Restless legs: when your legs will not let you sleep.

An irresistible urge to move your legs

The SPI is characterized by aurge to move legsaccompanied by unpleasant sensations—tingling, tightness, discomfort, “bugs inside”—that are difficult to describe. appear or worsenat rest(sitting or lying down), especially at the end of the day, andrelieve with movement. That's why they interfere so much with sleep.

Many people also presentperiodic leg movements during sleep, repeated shocks that fragment the rest without the person knowing it, and that the partner notices. The result is insomnia, unrefreshing sleep and daytime fatigue.

It is a real and common disorder, with a neurological basis (related to dopamine and brain iron), which for years has been undervalued. Today it is well diagnosed and responds to treatment.

Signs and symptoms of the disease

Patients describe the discomfort with terms such asrestlessness, tingling, cramps, stinging, nervousness, pain, deep strange sensations, burningor even “crazy legs.” Its main features are:

• Irresistible urge to move your legs(or the arms), accompanied or not by uncomfortable sensations.
• Home or worsening during periods of inactivity: sitting, lying down, at the movies or during long trips by car or plane.
• Relief with movement: Discomfort is relieved or disappears when walking, moving, or rubbing your legs. This urgent need to move gives the disorder its name.
• Worsening in the late afternoon or evening: This is why it makes it difficult to start or maintain sleep, while during the day the discomfort disappears or is minor.

Furthermore, in more than one80% of patientsappearperiodic leg movementsduring sleep and sometimes during wakefulness, repeated jerks that fragment the rest.

How SPI is confirmed

Restless legs syndrome can often be diagnosed in the office based onpatient's medical history: the diagnosis is clinical. However, along with history, some tests can be very useful:

• blood test with iron and ferritin levels; This last parameter is altered in many patients.
• Studies in the sleep laboratory(nocturnal polysomnography and suggested immobilization test): determine if there are periodic movements in the legs or arms and evaluate the quality of sleep.
• Electromyography and nerve conduction: rule out injuries to the roots and peripheral nerves of the extremities.
• Ultrasound of brain parenchyma(substantia nigra): neuroimaging technique that directly measures brain iron stores and helps exclude other neurological disorders.

Family members with the same disorder must also be taken into account—there is a family predisposition—and a history of response to dopaminergic drugs. The physical examination and routine medical tests are usually normal.

When and how to treat RLS

RLS is a chronic and progressive disorder. At first it manifests itself sporadically with discrete discomfort, but over time the intensity and frequency increase and it is not uncommon for significant problems to appear in initiating and maintaining sleep, with restlessness, nervousness and restlessness. The consequences are very negative for the patient's well-being, so in these cases treatment must be considered, always personalized to minimize long-term risks.

Non-pharmacological measures

• Maintain aregular sleep schedule, perform moderate physical exercise in the late afternoon and reduce the consumption ofcoffee, tobacco and alcohol, which worsen the discomfort.
• Avoid drugs that can aggravate symptoms:antihistamines, some sedatives that block dopamine, and certain antidepressants.
• Correct possible secondary causes: iron deficiency, kidney disorders, drugs, etc. Approximately in a20% of casesThere are other medical situations that explain the symptoms (anemia, kidney failure, polyneuropathy, pregnancy, drugs, etc.).

Pharmacological measures

The first step in choosing the ideal treatment is based on theiron status. If there is a deficit, the first therapeutic option will be to replenish the deposits, orally or intravenously, depending on the case. If there is no iron deficiency, approved symptomatic treatments can be used:

• Dopamine agonists: first-line drugs, used at lower doses than in Parkinson's disease.
• Antiepileptics: also useful in the treatment of RLS, especially when there is a neuropathic pain component.
• Opioids: reserved for more refractory or serious cases, which require extensive experience for proper use.

Relieve symptoms and recover sleep

The first step iscorrect what can be done: replenish iron when ferritin is low - it often greatly improves symptoms -, review drugs that make it worse and adjust habits (caffeine, alcohol, schedules, gentle exercise).

When you need more

In cases where it is required, we havespecific pharmacological treatmentvery effective, which is prescribed and adjusted individually to avoid unwanted long-term effects. The goal is for your legs to stop marking your nights and for you to recover a restful sleep, with monitoring to maintain control.

What to do if you suspect you have RLS

At the Sleep Research Institute we address RLS in a comprehensive and personalized way. Under the direction ofDr. García-Borreguero, a recognized expert in restless legs syndrome, our medical team is dedicated to providing you with the specialized care you deserve.

• Experience and specialization: Dr. García-Borreguero leads the team with extensive experience in the diagnosis and treatment of RLS, backed by his dedication to research.
• Comprehensive approach: A multidisciplinary team will work with you to understand your needs and design a personalized treatment plan.
• Advanced technology: modern facilities and cutting-edge technology for accurate evaluations and the best care.

If you suspect you may have restless legs syndrome, don't hesitate to schedule a consultation. Your rest is our priority.