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Fighting restless legs syndrome. Causes of restless legs syndrome and how to treat it

Restless legs syndrome (RLS) is a sensorimotor neurological disorder manifested by increased motor activity of the lower extremities, mainly at rest. Usually, characteristic symptoms have a pronounced circadian rhythm with onset or intensification in the evening and at night. The most common complaints of patients are disturbance and deterioration in the quality of sleep, affective and anxiety disorders, deterioration in the quality of life associated with health status and decreased performance. This disease is common among all age groups, but the number of patients increases with age. Thus, in old age it affects 9-20% of people. At least a third of RLS cases first appear between 20 and 30 years of age. In women, this disease occurs 1.5 times more often than in men, and this disproportion increases due to the fact that women more often seek medical care. Sometimes it is quite difficult for clinicians to diagnose RLS or determine the extent and severity of this disease, as well as evaluate the advantages and disadvantages of treatment. It should be noted that for doctors general practice, these problems are more acute than for narrow specialists.

According to statistics, 5-10% of the adult population suffers from restless legs syndrome. At the same time, a third of those suffering from the disease are bothered about once a week, and two thirds – from two times or more. Most often, this disease is found in adults in middle and old age, and women suffer from restless legs syndrome 1.5 times more often than men.

Restless legs syndrome, depending on the cause, can be primary or secondary. However, it has not yet been possible to find out the exact reason for the development of primary RLS, but it is assumed that it lies in malfunction some brain structures. Primary RLS occurs in close relatives. It usually appears in the first 30 years of life and is thought to be associated with defects of chromosomes 9, 12 and 14.

Secondary RLS occurs during pregnancy (usually in the second and third trimesters), with iron deficiency in the body and with end-stage renal failure. There are also known cases of the development of restless legs syndrome in diabetes mellitus, amyloidosis, rheumatoid arthritis, diseases thyroid gland, alcoholism, radiculopathy, multiple sclerosis, as well as deficiency of vitamin B12, thiamine, folic acid, magnesium. In this case, most often the disease develops after 45 years. Also, sometimes restless legs syndrome develops in those suffering from Parkinson's disease, Huntington's chorea, and Tourette's syndrome.

Unpleasant sensations in the legs can be various diseases. But if they arise at rest, disappear during movement, increase in evening time or at night, without appearing during the day, are accompanied by leg movements and problems with sleep - be sure to consult a neurologist if you suspect Eckboth syndrome.

Who is susceptible to the syndrome?

And although this disease is often confused with other diseases, for example, varicose veins of the legs, there are still groups of people who fall into the so-called risk group. Often, restless legs syndrome makes itself felt in parallel with the development of other diseases, such as kidney failure or diabetes.

People with a lack of iron and folic acid in the blood also suffer. Symptoms of such anxiety often occur in pregnant women in the second and third semesters of pregnancy, but after childbirth, most often, all discomfort quickly disappears.

Also, obese people are more susceptible to the syndrome, especially at a young age.

Oddly enough, the desire to constantly go somewhere, most often, does not arise among those who are real life moves a lot, but, on the contrary, those who lead a sedentary lifestyle.

However, in most cases, the disease is not at all associated with any additional diseases, in such cases, patients develop serious metabolic disorders. Unfortunately, what is the reason for such failures – doctors are still not able to answer this question.

Causes and consequences of RLS

Not so long ago, doctors called work disorders the cause of restless legs syndrome. nerve endings and vessels. But recent studies have shown that the disease is a mental disorder. This is due to a failure of chemical processes in the parts of the brain responsible for the motor processes of the limbs. This made it possible to single out Ekbom's syndrome as a separate section of diseases.

Observations of patients suffering from symptoms of the disease have shown that it generally begins as a concomitant to more serious problems of the body.

