Restless Legs: Uncomfortable and Overlooked

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Restless Legs: Uncomfortable and Overlooked

By ANAHAD O'CONNOR

Published: May 25, 2004

illions of Americans suffer from restless legs syndrome, but few receive

proper diagnoses, according to a new study.

At least 12 million Americans suffer from the syndrome, which causes

sometimes painful throbbing and tingling in the legs. Yet despite the

prevalence of the condition, few patients know what is wrong, and doctors

rarely diagnose it, the study found.

The symptoms often strike at night and can lead to insomnia, chronic daytime

fatigue and depression.

" Even in people who have the most severe and most frequent symptoms, the

disease is ignored because doctors don't pick up on the signs, " said Dr.

Wayne Hening, a clinical assistant professor of neurology at Wood

Medical School in New Brunswick, N.J., and the lead author of the

report. " There just isn't enough information for the primary care physician

to spot the symptoms and make the diagnosis. "

The new study, published online today by the journal Sleep Medicine,

surveyed 23,052 people and 182 primary care physicians over a two-week

period. The survey was financed by GlaxoKline, which has a drug to

treat restless leg syndrome in clinical trials.

About 1 in 10 people who answered the questionnaire reported symptoms of

restless legs syndrome at least once a week. The researchers then looked at

a subgroup that reported symptoms at least twice a week. Nearly 65 percent

of these chronic sufferers said that they had seen a doctor about their

symptoms, but the condition was diagnosed in less than 13 percent.

Asked about the impact of the symptoms on their quality of life, most

subjects said it was significant. About 70 percent of the chronic sufferers

said it took them an average of 30 minutes to fall asleep each night and 60

percent said they awoke at least three times a night.

The sleep disturbances caused by the syndrome also appeared to take a toll

on the participants' everyday lives. Nearly half the chronic sufferers said

they often had trouble concentrating the next day; a similar percentage

reported a tendency to become depressed.

Dr. Ray L. Watts, a neurologist who was not involved with the study, said

many doctors failed to diagnose the disease because patients have trouble

describing its symptoms.

" Most people say they have an unpleasant or creepy-crawling feeling in their

legs that only with further questioning can you recognize as R.L.S., " said

Dr. Watts, who is chairman of the department of neurology at the University

of Alabama, Birmingham. " More often than not, doctors misdiagnose it in the

early stages or mistake it for something else. Sleep specialists and

neurologists can spot it, but often general practitioners don't know what

questions to ask. "

With just a few questions, Dr. Watts said, a doctor can diagnose or rule out

the disease in a matter of minutes. People who do have it, he said, find

that it is usually most severe at night or while sitting or lying down.

Getting up and moving the legs usually provides temporary relief. A lack of

sleep is a hallmark of the disease, he said.

There is no approved treatment for restless legs syndrome in the United

States, but several medications prescribed for Parkinson's disease and

epilepsy are known to ease symptoms.

Avoiding certain substances and stimulants, like nicotine, can also help,

Dr. Hening said.