Got the "Creeps"?

Elusive disorder
RLS is an elusive disorder because there are no diagnostic tests, no exact causes and no cures. It affects both genders and can occur at any age, but is more common among people over 60. RLS can be primary, unrelated to other disorders, or secondary, related to other conditions such as Parkinson's disease, pregnancy, diabetes, iron deficiency or kidney failure. As a result, physicians may do tests to rule out other possible causes of the symptoms.

"We do know that RLS is due to an imbalance of dopamine, a neurotransmitter in the brain, but we really don't know what the cause of that is," explains Holland neurologist Craig Kuesel, DO.

"Although there's no test to confirm the disorder, it's fairly easy to diagnose based on the patient's symptoms and medical and family histories," Kuesel says, adding that caffeine, alcohol and tobacco can trigger symptoms in patients who are predisposed to RLS.

Losing sleep
One troublesome aspect of RLS is that it worsens when resting or relaxing, particularly at night. Patients with severe cases can become sleep deprived, which leads to a whole host of other health and wellness problems if left untreated.

"RLS can be so uncomfortable that people lose sleep, and if you don't sleep, it's going to be hard to concentrate and do daily activities," states William Brackenridge, Pharm.D., Holland Hospital's director of Pharmacy and Cardiopulmonary Services, who oversees the Center for Sleep Disorders.

"Patients can become tired or depressed, which compounds the problem," Brackenridge adds. For example, Margaret, a 78-year-old Holland resident who recently developed RLS, says the disorder is so irritating and sometimes painful that it often keeps her from falling asleep at night. "It's just horrible," she says. "It's a burning sensation like bugs are biting my legs, so I keep moving my legs to make it go away. Then I toss and turn all night, and I'm tired in the morning."

Relief for RLS
Massaging, stretching or moving the legs can provide temporary relief, but often medication is necessary to ease the discomfort. "Medications, many of which are used to treat Parkinson's disease, work quite well even at low dosages for 90 percent of patients," Kuesel explains.

Recent studies at Johns Hopkins and Pennsylvania State universities also have linked RLS with brain iron deficiency. Their findings show that cells from the substantia nigra of the brain lack a protein that regulates iron in the body. Because of this, physicians may prescribe iron supplements to ease symptoms.

"The doses and combinations of medication prescribed may require several changes to optimize their effectiveness," Brackenridge says, "but it is worth the effort if this provides relief." In addition, pain relievers and sedatives have been used to ease RLS symptoms and help people fall asleep and get a good night's rest.  

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