated episodes. This is taken at the onset of symptoms, but should not be taken regularly it can make the problem worse. Anticonvulsant drugs such as gabapentin may be tried if dopamine treatment is ineffective.

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