In addition to brain disorders, it can accompany a lack of vitamins and minerals, and it can also be caused by:

Anemia due to lack of iron, indicated by low hemoglobin levels
Damage to nerve endings due to diabetes mellitus (neuropathy)
Deficiency of B vitamins, magnesium and calcium
Taking or refusing sedatives, vasodilators and antidepressants
Kidney diseases
Nerve damage spinal cord
Arthritis of various etiologies
Lyme disease
Parkinson's disease
Smoking, alcohol and caffeine abuse
Stress and nervous disorders
Hereditary predisposition
Pregnancy

The disease develops very slowly. On early stages it may not cause much concern. Timely diagnosis and treatment can easily cope with it. But the apparent innocence of the symptoms misleads most sufferers of restless legs syndrome. People don't contact medical institutions until it leads to severe sleep disturbance and stress, and sometimes to mental disorders, from which it is no longer so easy to get rid of.

Symptoms of restless legs syndrome

The main symptoms of restless legs syndrome are sensory disturbances, which are expressed in paresthesia and movement disorders.

The disorders affect both legs, and the movements of the limbs are most often asymmetrical.

Sensory disturbances occur when a person is sitting or lying down. Symptoms are at their peak between 12 and 4 am. To a lesser extent, symptoms appear between 6 and 10 am.

Complaints that patients may make:

Tingling feeling in the legs.
Feeling of numbness in the lower extremities.
Feeling of pressure on the legs.
Itchy skin of the lower extremities.
Feeling of goosebumps running down your legs.

These symptoms are not accompanied severe pain, but they are very annoying to a person and cause him serious physical discomfort. Some patients report a dull, tingling or mild but sharp pain.

Localized discomfort mainly in the lower legs, less often affecting the feet. As the pathology progresses, the hips, arms, perineal area and even the torso are involved in the process.

In the initial stages of the development of RLS, a person begins to experience discomfort 15-30 minutes after he goes to bed. In the future, unpleasant sensations begin to disturb almost immediately after the cessation of physical activity, and then daytime hours when the legs are at rest. It is very difficult for such people to drive a car, fly, visit the theater and cinema, etc.

In general, a clear symptom of restless leg syndrome is that the person only feels uncomfortable when they are not moving. To eliminate discomfort, he is forced to move them: shake, wiggle, bend and unbend. Sometimes patients get up and stomp on the spot, massage their feet, walk around the room at night. However, after they go to bed, the discomfort returns. When a person suffers from RLS for a long time, he defines for himself a specific ritual of movements that bring him maximum relief.

At night, people experience excessive motor activity in their legs. The movements are stereotypical and constantly repeated. A person bends either the big toe or all the toes, can move the foot. In severe cases of the syndrome, people bend their legs at the hip and knee joints. Each episode of motor activity does not take more than 5 seconds. Then there is a break of 30 seconds. Such episodes are repeated for several minutes or several hours.

If the pathology has mild course, then the person himself may not even know about such a violation. It can only be diagnosed during polysomnography. When RLS is severe, the patient wakes up several times a night and cannot fall asleep for a long time.

Such pathological behavior during sleep cannot go unnoticed. During the daytime, a person feels tired and weak. His mental functions worsen, attention suffers, which affects his working capacity. Therefore, restless legs syndrome can be attributed to risk factors for the development of depression, neurasthenia, increased irritability and mental instability.

Typically, with primary restless legs syndrome, pathological symptoms persist throughout life, but their intensity varies. Stronger than man the disease begins to disturb during an emotional shock, after the consumption of drinks containing caffeine, after playing sports.

The vast majority of people indicate that the pathological symptoms, although slowly, still progress. Sometimes there are periods of calm, which are followed by periods of exacerbation. Long-term remissions, which last for several years, occur in approximately 15% of patients.

If a person has secondary restless legs syndrome, its course is determined by the underlying pathology. However, remissions are rare.

Diagnostics

During polysomnography, periodic movements in the limbs are recorded.

Precisely because the main signs of restless legs syndrome are associated with subjective sensations, which are expressed to the patient in the form of complaints, the diagnosis of this disease is based solely on clinical signs.

In this case, additional research methods are carried out to find the possible cause of the disease. After all, some pathological conditions may occur unnoticed by the patient, manifesting only as restless leg syndrome (for example, iron deficiency in the body or the initial stage of a spinal cord tumor). Therefore, such patients are given general analysis blood test, blood sugar test, general urine test, determine the level of ferritin in plasma (reflects the saturation of the body with iron), do electroneuromyography (shows the condition of the nerve conductors). This is not the entire list of possible examinations, but only those that are carried out for almost every patient with similar complaints. The list of additional research methods is determined individually.

