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House Call Doctor and Grammar Girl Discuss Restless Legs Syndrome

Restless Legs Syndrome affects millions of Americans. And Grammar Girl is one of them. She joins House Call Doctor to discuss her most pressing questions about the condition, as well as to learn some of the best treatments to help sufferers calm their restless legs and get some sleep.

By
Sanaz Majd, MD,
Episode #136

House Call Doctor and Grammar Girl Discuss Restless Leg Syndrome

Restless Legs Syndrome, otherwise known as Willis-Ekbom Disease, affects up to 10% of the American population. That's millions of people who have trouble sleeping because of their twitchy, restless legs. 

Grammar Girl, Mignon Fogarty, is one of them. That's why we sat down to discuss her biggest concerns about the condition and how they can best be treated to help alleviate the frustrating symptoms.

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Grammar Girl: When my legs first started feeling twitchy in graduate school, I was really worried that I had multiple sclerosis or Parkinson's disease or some other serious neurological disorder, so I was relieved to find out it was just Restless Legs Syndrome. And then after I had a name for it, I was talking about it with my father, and he said he has the same problem with his "twitchy legs" at night.

Is it normal for symptoms to start out of the blue? In your late 20s? And it is typical for the condition to run in families?

House Call Doctor: RLS does tend to run in families, as there seems to be a genetic component.  If you ask your parents or siblings, more than likely you will learn that they, too, suffer from similar symptoms to some extent.

RLS symptoms do seem to get more frequent with age, and symptoms also seem to last longer with age.  However, if you dig more deeply into a patient’s history, you’ll find that they first experienced the symptoms while young – typically sometime between age 11 and 20.  Although, most people get diagnosed around age 40 since it tends to be more severe by that time.

GG: I can go for weeks or maybe even a month or two without having a problem, and then it will just seem to "come on" out of the blue. It also seems to get worse when I'm really tired. Is it normal that it would be so erratic and also that it would be worse when I'm tired?

HCD: Patients with RLS can go into remission for weeks to even months without symptoms.  This tends to be more common in the early stages of the disorder.

Fatigue is actually a trigger for RLS.  That’s why maintaining a good sleep-wake schedule is very important for these patients. Try to sleep at the same time and wake up at the same time every day, because changes in your sleep pattern can trigger the symptoms.

GG: I've noticed that it seems to get worse when I take antihistamines such as Benadryl, which seems weird. Is that normal? (And if so, are there other classes of hay fever medicine that I could take without exacerbating my RLS?)

HCD: Sedating antihistamines, like diphenhydramine (Benadryl), can trigger RLS symptoms in some patients.  Even though it is supposed to be sedating, it tends to be more activating in those with RLS.  If you suffer from RLS and allergies, I would stick to the non-sedating antihistamines – such as cetirizine or loratadine (which are all over-the-counter, like diphenhydramine, and they actually last longer).

GG: Does having RLS mean that I'm at an increased risk of getting other diseases?

HCD: There is a link between iron-deficiency anemia and RLS – so we do recommend checking for anemia, along with a test called “ferritin” that reflects the body’s iron stores.  If this level is below 50, sometimes treatment with over-the-counter iron can relieve the RLS symptoms. Check out more on iron supplements as a treatment for RLS in Nutrition Diva's episode.

And people with other neurologic disorders, like Parkinson’s and MS, tend to suffer from RLS as well. But the majority of people who develop RLS do so without an underlying cause and are not at risk for developing any other medical conditions.

GG: I always have trouble sleeping at night, and audiobooks have been hugely helpful in improving my sleep. I've never thought about it before, but is there any evidence that a distraction, such as someone reading to you, can lessen the symptoms of RLS?

HCD: RLS is a condition that strikes at rest, when you are trying to relax.  So I’m not surprised that listening to audiobooks at night provides you with enough distraction to deter your RLS symptoms.  If this method works for you, as long as the storyline is not too activating enough to keep you from sleeping, then I think it could be a great tool to deal with your RLS symptoms when they strike.  

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For more on causes, treatments, and symptoms of RLS, check out the QDT

Restless Legs Syndrome homepage.

Do you suffer from RLS? Post your experiences in the comments section or on the House Call Doctor’s Facebook and Twitter pages!

Counting sheep image courtesy of Shutterstock..

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