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Sunday, March 26, 2023

What can we do about restless legs syndrome?

By Jeannine StewartSpecial to CSMS MagazineAlmost five million sufferers don’t know what to do. How can you tell if you are one and what do you do about it? If you have trouble sleeping because of a burning, tingling or “creepy-crawly” sensation in your legs, you may be suffering from restless legs syndrome (RLS).            This neurological disorder affects 2% of the population—some so severely that they’re unable to sit still long enough to travel in an automobile or airplane or see a movie. RLS isn’t dangerous, but it can seriously disrupt your sleep and quality of life.What are the symptoms? RLS sufferers generally have more leg discomfort when sitting or lying down than when standing. The leg discomfort is especially bad at night, making it hard to fall asleep. Some sufferers kick during sleep. All have an almost uncontrollable desire to move their legs around.            RLS can strike at any age, but most cases occur after age 40. It often gets worse over time. There is no known way to prevent RLS. One-third to one-half of all cases seems to be inherited. RLS can also be caused by nerve of diabetes, kidney disease or a pinched nerve in the back…a deficiency of iron…or, theoretically, a deficiency of the neurotransmitter dopamine.Best ways to control symptoms Some RLS sufferers derive relief from iron supplements. The typical dosage is 300 mg three times a day—but check with your doctor first to make sure supplements are right for you. Others swear by supplements of vitamins E and B-12 and folate.             According to specialists, most severely affected patients, however, generally do not benefit from vitamin supplements. What about nondrug therapies? Two seem to he particularly helpful

  • Revise your sleep schedule. Try to sleep when your RLS symptoms are least pronounced. You may be able to work out a flextime arrangement with your employer to accommodate this schedule this schedule.
  • Avoid caffeine and alcohol. They make RLS worse.

If symptoms persist, consult a doctor who has experience treating RLS patients. Unforntunately, RLS is often misdiagnosed as anxiety, stress, depression or garden-variety insomnia. Doctors often have a difficult time recognizing RLS, because patients seldom display the telltale leg symptoms in the doctor’s office.            Once properly diagnosed, however—either by a primary-care doctor or a neurologist specializing in sleep or movement disorders—RLS can be effectively treated. Well-controlled clinical trials indicate that 80% of RLS sufferers experience relief from long-term use of one or more of the following drugs…

  • L-dopa, pergolide (Permax) or bromocriptine (Parlodel). These drugs boost dopamine levels. Potential side effect: Nausea, vomiting, light-headedness and fainting and “rebound” of symptoms into daylight hours. 
  • Clomazepam (Klonopin) and other benzodiazeines. Potential side effects: Drowsiness and mental dullness. 
  • Acetaminophen with codeine, oxycodone (Percodcet) and other opiates. Potential side effect: Constipation. 

Benzadiazepines and opiates can be addictive, but the risk is small if the drugs are used under close medical supervision.Note: Jeannine Stewart is a neurologist who lives in suburban Atlanta. She wrote this piece exclusively for CSMS Magazine.Also see Blueberry Meringue TartsHave you tried grilled turkey burgers with avocado mayonnaise?

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