One of the research methods that indirectly confirms the presence of restless legs syndrome is polysomnography. This is a computer study of the human sleep phase. In this case, a number of parameters are recorded: electrocardiogram, electromyogram, leg movements, chest and abdominal wall, video recording of the dream itself, and so on. During polysomnography, periodic movements in the limbs are recorded that accompany restless legs syndrome. Depending on their number, the severity of the syndrome is conditionally determined:

mild course - up to 20 movements per hour;
moderate severity - from 20 to 60 movements per hour;
severe course - more than 60 movements per hour.

Restless legs syndrome: comprehensive therapy

To alleviate the patient's condition, it is necessary to use the following treatment:

It is very important to understand that if you have restless legs syndrome, then you are sick, and the disease must be treated. You shouldn’t leave everything to chance and hope for “maybe.” Only timely assistance highly qualified specialists will be able to, if not cure, then significantly reduce your attacks.

Restless legs syndrome: treatment at home

Non-drug treatment can also bring noticeable relief. It is necessary to strictly follow the rules recommended by doctors:

Physical activity on the legs, especially before bed. But this does not mean that you need to sit in the gym for days or do weightlifting, since the load should be moderate. Yoga or Pilates are great, as are regular stretching exercises. It is worth noting that even the patients themselves claimed that the physical activity given to the legs at the onset of the disease relieved the symptoms, and the disease simply receded. But if you let everything take its course, restless legs syndrome will soon develop, and stress will not bring relief, but new pain and symptoms.
Voluntary massage and rubbing of the legs.
Contrast foot baths: alternating cold and hot water.
Mental training: Concentration will not only train the brain, but will also help cope with neuropsychiatric stress. Start drawing, weaving beads, debating, or playing strategy videos.
Physiotherapeutic procedures do not benefit everyone, but sometimes magnetic therapy, mud, paraffin and lymphatic press work wonders. All this is purely individual.
Refusal of coffee, tea and chocolate, as well as any caffeinated products.
Compliance with the daily routine: you need to go to bed at the same time. It is better to fall asleep and wake up late, then during the day you will not want to fall asleep. Make your sleeping conditions as comfortable as possible.
Do not use drugs that cause RLS.

Additional techniques

As an adjunct to drug therapy and the right image In life, when treating Ekbom syndrome, physiotherapeutic procedures are used, which include:

Vibromassage.
Magnetotherapy is the use of magnetic fields that have anti-inflammatory, analgesic and decongestant effects.
Mud applications - a method using therapeutic mud. When used, blood circulation improves, the movement of red blood cells improves, and metabolism is normalized.
Limfopress - creating pressure on lymphatic system in order to normalize metabolic processes in the body and increase the tone of the veins of the lower extremities.
Reflexology is a method in which special needles are inserted into specific points on the body.
Darsonvalization of the legs - using a special device, the impact is carried out on certain part bodies with high-frequency fast-damping current.

Prevention

Refusal bad habits(smoking, alcohol).
Compliance healthy image life:
- regular walks in the fresh air;
- physical education;
- observance of the regime of day and night (night sleep for at least 8 hours).
Balanced and rational diet: eating foods high in fiber (vegetables, fruits, greens), avoiding canned, fried, spicy, hot foods.
Timely contacting a doctor in case of health problems.
Control of arterial (blood) pressure.
Resolving conflicts at home and at work.
Refusal or limitation of coffee and strong tea consumption.
Avoid drinking caffeinated drinks (Coca-Cola).
Limiting the consumption of chocolate, cheese, and red fish (the tyramine it contains increases the manifestations of restless leg syndrome).

Restless legs syndrome was described back in the mid-twentieth century by one fairly well-known neurologist from Switzerland, Karl Axel Ekbom. And although this disease has been studied for a long time, but this problem is still very relevant.

Description of the pathology

This syndrome is a neurological disease that manifests itself as paresthesia of the lower extremities and their excessive motor activity when at rest or during sleep.

According to statistics, 10-25% of the world's population have signs of this syndrome. Although this condition can occur at any age, it is most common among middle-aged and elderly patients, although cases of restless legs syndrome have been seen in children. There is also an assumption that women suffer from this disease one and a half times more often than men.

