Restless leg syndrome (RLS), also known as Willis-Ekbom disease, causes an uncomfortable urge to move the legs, typically in the evening or at night. It's a common cause of insomnia and disrupted sleep.
Symptoms of RLS
- Uncomfortable sensations in the legs (crawling, tingling, aching)
- Irresistible urge to move the legs
- Symptoms worsen at rest and in the evening
- Relief with movement — walking or stretching
- Difficulty falling asleep
Diagnosis
RLS is primarily diagnosed based on clinical criteria. Additional testing may include:
- Iron studies — low ferritin is a common treatable cause
- Blood tests — to check kidney function and other potential causes
- Sleep study — to assess periodic limb movements during sleep
Treatment Options
- Iron — by mouth or IV when ferritin is 75 ng/mL or lower, or transferrin saturation is under 20% (a higher cut-off than the usual "low" for RLS)
- Alpha-2-delta medicines (gabapentin, gabapentin enacarbil, pregabalin) — the main first medicines in the 2024 AASM guideline
- Dopamine medicines (pramipexole, ropinirole, rotigotine) — no longer advised for routine use because they can make RLS worse over time; sometimes used short term
- See our restless legs guide for the full treatment steps and sources
- Lifestyle changes — regular exercise, avoiding caffeine and alcohol
- Sleep hygiene improvements
Call (512) 931-1575 to schedule your RLS evaluation.
