Restless, tingling legs force those affected to get up at night and walk around. In contrast, periodic leg movements during sleep often interrupt the night’s sleep unnoticed.
Restless legs – syndrome of restless legs
Leg maladies do not allow five to ten percent of the population to fall asleep for a limited or longer period in their lives. Tingling and pulling in the calves often causes problems during the daytime. Older people complain about it more often, but also younger people. Pregnant women in particular suffer from restless legs every now and then.
In addition, fluctuating temperatures, alcohol abuse, smoking and the side effects of certain medications, such as antidepressants, may play a triggering role.
Restless Legs Syndrome can also be associated with diabetes, iron deficiency, bowel disease, multiple sclerosis, or depression. Often there is a family predisposition, especially in people who are more severely affected by the disorder.
Medical researchers assume that faulty nerve impulses trigger the symptoms. Restless Legs syndrome is often associated with periodic nocturnal leg movements.
Symptoms: Unpleasant tingling, “running ants”, pulling pain mainly in the calf muscles set in a calm attitude, especially in the evening before falling asleep. By moving the legs and moving around, the symptoms are usually mild. The associated urge to move not only makes it difficult to fall asleep, but also forces those affected to get up at night. The deep sleep percentage is shortened or sometimes completely eliminated. Significant daytime tiredness, concentration and performance disorders are the result.
The tingling and stinging can significantly affect day-to-day life. It is then difficult to sit quietly longer, such as when driving, in professional meetings, in the cinema or on other occasions.
Diagnosis: Medical history and symptoms usually provide the physician with essential information for the diagnosis of a restless leg syndrome. To exclude other diseases, followed by physical examinations and blood tests, which also show certain iron levels (especially ferritin). In addition, a test with L-Dopa, a Parkinson’s drug, provides information. If nerve damage is suspected, neurological examinations may also be indicated. Sometimes the doctor considers a checkup in a sleep laboratory.
Therapy: Easier, temporary ailments can often be contained with general measures. These include sports activities as well as the renunciation of alcohol and caffeinated drinks. Existing diseases and disorders, such as iron deficiency and anemia, the doctor will treat specifically. More severe, persistent complaints are usually drugs, especially preparations that are actually intended for Parkinson’s disease, such as dopaminergic drugs and dopamine agonists. Another option is the oxycodone / naloxone combination.
Further information on the clinical picture, diagnosis and therapy can be found in the guide “Restless Legs Syndrome (RLS, restless legs)”.
Periodic limb movements during sleep
It is primarily the legs, more rarely the arms, that are active at night, without the sleeper consciously perceiving the activities of his extremities. The quality of sleep, however, suffers greatly, deeper sleep phases are disturbed. Especially older people over 60 have to do with it, many at the same time also with sleep apnea and narcolepsy.
The causes are not yet clear. As with restless legs, there is apparently a hereditary condition. Likewise, certain medications such as antidepressants, smoking, alcohol, caffeine, mineral deficiencies or physical and emotional stress are sometimes considered as triggering factors. The symptoms may also be related to kidney or metabolic diseases, often resulting in poor circulation of the legs.
Delinquencies are the periodic movement disorders of harmless muscle twitching, which many people experience before falling asleep, but who lay down after a short time and do not affect sleep further.
Symptoms: The leg muscles, sometimes the arms, start to twitch (periodically) at regular intervals. The muscle twitch stops for a few seconds and occurs frequently in the first half of the night. Those affected rarely notice but wake up briefly without realizing it. The so constantly interrupted sleep has an increased daytime sleepiness with sometimes downright sleep attacks.
Diagnosis: Often it is the bed partners who are disturbed by the sometimes-violent movements and can provide appropriate information. The doctor first interrogates the affected person in detail and examines him physically, in order to be able to determine possible comorbidities not yet known. For a definitive diagnosis of the periodic movements, the doctor may sometimes consider an examination in a sleep laboratory. It records how often muscle twitching occurs at night and how they disturb sleep.
Therapy: The treatment depends on the discomfort of a person affected by the nocturnal movement disorder. Many do not feel significantly affected and do not need special treatment. Basically, helpful are a healthy lifestyle and a behavior that benefits sleep. If, for example, nocturnal respiratory distress syndrome occurs, the leg activity often involves the treatment of sleep apnea by nasal positive pressure ventilation.
Likewise, the complaints usually go back when an existing underlying disease is treated consistently. If the leg movements persist persistently and the daytime fatigue is particularly pronounced, medications such as anti-Parkinson’s disease drugs can sometimes help.