A similar disorder often occurs in pregnant women; therefore, women experience severe insomnia and mental disorders that cannot be compatible with full pregnancy.

We will look at the treatment of restless legs syndrome in this article.

Manifestation of pathology in children

This pathology in children is often falsely attributed to a syndrome called “growing pains.” Exist clinical researches, with the help of which they found out that restless legs syndrome in childhood caused by a lack of attention from parents, resulting in psychological disorders. Other experts believe that this disorder is a consequence of motor hyperactivity in children during the day. The exact and unambiguous reasons for the development of this syndrome in children and adolescents have not yet been clarified, but it has already been proven that the disease tends to progress over the years and does not go away on its own.

Syndrome in pregnant women

Restless legs syndrome is often observed during pregnancy - in approximately 15-30% of cases. Most often, symptoms begin to appear in the third trimester, and then the disease goes away on its own during the first month of motherhood. But you also need to know that such a disorder can be directly related to existing problems in the body, including iron deficiency anemia.

Causes of restless legs syndrome

Primary cause- hereditary. This syndrome is present in 40-60% of cases in close relatives. We are talking about autosomal dominant and recessive types of inheritance.

Secondary causes of restless legs syndrome:

low level hemoglobin;
iron deficiency;
diabetes;
disruption of the endocrine organs;
long-term hypovitaminosis;
rheumatoid arthritis;
kidney diseases, leading to retention of toxic substances in the body;
obstructive pulmonary disease in chronic form;
severe poisoning alcohol;
diseases of the cardiovascular system;
in organism;
neurological disorders;
injuries of the spinal cord and peripheral nervous system, as well as peripheral neuropathies of various origins.

During pregnancy, hormonal imbalances, venous congestion in the lower extremities and a lack of folic acid and iron may occur.

Who else is having it?

Restless legs syndrome is sometimes noticed in patients suffering from the following conditions:

Parkinson's disease;
essential tremor;
Huntington's disease;
side amyotrophic sclerosis;
post-polio syndrome.

It still remains unclear whether this combination is explained by a random coincidence (due to the high prevalence of the syndrome), the presence of common pathogenetic mechanisms, or improper use of drugs.

Irrational use of drugs

Restless legs syndrome is often a side effect of certain medications (antihistamines, antidepressants, seizure medications, anti-vomiting medications, and hypertension medications). There are rarely cases when this phenomenon leads to excessive drinking high content caffeine

How does restless legs syndrome manifest? More on this later.

Symptoms

Many patients say that restless legs syndrome is when you go to bed, but can’t fall asleep. Cramps, itching, burning, crawling, numbness in the legs appear. Some describe their sensations as follows: tingling, twitching, feeling of discharge electric current, trembling, movement under the skin. As a result, there is a great desire to move the legs or other parts of the body in order to eliminate the discomfort in the limbs or at least reduce it a little. Symptoms also include one or both legs at distinct intervals. If both legs are involved at once, then they move simultaneously; in rare cases, movements of each are possible at different frequencies.

Peculiarity

Distinctive feature: pain during the syndrome depends on motor activity and posture. It happens that pain appears and intensifies when a person is motionless or in a sitting position, but more often they appear when lying down and decrease when moving. In order to eliminate the discomfort that arises, a person tries to stretch or bend his limbs, rub, massage, shake them, turn around in bed, get up and move around the room, or simply shift from foot to foot. Everyone has their own set of movements that help them eliminate discomfort in their limbs. In this case, the discomfort becomes less or goes away, but as soon as a person lies down, and sometimes just stops moving, these sensations are repeated again.

Manifestations of signs of this syndrome usually have a clear schedule, appearing and growing in the evening or at night. In extremely severe cases, the typical circadian rhythm disappears, and discomfort is constantly present.

It happens that the symptoms of the idiopathic or primary syndrome increase over time, but some people can go for weeks or months without observing any signs of illness at all. If restless legs syndrome appeared due to an illness, against the background of taking medications or pregnancy, then it can disappear as soon as the provoking factor disappears. How to treat restless legs syndrome is of interest to many. More on this later.

