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For the first time about a spe­cif­ic sleep dis­or­der, in which a per­son is awak­ened by unpleas­ant sen­sa­tions in the legs, doc­tors start­ed talk­ing back in 1672. Then the con­di­tion, lat­er called rest­less legs syn­drome, was described by the Eng­lish physi­cian Thomas Willis. How­ev­er, a full descrip­tion of the pathol­o­gy was made much lat­er — only in 1943 by the Finnish sci­en­tist Carl Alex Ekbom. Med­AboutMe found out how rest­less legs syn­drome man­i­fests itself, why the pathol­o­gy occurs and how it is treat­ed.

Causes of the syndrome: the role of hormones

Today, rest­less leg syn­drome is receiv­ing more and more atten­tion. Accord­ing to sta­tis­tics, this is a fair­ly com­mon devi­a­tion, with vary­ing inten­si­ty it man­i­fests itself in 5–10% of the pop­u­la­tion. And accord­ing to some reports, there are much more patients, it’s just that the syn­drome is not always cor­rect­ly diag­nosed. It is known that 15% of sleep dis­or­ders are caused by this pathol­o­gy.

It is not yet pos­si­ble to ful­ly under­stand why exact­ly there are uncom­fort­able sen­sa­tions in the legs. But recent research has linked Ekbom’s syn­drome to a lack of dopamine. This hor­mone is direct­ly relat­ed to the feel­ing of sat­is­fac­tion and joy, but, in addi­tion to influ­enc­ing human emo­tions, it plays an impor­tant role in the reg­u­la­tion of mus­cle activ­i­ty and the periph­er­al ner­vous sys­tem. For exam­ple, it is the lack of dopamine that is the cause of Parkin­son’s dis­ease. In addi­tion, a con­nec­tion has been estab­lished between itch­ing and burn­ing in the legs, which is char­ac­ter­is­tic of Ekbom’s syn­drome, while tak­ing drugs that affect the activ­i­ty of dopamine. First of all, we are talk­ing about selec­tive sero­tonin reup­take inhibitors (SSRIs). Some experts sug­gest that the vio­la­tions are asso­ci­at­ed with a hered­i­tary pre­dis­po­si­tion.

In addi­tion, doc­tors iden­ti­fy a num­ber of risk fac­tors that increase the like­li­hood of devel­op­ing a syn­drome that affects sleep:

  • Chron­ic renal fail­ure.
  • Lack of B vit­a­mins.
  • Lack of trace ele­ments: iron (against the back­ground of iron defi­cien­cy ane­mia), mag­ne­sium.
  • Dis­eases of the thy­roid gland.
  • Dia­betes.
  • Arthri­tis.
  • Dam­age to the spinal cord and spine.
  • Mul­ti­ple scle­ro­sis.
  • Cir­cu­la­to­ry dis­or­ders in the extrem­i­ties.
  • Alco­holism, poi­son­ing.
  • Preg­nan­cy (in the 2nd and 3rd trimesters, tem­po­rary symp­toms appear in almost 20% of women).

Symptoms: itching and burning in the legs

Symptoms: itching and burning in the legs

A per­son suf­fer­ing from Ekbom’s syn­drome com­plains of dis­com­fort in the legs. First of all, the fol­low­ing symp­toms are not­ed:

  • Itch­ing and burn­ing in the mus­cles.
  • Tin­gling, pinch­ing.
  • Mus­cle ten­sion.
  • Sen­sa­tion of stretch­ing, rem­i­nis­cent of the onset of con­vul­sions.
  • Dull aching pain.

Some­times the pathol­o­gy devel­ops in one limb, but soon tin­gling, itch­ing and burn­ing pass to both legs. It is char­ac­ter­is­tic that dis­com­fort appears only at rest and dis­ap­pears as soon as a per­son begins to move. More­over, the sen­sa­tions are so unbear­able that it is sim­ply impos­si­ble to ignore them. More­over, some patients even go for long walks dur­ing night attacks.

Symp­toms occur with a cer­tain cyclic­i­ty, for most they are most pro­nounced in the first half of the night, they decrease by morn­ing, and dur­ing the day they may not both­er at all. Of course, this sit­u­a­tion sig­nif­i­cant­ly affects sleep, so peo­ple with this pathol­o­gy are often diag­nosed with insom­nia, day­time sleepi­ness, poor con­cen­tra­tion, and chron­ic fatigue.

