Restless legs syndrome: symptoms, diagnosis and treatment of sleep disorders

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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. Healthy­in­fo 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:

    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

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:

man, face, psychosis
football, players, opponents
sock, stocking, leg
ai generated, woman, urban
insect, bug, beetle
    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

By Yraa

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