Treatment for restless legs syndrome

With a syndrome, treatment should first of all be directed to the elimination of the primary disease. So, with diabetes, you need to normalize the balance of glucose and insulin, take Metformin so that the pain in the lower extremities disappears, and you also need to make up for the lack of iron, folic acid and other vitamins and minerals. Therapy is symptomatic, and along with taking medications, they also resort to non-drug measures. What does it mean?

Non-pharmacological measures

Non-pharmacological measures include the following:

moderate physical exercise during the day;
an evening walk;
evening contrast shower;
a balanced diet with the exclusion of coffee, strong teas and other products that contain caffeine (chocolate, Coca-Cola, etc.) in the evening and during the day;
restriction in the consumption of alcoholic beverages;
to give up smoking;
establishing a normal, full-fledged daily routine.

Baths and massage

Warm foot baths or a light warming massage before bed will definitely help improve the condition. It is recommended to sleep in a cool, quiet room. Physiotherapeutic procedures indicated:

vibration massage;
magnetotherapy - the use of magnetic fields that have an analgesic, anti-inflammatory and anti-edematous effect;
use of therapeutic mud applications.

Since the causes and treatment of restless legs syndrome are interrelated, it is necessary, as already mentioned, to direct all actions towards eliminating the provoking factors.

It is also necessary to observe a calm sleep pattern, create comfortable conditions for falling asleep (well-ventilated, quiet room). Diuretics should be avoided. A very useful habit is to go to bed and get up at the same time every day. Gradually you need to reduce the intensity of lighting in the room about an hour before bedtime, you can also read some interesting book before bedtime.

Use of drugs

Special medications for restless legs syndrome should be prescribed only in cases where the pathology significantly affects the patient’s vital functions, thereby causing stable sleep disturbance. In cases of severe discomfort, you have to choose drugs from four main groups:

dopaminergic agents;
anticonvulsants;
opioids;
benzodiazepine.

Benzodiazepines promote sleep, but can become addictive if used over a long period of time. There are also side effects from their use - drowsiness during the day, low libido, and occasional confusion at night. Therefore, such drugs can only be used for a strictly limited time and under the supervision of a doctor.

Dopaminergic medications are very effective for the symptoms of restless legs syndrome. But they can cause side effects such as dry mouth, headaches, nausea, dizziness, muscle spasms and irritability. True, in most cases this all manifests itself in a mild way.

Dopamine receptor agonists (DRAs) can be taken daily for a long time without significant harm to health. Side effects from them: headache, nausea, fatigue, dizziness, drowsiness during the day. In order to avoid such manifestations, start taking the drug with small doses. It should be noted that, while eliminating the symptoms of restless legs syndrome, dopaminergic drugs do not always help normalize sleep, so they must be taken in combination with sedatives.

Folic acid, magnesium, iron, vitamins C, B, E are taken to replenish the body with useful substances. In rare cases, it happens that particularly intense pain cannot be eliminated by taking other drugs, then opioids are prescribed. But their use can be dangerous because they are narcotic substances and can cause addiction. Anticonvulsants are used as adjuncts for restless legs syndrome. During pregnancy, second-generation iron supplements are recommended that do not harm the baby.

Mirapex is very effective for restless legs syndrome. Eases negative symptoms. Can be used for a long time.

What to exclude?

It is necessary to avoid the use of substances and medications that can increase the manifestations of restless legs syndrome:

Preparations containing alcohol. This type of alcohol intake can and can alleviate the symptoms for a while, but in the future the manifestations of the disease will worsen significantly.
Antiemetic drugs such as Reglan, Metoclopramide, Compazin, Prochlorperazine. They significantly aggravate the symptoms of the syndrome. If there is an urgent need to suppress nausea and vomiting, it is necessary to use Kytril or Zofran.
Antihistamines- Diphenhydramine and other over-the-counter antipyretics.
Tricyclic antidepressants - Azafen, Amitriptyline and the like.
Selective serotonin reuptake inhibitor (Prozac, Trazodone), although in some cases a positive effect was observed when taking these drugs, especially Bupropion.
Calcium channel blockers (Finoptin, Corinfar).
Typical antipsychotics(phenothiazines).
Atypical antipsychotics(Risperidone, Olanzapine).
Anticonvulsants (Zonisamide, Metsuximide, Phenytoin).

