When Sleep Becomes a Nightmare
Juky 16, 2004
by Randy Dotinga, HealthDay

FRIDAY, July 16 (HealthDayNews) -- Doctors and researchers are finally paying attention to an obscure neurological disorder that disrupts the sleep of countless people worldwide, forcing them to get up and walk around or face discomfort throughout the night.

Experts say many "restless leg syndrome" sufferers don't realize they have an illness and fail to seek help. Some even think the condition is perfectly normal until a bedmate breaks the news that it isn't.

But even now, about a decade into the disease's renaissance as a topic of attention, not everyone takes it seriously.

"If you say 'restless leg syndrome,' people will still laugh sometimes,'" said Dr. Bruce Ehrenberg, a neurologist at Tufts University School of Medicine in Boston who studies the illness. "Our goal is to get to the point where people don't laugh."

The syndrome strikes people when they're sitting or lying down. Suddenly, they feel the need to get up.

"It's an urge to move, and some people can't describe it at all. Others give it various names, from creepy crawlies to burning to a deep sensation of pain or squeezing," said Ehrenberg, who serves on the board of the Restless Leg Syndrome Foundation. "Thirty percent of them have a painful feeling, which is sometimes excruciating, but most often it's not that severe."

Typically, patients only feel better once they get up and walk around or involuntarily move their legs.

"They may walk for an hour or go do something to distract them until they feel it's safe enough to go back to sleep again," said Dr. Christopher Earley, an associate professor of neurology at Johns Hopkins University.

No one knows exactly how many people suffer from the lifelong condition for which there is no cure, but the National Institute of Neurological Disorders and Stroke (NINDS) estimates 12 million Americans have it. Slightly more women are affected by the disease, and it tends to strike in middle age. A family history of the problem seems to play a part in 50 percent of the cases. Those with chronic diseases such as diabetes, kidney failure and Parkinson's disease also appear to be susceptible.

Perhaps a third of sufferers seem to have the worst cases.

"Most patients who come to our awareness have had it probably for well over 10 years; all of them had it almost on a nightly basis," Earley said.

Worldwide, French Canadians and Icelanders seem to be especially susceptible, while Asians appear to not be as affected as people in the West.

Before the mid-1990s, most researchers would have assumed that the condition affected fewer than one in 100 people, Earley said. But then things changed with the creation of a foundation devoted to the illness. "People started coming out of the woodwork. People started becoming aware that this is more prevalent than anticipated," he said.

Despite years of research, the causes of restless leg syndrome remain elusive. However, the problem does appear to be in the brain, not the legs, and scientists think it may have something to do with the brain chemical dopamine and a shortage of the mineral iron in the body.

Small doses of drugs such as Levodopa, which is used to treat Parkinson's disease, help patients, as do strong painkillers such as oxycodone or codeine. Cutting back on coffee, alcohol and tobacco can also work in milder cases, as these substances appear to aggravate symptoms, according to NINDS.

So what should you do if you think you have restless leg syndrome? Talk to your doctor and look into treatment, Earley said. The Parkinson's disease drugs may be appropriate if the condition comes on every night, while painkillers and sleep aids could help if it's an occasional problem, he said.

Luckily, experts say, the disease is fairly easy to treat. Sleep -- and calm legs -- should return.

More information
To learn more about the condition, visit the http://www.rls.org/]Restless Leg Syndrome Foundation[/url].