Issue date: 4/7/08 Section: Money/Health

Media Credit: Andrea Pendergast

Clink. Clank. Clunk.

It's your roommate again, digging through the pots and pans at 3 a.m., unable to sleep and hoping a snack will solve the problem.

You're hoping so too, because this early morning wake-up routine is starting to get on your nerves and creating tension in your relationship. But, if your roommate is suffering from Restless Leg Syndrome, this midnight rummaging may be the only cure.

Georgianna Bell, executive director of the Restless Leg Syndrome Foundation, said RLS can be very frustrating to deal with, and creeps into all aspects of the patient's life.

"(It can be) distressing for relationships, (for) the people you live with understanding what you're going through and making accommodations to help you deal with it (isn't easy)," she said. "It really affects the entire quality of life."


Diagnosis
A person with RLS experiences an overwhelming urge to move their legs while at rest, according to the National Sleep Foundation Web site. Approximately 10 percent of adults in the United States struggle with RLS.

But researchers have yet to determine an exact mode of diagnosis, Bell said, so its difficult to determine how accurate those numbers are.

"There's nothing that we call a bio-marker for RLS," she said, adding a person's blood glucose level is an example of the the biological marker for diabetes.

Instead, patients are asked four questions to determine if he or she has RLS, Bell said. Do you have an overwhelming urge to move your legs? Is it usually accompanied by sensations ... deep in the legs? Does it occur or does it get worse at rest? Does it get better when you move?

The last question, she said, is really important in determining if a patient has RLS.

"That's kind of the differentiator between RLS and common leg cramps that people get at night when they are in bed," she said. "(RLS) always temporarily at least gets better with movement."

Bell said the diagnosis of RLS can be determined by looking at someone's brain, but by that time it's too late.

"You could compare the diagnosis of RLS maybe to Alzheimer's," she said. "The only way to get a confirmed diagnosis is by looking at people's brains after they are dead."

Also, research has been done linking genetics with RLS, but researchers are still unsure exactly which gene causes the problem, she said.

How it works
RLS affects a person's ability to do anything in the evening, Bell said. For a college student with RLS, tasks such as sitting and studying after dinner may be impossible.

Thus far, the onset of RLS has not been connected with any particular age group, Bell said.

"It seems generally that if you have RLS it can be somewhat infrequent in your early years and when you hit your 40s, it starts to get worse," she said. "That's not always true. There are children that can have severe RLS."

A person dealing with RLS symptoms may fall victim to other related conditions.

People with RLS might also have symptoms of Periodic Limb Movement Disorder in which a person experiences involuntary leg twitching during sleep or throughout the night - ultimately disrupting his or her sleep, according to the National Sleep Foundation.

Life with RLS
A variety of treatments are available for dealing with RLS, Bell said, although they can be different for every patient.

The first step is to look at lifestyle factors that may be triggering a patient's "RLS attacks," Bell said. For some people, that could include drinking alcohol at night, smoking tobacco, or getting too much exercise - although for some people moderate exercise is helpful.

Bell said she suggests patients keep a lifestyle diary and take note of which dates the RLS were worse and which activities may have accompanied those dates.

To deal with the pain of the symptoms, Bell said some patients take a warm bath or massage their legs, while others stand in place and march up and down.

For some, mental distractions help to relieve the symptoms, she said. Doing things such as playing computer games or chess, knitting or waking up in the middle of the night to do housework.

The Food and Drug Administration has approved only two medications to treat RLS, but more may be coming, Bell said. Patients also use off-label drugs, which are medications that are approved for other diseases but happen to work well in the treatment of RLS.

Looking ahead
RLS has been determined to be a neurological disorder, according to the National Sleep Foundation. In a recent study by John Hopkins and Pennsylvania State Colleges, researchers linked a brain iron deficiency with the causes of RLS.

These recent findings could mean good news for creating a cure, according to the National Sleep Foundation. Drugs that aid in the uptake of iron may be one way to approach future developments of a treatment.

In the meantime, Bell said it's important that people continue to spread the word about RLS.

"We really want people to learn what RLS is," she said. "Our mission is to increase awareness and improve treatments - and we do that through educating health care providers and through research to find a cure."

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