Lifestyle

If you still can’t fall asleep due to discomfort in your legs, doctors advise:

change body position in bed;
take aspirin - this will muffle the symptoms, but do not forget that aspirin will not relieve you of the disease and is only good as a one-time measure;
stand up and walk around when your legs need movement, do not deny them;
wear cotton socks.

Prevention

Specific preventive measures There is no cure for primary restless legs syndrome. You can only delay its development. To do this, you need to walk a lot, avoid drinking coffee, alcohol and tobacco, and eat a balanced diet.

Prevention of the secondary syndrome consists in the timely treatment of diseases that cause this pathology. Only, for example, during pregnancy no treatment can help. In such cases, the doctor should simply explain to the woman that this is a short-lived phenomenon, and everything should pass after childbirth.

Uncomfortable sensations in the legs that occur mainly at night, provoking the awakening of the patient and often leading to chronic insomnia. In most patients, it is accompanied by episodes of involuntary motor activity. Restless legs syndrome is diagnosed based on the clinical picture, neurological examination, polysomnography data, ENMG and examinations aimed at establishing causal pathology. Treatment consists of non-drug methods (physiotherapy, sleep ritual, etc.) and pharmacotherapy (benzodiazepines, dopaminergic and sedatives).

Causes of restless legs syndrome

There are idiopathic (primary) and symptomatic (secondary) restless legs syndrome. The former accounts for more than half of the cases of the disease. It is characterized by an earlier onset of clinical symptoms (in the 2nd-3rd decade of life). There are familial cases of the disease, the frequency of which, according to various sources, is 30-90%. Recent genetic studies of RLS have revealed its association with defects in certain loci of chromosomes 9, 12 and 14. Today, it is generally accepted to understand idiopathic RLS as a multifactorial pathology that is formed under the influence of external factors against the background of a genetic predisposition.

Symptomatic restless legs syndrome manifests itself on average after 45 years of age and is observed in connection with various pathological changes occurring in the body, primarily metabolic disorders, damage to the nerves or blood vessels of the lower extremities. Most common reasons secondary RLS are pregnancy, iron deficiency and severe renal failure leading to uremia. In pregnant women, Ekbom syndrome occurs in 20% of cases, mainly in the 2nd and 3rd trimesters. As a rule, it goes away a month after birth, but in some cases it can have a persistent course. The incidence of RLS in patients with uremia reaches 50%, and it is observed in approximately 33% of patients on hemodialysis.

Restless legs syndrome occurs with a deficiency of magnesium, folic acid, cyanocobalamin, thiamine; for amyloidosis, diabetes, cryoglobulinemia, porphyria, alcoholism. In addition, RLS can be observed against the background of chronic polyneuropathy, diseases of the spinal cord (discogenic myelopathy, myelitis, tumors, spinal injuries), vascular disorders(chronic venous insufficiency, obliterating atherosclerosis of the lower extremities).

The pathogenesis has not been fully studied. Many authors adhere to the dopaminergic hypothesis, according to which RLS is based on dysfunction of the dopaminergic system. It is supported by the effectiveness of therapy with dopaminergic drugs, the results of some studies using PET, and an increase in symptoms during the period of daily decrease in dopamine concentration in cerebral tissues. However, what kind of dopamine disorders? we're talking about, It's not clear yet.

Symptoms of restless legs syndrome

The basic clinical symptoms are sensory (sensitive) disorders in the form of dys- and paresthesia and motor disorders in the form of involuntary motor activity. These symptoms affect mainly the lower extremities and are bilateral, although they can be asymmetrical. Sensory disorders appear at rest in a sitting position, and more often - lying down. As a rule, their greatest severity is observed in the period from 0 o'clock to 4 o'clock in the morning, and the least - in the interval from 6 o'clock to 10 o'clock in the morning. Patients are concerned about various sensations in the legs: tingling, numbness, pressure, itching, the illusion of “goosebumps running down the legs” or the feeling that “someone is scratching.” These symptoms are not acute painful in nature, however, they are very uncomfortable and painful.

