Restless legs syndrome (RLS) is a neurological sensory-motor disorder characterized by uncomfortable sensations in the legs — and sometimes arms — and an irresistible urge to move them, especially during rest in the evening and night. Movement typically provides temporary relief.
Core diagnostic criteria (all 4 must be present): 1. An urge to move the legs, usually accompanied by uncomfortable sensations — often described as "crawling," "burning," "itching," or "internal aching" 2. Symptoms occur or worsen during rest or inactivity 3. Movement (walking, leg shaking) temporarily relieves the urge 4. Symptoms are markedly worse in the evening or night than during the day (circadian pattern)
How RLS disrupts sleep: RLS symptoms peak right at bedtime, making it hard to fall asleep. Once asleep, 75–80% of RLS patients also have periodic limb movement disorder (PLMD), with repetitive leg jerks during sleep that cause frequent arousals.
Common associated factors: • Iron deficiency (even without anemia, low serum ferritin is linked to RLS) • Pregnancy (especially the third trimester; usually resolves after delivery) • Chronic kidney disease • Certain medications (antihistamines, some antidepressants) may trigger or worsen symptoms • Family history
Management approaches: • Start with testing serum ferritin levels — iron supplementation is effective for a significant proportion of RLS patients • Reduce caffeine and alcohol • Moderate evening exercise (excessive exercise can sometimes worsen symptoms) • Hot or cold compresses for temporary relief • Moderate to severe RLS has prescription medication options — evaluation by a doctor is required