Restless Legs Syndrome (RLS)

Restless legs syndrome (RLS), or Willis-Ekbom disease, is a neurological sleep disorder. With it, you may feel creeping, crawling, tingling or burning sensations, usually in both legs (but can also affect the arms, chest or head). Your legs may move or twitch when you are sleeping.

Symptoms are most common when you are sitting or lying down and can ease up when you walk or stretch. You may feel a strong urge to move to make the discomfort go away. Movement can help but the symptoms often return when you stop moving.

Restless legs syndrome is common and can affect anyone. It’s most often found in women, white people and middle-aged and older adults. Symptoms often get worse as you get older. 

It can also occur in children, usually if there’s a family history of RLS. It can be hard to diagnose in children and may seem like growing pains or attention deficit hyperactivity disorder (ADHD).

RLS can be mild (occasional), moderate (symptoms once or twice a week) or severe (symptoms more than two times a week) and can interrupt your sleep, impact your activities and affect your quality of life. 

Causes of restless legs syndrome (RLS)

Various factors may trigger RLS:

• Genetics: RLS tends to run in families. It’s not clear how those genes contribute to the disorder.
• Dopamine imbalance: Dopamine is a neurotransmitter that helps regulate movement and sensations. If you have RLS, you may have an imbalance in your dopamine levels or a problem with the way your brain’s dopamine signaling pathways work. Medications that affect your dopamine levels may help reduce symptoms of RLS.
• Iron deficiency: Your body needs iron to produce dopamine, so if you don’t have enough iron you might have symptoms of RLS. Medical conditions that may cause iron deficiency, like anemia or chronic kidney disease, are linked with a higher risk of RLS.
• Medical conditions: Peripheral neuropathy, kidney failure, spinal cord conditions, sleep apnea, substance use disorder and Parkinson’s disease are linked with RLS.
• Pregnancy: RLS in pregnancy usually develops in the third trimester and goes away after you deliver.

Symptoms of restless legs syndrome (RLS)

Restless legs syndrome feels like uncomfortable or unpleasant sensations deep within the legs. It may feel like something crawling or moving beneath the skin, prickling or tingling like pins and needles, heat or burning in the legs, pulling, throbbing or aching.

Sometimes the symptoms are hard to describe, but it’s clear that moving or stretching the legs helps. The urge to move your legs may be irresistible. Symptoms can vary from person to person and may fluctuate over time.

Symptoms usually occur when you are inactive or resting, especially in the evening and at night. They can make it hard for you to fall asleep or stay asleep. You may also notice symptoms when you sit for a long time, such as during long car rides or flights or when you nap or try to relax during the day. 

RLS can impact your life and the quality of your sleep. It can interfere with activities where you need to sit for a long time, such as working at a desk, watching a movie or traveling. Symptoms can make it hard for you to relax and unwind and you may feel stressed or frustrated.

Because RLS can wake you up at night and make it hard for you to fall back asleep, you may feel tired during the day, irritable and have trouble concentrating. You may have mood changes, memory problems or lower productivity. You could develop depression or anxiety.

When to get medical help

You’ll want to consult a health care provider if your symptoms significantly impact your quality of life or interrupt your sleep. You should consider seeking help if you have:

• Ongoing sensations in your legs that bother you, especially if they happen when you’re resting or inactive.
• Trouble falling asleep or staying asleep because of the discomfort or restlessness in your legs.
• Daytime tiredness, irritability or trouble concentrating because your symptoms disrupt your sleep.
• Symptoms of RLS that get worse over time or fail to improve with self-care.

Learn more about diagnosing and treating restless legs syndrome.