Most common initial site of occurrence sensory impairment are lower legs, less often - feet. As the disease develops, paresthesia covers the thighs and can occur in the arms, perineum, and in some cases on the torso. At the onset of the disease, discomfort in the legs appears after 15-30 minutes. from the moment the patient went to bed. As the syndrome progresses, their onset occurs earlier, even during the daytime. Distinctive feature sensory disorders in RLS is their disappearance during the period of physical activity. To relieve discomfort, patients are forced to move their legs (bend-unbend, turn, shake), massage them, walk in place, and move around the room. But often, as soon as they lie down again or stop moving their legs, unpleasant symptoms are coming back again. Over time, each patient develops an individual movement ritual that allows them to most effectively get rid of discomfort.

About 80% of patients with Ekbom syndrome suffer from excessive motor activity, episodes of which bother them at night. Such movements are of a stereotypical, repetitive nature and occur in the feet. They represent dorsiflexion thumb or all toes, spreading them to the sides, flexion and extension of the entire foot. In severe cases, flexion-extension movements in the knee and hip joints may be observed. An episode of involuntary motor activity consists of a series of movements, each of which takes no more than 5 s, the time interval between series is on average 30 s. The duration of the episode varies from several minutes to 2-3 hours. In mild cases, these movement disorders go unnoticed by the patient and are detected during polysomnography. In severe cases, motor episodes lead to night awakenings and may occur several times during the night.

The consequence of sensorimotor disorders that occur at night is insomnia. Due to frequent awakenings at night and difficulty falling asleep, patients have poor sleep and feel groggy after sleep. During the day, they experience decreased performance, the ability to concentrate suffers, and fatigue occurs. As a result of sleep disturbances, irritability, emotional lability, depression, and neurasthenia may occur.

Diagnosis of restless legs syndrome

The diagnosis of RLS does not present significant difficulties for a neurologist, but requires a thorough examination of the patient for the presence of the disease that caused it. If the latter exists, corresponding changes may be detected in the neurological status. With the idiopathic nature of RLS, the neurological status is unremarkable. For diagnostic purposes, polysomnography, electroneuromyography, and examination of the levels of iron (ferritin), magnesium, folic acid, and vitamins are performed. B, rheumatoid factor, assessment of kidney function (blood biochemistry, Rehberg test), ultrasound of the vessels of the lower extremities, etc.

Polysomnography makes it possible to record involuntary motor acts. Considering that their severity corresponds to the intensity of the sensitive manifestations of RLS, polysomnography data in dynamics can be used to objectively assess the effectiveness of the therapy. It is necessary to differentiate restless legs syndrome from night cramps, anxiety disorders, akathisia, fibromyalgia, polyneuropathy, vascular disorders, arthritis, etc.

Treatment for restless legs syndrome

Therapy for secondary RLS is based on treatment of the causative disease. A drop in serum ferritin concentration to less than 45 mcg/ml is an indication for the prescription of iron medications. When identifying other deficiency states their correction is carried out. Idiopathic restless legs syndrome has no etiopathogenetic treatment; it is treated with drug and non-drug symptomatic therapy. It is necessary to review the medications taken before the diagnosis of RLS. Often they are antipsychotics, antidepressants, calcium antagonists and other medications that enhance symptoms.

As a non-pharmacological measure important have a normalized regimen, moderate daytime physical activity, walks before bed, a special ritual of falling asleep, eating without consuming caffeine-containing foods, giving up alcohol and smoking, and a warm foot bath before bed. In a number of patients, certain types of physiotherapy (magnetic therapy, darsonvalization of the legs, massage) have a good effect.

Restless legs syndrome requires drug treatment if symptoms are severe and chronic disorders sleep. In mild cases, it is sufficient to prescribe sedatives of plant origin (valerian, motherwort). In more severe cases, therapy is carried out with one or more pharmaceuticals from the following groups: anticonvulsants, benzodiazepines (clonazepam, alprazolam), dopaminergic drugs (levodopa, levodopa + benserazide, bromocriptine, pramipexole). While effectively eliminating the symptoms of RLS, dopaminergic pharmaceuticals do not always solve sleep problems. In such situations, they are prescribed in combination with benzodiazepines or sedatives.

