Not just insomnia. What makes Italians’ nights worse is the feeling of restlessness in their lower limbs which triggers an unstoppable desire to move and massage themselves continuously. This chronic disorder is called restless legs syndrome. To avoid a strong impact on the quality of life, it is good to know it and know how to intervene to treat it.
When does it appear?
«This phenomenon arises above all in the evening and becomes worse at night, when the individual, who he is lying downtry to fall asleep,” says the professor Michele Terzaghiresponsible for the complex neurophysiopathology unit and the sleep center of theIRCSS Mondino Foundation, and associate professor at the University of Pavia. It can get worse even when you sit for a long timefor example during a train or plane journey.
Restless legs syndrome: symptoms
People affected by the syndrome experience:
motor restlessness;
tickling and tingling from knee to toe;
contractions.
According to the Istituto Superiore di Sanità, 80% of these individuals also experience periodic movements of the limbs during sleep (Periodic Limb Movements of Sleep, PLMS), which occur every 10-60 seconds.
Women are more at risk
«Although it is difficult to give a general picture, a rather high percentage suffers from this syndrome, up to 10-15% of the adult population. It is above all women who are the most affected. In particular, during menopause or during pregnancy”, continues the expert. According to the Istituto Superiore di Sanità, in fact, 1 in 5 women experience symptoms of the disorder during the third trimester of pregnancy. For this reason, although it is difficult to identify a cause, restless legs syndrome can be linked to hormonal changes.
Restless legs syndrome: triggers
Among the factors that affect restless legs syndrome, it is known with certainty that the dopamine plays a central role. In particular, it is as if the inputs given by the muscles had a short circuit, contributing to dysregulating the activity. “Also there iron deficiency, a mineral involved in the production of dopamine, may be causing the problem. There are also other pathologies attributable to the disease such as: kidney failure, multiple sclerosis and thyroid problems. Even the use of some drugs including various antidepressants and neuroleptics can trigger the problem.”
Restless legs syndrome e cardiovascular diseases
Some studies have identified predisposing factors for the syndrome. According to recent studies, those who suffer from restless legs syndrome are twice as likely to develop cardiovascular diseases as the heart attack and the coronary heart disease. The cause is still unknown but it is hypothesized that rapid movements of the lower limbs are associated with an increase in heart rate and blood pressure.
Tests to arrive at a diagnosis
There is no specific diagnostic test to detect restless legs syndrome: the diagnosis is made during one neurological examination through observation of the patient’s clinical history and reported symptoms. It is important to use a blood test where the value of plasma ferritin, thyroid hormones, blood sugar and creatinine is checked, which is a sign of possible renal failure.
How to treat it
Magnesium and yoga for milder ailments
In milder cases, the specialist can suggest some simple measures to alleviate the ailments, such as gently massaging the legs, taking a warm bath, practicing yoga or tai-chi, distracting the mind with reading or television, walking or stretching. «Magnesium supplementation can also be a factor assists with symptomsalthough its effectiveness is not reported in scientific literature”, continues the specialist.
Moving helps reduce discomfort
Movement helps reduce discomfort, but the benefit is temporary: as soon as you go back to bed the problems return. «In approximately 30% of cases, this syndrome significantly reduces the quality of sleep. Three times or four out of ten, it delays falling asleep by more than an hour”, warns Terzaghi.
If insomnia becomes an additional problem
It often happens that restless legs syndrome causes insomnia. By waking up the sufferer at night, the sleep disorder can become autonomous: «In these cases, the doctor can prescribe therapies and specific medicines for sleeping».
Medicines for the most serious cases
In more serious cases, however, the doctor can prescribe drugs that regulate dopamine levels, such as ropinirole, pramipexole, rotigotine, or iron, in case there is a known deficiency. If pain is present, the specialist may recommend medication painkiller. Unfortunately, treatments do not necessarily eliminate the problem, which varies in intensity and frequency over time.
The recommendations
It is forbidden to underestimate the problem. «Many people declare that they have been living with this disorder for years», warns Professor Terzaghi who invites people to improve your sleep hygienealways going to sleep at the usual time, avoiding alcohol, nicotine and caffeine abuse after 6pm. «Furthermore, when you suspect you are suffering from restless legs syndrome you should contact your GP, who will recommend a visit to a neurologistbetter if an expert in Sleep Medicine to find a cure and resolve the disorder, returning to living more peaceful days and nights.”