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.
- 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
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:
- Light — up to 20 movements in 1 hour.
- Average — 20–60 twitches in 1 hour.
- 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
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