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Restless Legs Syndrome (RLS)

Summary

Restless Legs Syndrome (RLS) is a neurological disorder that causes an irresistible urge to move the legs, often accompanied by uncomfortable sensations such as tingling, crawling, or aching. These symptoms typically:

  • Worsen in the evening or at night and are most noticeable when resting.
  • Improve with movement, such as walking or stretching.
  • Affect the legs more than the arms, though other body parts can sometimes be involved.

RLS can make it difficult for children to fall asleep and may lead to daytime sleepiness, mood changes, and trouble focusing in school.

Diagnosis and When to Seek Help

Parents should consult a doctor if their child:

  • Complains of strange leg sensations that are relieved by movement.
  • Has difficulty sleeping due to discomfort in the legs.
  • Frequently tosses and turns in bed or moves their legs involuntarily at night.
  • Appears tired, irritable, or struggles with concentration during the day.

A doctor may diagnose RLS based on:

  • A detailed medical history and symptom description.
  • Family history, as RLS can be hereditary.
  • Blood tests to check for iron deficiency, which is commonly linked to RLS.

Management and Treatment

While there is no cure for RLS, symptoms can often be managed with lifestyle changes and, in some cases, medication.

  • Non-Medical Approaches:
    • Maintain a consistent sleep routine with relaxing bedtime habits.
    • Ensure the child gets regular exercise, but avoid strenuous activity close to bedtime.
    • Reduce caffeine and sugary foods, especially in the evening.
    • Try leg massages, warm baths, or stretching before bedtime.
  • Medical Treatment:
    • Iron supplements may help if an iron deficiency is present.
    • In severe cases, a doctor may consider dopamine agonists, benzodiazepines, or other medications. 

Follow-Up and Support

  • Monitor symptoms and keep a sleep journal to track patterns.
  • Work with teachers if RLS affects concentration and school performance.
  • Discuss ongoing concerns with a doctor, especially if symptoms worsen or disrupt daily life.

With the right management, children with RLS can enjoy restful sleep and improved daytime function.

History and Exam

Key diagnostic factor

  • Presence of risk factors
  • Urge to move the legs
  • Dysaesthesias
  • Evening or night symptoms

Other diagnostic factors

  • Alcohol use
  • Caffeine use

Risk factors

  • Conditions associated with iron deficiency
  • Pregnancy
  • Family history of RLS
  • Use of antidepressants antihistamines and metoclopramide

Diagnostic Investigations

1st investigations to order

  • Clinical diagnosis
  • Iron studies

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    Other Related Conditions

    Obstructive Sleep Apnoea

    Insomnia

    Parasomnia (night terrors)

    Narcolepsy

    Delayed Sleep Phase

    Behavioural sleep conditions

    Rhythmic movement disorder

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      1 Reason for referral *

      2 Parent Surname *

      3 Patient First Name *

      4 Email *

      5 Patient Surname *

      6 Phone *

      7 Child’s date of birth *

      8 ADDRESS