“Misunderstood” is the word almost every RLS victim uses to describe his or her situation in daily living. The second most used word is: “misdiagnosis” while trying to cope with the medical world.

Sometimes at night, when my legs want to move and force me to rise from my bed to walk alone in the dark house.

Sleep Thief who steal from victims the pleasure of living a normal life, This sneaky character arouses annoying, tickling sensations in the legs, and sometimes in the arms which force a victim to move, weather he or she wants to move or not. The sleep thief offers no choice. Walking, even standing while marching in place, does calm those jittery feelings-temporarily-but, when the victim sits or lies down again, the urgency to move returns, with a vengeance.

Recurrent, unpleasant, peculiar creeping or crawling sensation in the legs, occasionally in the legs, occasionally in the thighs or feet, felt deep inside the muscle or bones, which prevents the patient from keeping the involved extremities still. Bilateral and symmetric involvement or preponderant on one side: seldom affecting the arms and hands in “ tono minor.” Seldom true pain. Worse in the evening and at night or when the patient rest for some time. Sometimes lasting only a short period, sometimes hours. Sensation is relieved by movement, but reappears a short time after patient returns to bed. This is an important cause of severe insomnia. 

“It’s like a toothache in my legs. Tickling pin--- difficult to explain--- It is inside my bone. I feel like rats were crawling on my legs at night.”

Restless leg is a feeling, which is very hard to describe, and the words that people use to talk about it are often confusing to the doctor. It may be an ache. It may be a crawling feeling like you have worms in your legs. It may be like a tiny set of itches or pin pricks. And because the words are so different from person to person, the physician may think it’s simple a cramp, or may be it’s arthritis, maybe it’s just nervousness, maybe it’s due to loss of blood flow in the legs or of problem related to diabetes which causes changes in the nerves.

But there is one interesting thing about restless legs which is only true that problems: if you move or walk, the symptoms gets much, much better or may go away. If you have that and it goes away by moving your legs, you probably have restless leg.

Some victims experience a slow annoyance like a feather duster lightly skimming over the legs which may last for a short time, or turn into a demand to stand and later to walk or dance about. The demand to move the legs, which sometimes become excessive, make rational thinking difficult because nothing seems to be able to stop the senseless movements. 

The sleep thief has many relatives, similar but different. The first cousin, which is often associated with and/or confused with restless legs syndrome is nocturnal myoclonus, known as Periodic Limb Movement in Sleep (PLMS). These jerking movements recur every twenty seconds during a part of the night’s sleep. They may or may not awaken the suffering. Most patients with RLS have PLMS, but PLMS may occur by themselves in non-RLS patients as well.

Perhaps most troublesome is the speed with which the urge to move can and sometimes does become uncontrollable: but, the great joy is, it may stop just as rapidly as it began. There seems to be no reason for the beginning, or the end of action.

Leg sensation typically occur while sitting down to watch TV in the evening or while lying down trying to go to sleep at night, but they also may occur during the day while sitting at desk. Many RLS patients find riding in a car, or other modes of transportation requiring periods of uninterrupted sitting, so troublesome that the need to stand or walk around to relieve the sensations becomes overwhelming.

PLMS may be so gentle the patients may sleep through the night but some PLMS patients may kick very violently and may injure their bed partners or themselves. The spouse of the PLMS patient is sometimes a victim of insomnia as often he or she will be awakened by the partner’s incessant kicking. Other parts of the body, especially the ams in addition to the legs, may be involved. 

We do not yet know if the patients with PLMS are in any away genetically related to the people with RLS. However, it is true that the same medications tend to be helpful for each group albeit not always the equal benefit.

Although nearly all individuals with RLS also have PLMS, there are many people who have PLMS who do not have RLS.

In a sense, RLS is a sensory disorder (causing unpleasant sensations in the leg), The other conditions besides RLS that are associated with PLMS have a common theme of sensory disturbance or abnormal sensory input, including peripheral nerve disorder, compression of lumbosacral nerve roots (sciatica), circulatory disturbance, and exposure to cold, metabolic disturbances and aging.

RLS are:

1. A desire to move the legs usually associated with discomfort in the legs

2. Motor restlessness-patients move to relieve the leg discomfort

3. The symptoms are worse at rest, ie., lying or sitting, with at least temporary relief by activity.

4. The symptoms are worse at night. 

RLS: A FAMILY AFFAIR

It has been estimated that one-third of RLA cases are familial: related to, or characteristic of a family, tending to occur in more members of a family than expected by chance alone. RLS follows an autosomal dominant type inheritance pattern. This means that males and females are equally affected and that RLS keeps being passed on from one generation to the next as opposed to an autosomal recessive pattern where a particular genetic disease will skip generations only to return in later generations. Also, only one parent has to be affected with RLS for children to get it.

RLS affects 5% of our population ( over 12 millions Americans)may be suffered from it in various degrees of intensity, from occasionally annoyances to daily severe attacks. Most cases of RLS are diagnosed for patients aged sixty or more years, yet we are finding more young person suffers severely.

RLS is children RLS can also occur in children.  20% of adult RLS suffers recalled the onset of their symptoms between 11 and 20 years of age.