The man­i­fes­ta­tion of the syn­drome is quite indi­vid­ual, in some patients the symp­toms may com­plete­ly dis­ap­pear for sev­er­al months or even years and dis­turb only under cer­tain con­di­tions. For oth­ers, the aching pain is present every night. If the symp­toms appear for a long time, then depres­sion occurs against the back­ground of lack of sleep.

Diagnosis of pain and itching in the legs with the syndrome

Rest­less legs syn­drome is extreme­ly dif­fi­cult to diag­nose, since in the vast major­i­ty of patients such dis­com­fort is not asso­ci­at­ed with patho­log­i­cal or organ­ic lesions. Only in rare cas­es is inflam­ma­tion of the nerves or periph­er­al vas­cu­lar dis­ease detect­ed.

Anoth­er diag­nos­tic prob­lem is the time of onset of symp­toms. As a rule, pain and oth­er signs appear only at night, and dur­ing the day they do not both­er. There­fore, it is dif­fi­cult for a doc­tor to objec­tive­ly assess the described symp­toms.

The only pos­si­ble method of diag­nos­ing a patient with such com­plaints is polysomnog­ra­phy. The study takes place dur­ing sleep, sen­sors are attached to the human body that record the activ­i­ty of the ner­vous sys­tem. In this case, the doc­tor can assess the sever­i­ty of the man­i­fes­ta­tion of Ekbom’s syn­drome. There are three degrees:

  1. Light — up to 20 move­ments in 1 hour.
  2. Aver­age — 20–60 twitch­es in 1 hour.
  3. Severe — more than 60 move­ments in 1 hour.

When diag­nos­ing, the doc­tor needs to exclude oth­er dis­eases that cause sim­i­lar symp­toms. In par­tic­u­lar, akathisia (rest­less­ness) is a state of increased activ­i­ty in which the patient has severe anx­i­ety and a desire to move or con­stant­ly change pos­ture. It dif­fers from rest­less legs syn­drome in that the whole body is involved in the process — a per­son makes ner­vous move­ments with his hands, can become loose, rub his face.

Restless legs syndrome treatment: massage, proper sleep

Restless legs syndrome treatment: massage, proper sleep

Treat­ment large­ly depends on the sever­i­ty of the syn­drome. If uncom­fort­able sen­sa­tions have led to a per­sis­tent sleep dis­tur­bance, are asso­ci­at­ed with depres­sive con­di­tions, the patient may be pre­scribed drug ther­a­py. First of all, dopamin­er­gic drugs, anti­con­vul­sants, seda­tives are pre­scribed.

For most patients, this treat­ment is not required. Var­i­ous pro­ce­dures will help to get rid of pain and oth­er dis­com­fort. Mas­sage is most effec­tive in this con­text, but mag­ne­tother­a­py, dar­son­va­l­iza­tion, acupunc­ture and mud appli­ca­tions also help patients.

Doc­tors also rec­om­mend fol­low­ing a num­ber of rules that will help improve sleep and speed up falling asleep:

  • Do not overeat at night, for din­ner it is bet­ter to choose light meals, with­out meat, fat­ty gravy, spices.
  • Refuse before going to bed from strong tea and cof­fee, it is bet­ter to drink herbal tinc­tures.
  • In the evening, take walks in the fresh air, and 1–2 hours before bed­time, on the con­trary, spend time alone.
  • Take an essen­tial oil bath or warm show­er.
  • Rub your feet, use hot or cold foot baths.
  • Prop­er­ly orga­nize the space of the bed­room — black­out cur­tains, silence, fresh cool air, hard or medi­um hard mat­tress.
  • Do not over­load the ner­vous sys­tem — it is best to read a book before going to bed, you should refuse TV or a com­put­er.
  • Quit smok­ing at night.
  • Fol­low the regime, go to bed at the same time.

Neu­rol­o­gy. Nation­al lead­er­ship. / Ed. E.I. Guse­va, A.N. Kono­val­o­va, A.B. Hecht - 2014

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