Treatment of RLS during pregnancy requires special care. They try to use only non-drug methods of therapy, mild sedatives, and, if indicated, iron or folic acid supplements. If necessary, small doses of levodopa or clonazepam can be prescribed. Patients with depressive syndrome Antidepressants and antipsychotics are contraindicated; MAO inhibitors are used in therapy. Opioid pharmaceuticals (tramadol, codeine, etc.) can significantly reduce restless legs syndrome, however, due to the likelihood of developing addiction, they are used only in exceptional cases.

Forecast and prevention of restless legs syndrome

Idiopathic restless legs syndrome is usually characterized by a slow progression of symptoms. However, its course is uneven: there may be periods of remission and periods of worsening symptoms. The latter are provoked by intense exercise, stress, caffeine-containing products, and pregnancy. Approximately 15% of patients experience long-term (up to several years) remissions. The course of symptomatic RLS is related to the underlying disease. In most patients, adequately selected therapy can achieve a significant reduction in the severity of symptoms and a significant improvement in the quality of life.

Prevention of secondary RLS includes timely and successful treatment of kidney diseases, vascular disorders, spinal cord lesions, rheumatic diseases; correction of various deficiency conditions, metabolic disorders, etc. The prevention of idiopathic RLS is facilitated by compliance normal mode day, avoidance stressful situations and excessive exercise, avoidance of alcohol and caffeine-containing drinks.

Willis disease is a common disease nowadays neurological disease, popularly called restless legs syndrome. Expressed as discomfort in the legs. Because of this condition, you want to constantly move your legs, itching, burning, and “goosebumps” appear on the skin. The pathology is unpleasant - after a hard day at work it is impossible to sleep or lie down in a calm state.

The syndrome occurs most often in people over 40 years of age, but young people are also affected. The disease occurs more often in women than in men. This is explained by the fact that men have a stronger nervous system. The causes of the disease vary.

What it is?

Restless legs syndrome (RLS) is a condition characterized by unpleasant sensations in the lower extremities that appear at rest (usually in the evening and at night), force the patient to make movements that relieve them and often lead to sleep disturbances.

Current population studies indicate that the prevalence of RLS is 2-10%. RLS occurs in all age groups, but is more common in middle and old age. RLS causes approximately 15% of cases chronic insomnia- insomnia.

Causes

Primary syndrome is poorly studied and affects young people under 30 years of age. Not associated with major diseases, it accounts for up to 50%. Accompanies a person throughout his life, alternating periods of progression and remission. Occurs suddenly, the reasons are not clear, it may be:

heredity in 20-70% of cases;
disturbances in the functioning of the central nervous system;
psychological circumstances (stress, depression, fatigue).

Secondary syndrome - manifests itself against the background of a primary (neurological or somatic) disease, disappears after their elimination. Frequently encountered:

disruption of blood supply;
kidney diseases;
vitamin deficiency (group B) and magnesium deficiency;
diabetes mellitus, thyroid diseases;
abuse of alcohol, tobacco, caffeine;
treatment with certain medications.

Secondary syndrome occurs after 40 years of age or later. The exception is pregnancy. More than 16% of pregnant women suffer from this disease, 3 times more than non-pregnant women. There is a possibility of genetic transmission of RLS from mother to fetus, which poses a threat to pregnancy.

Pathogenesis

The effectiveness of dopaminergic drugs and the possibility of worsening symptoms under the influence of antipsychotics indicate that a key element in the pathogenesis of RLS is a defect in dopaminergic systems. Clear circadian rhythm clinical manifestations RLS may reflect the involvement of hypothalamic structures, in particular the suprachiasmatic nucleus, which regulates the daily cycles of physiological processes in the body.

It is possible that in some patients with RLS, polyneuropathy, iron deficiency, coffee abuse or other factors only reveal the existing hereditary predisposition, which partly blurs the line between idiopathic and symptomatic variants of RLS.

Symptoms of RLS

The symptom is characterized by the occurrence of unpleasant sensations of a piercing, scraping, itching, pressing or bursting nature in the lower extremities. The onset of symptoms mainly occurs at rest, with physical activity they are significantly reduced.

To alleviate the condition, patients resort to various manipulations - stretching and bending, massaging, shaking and rubbing their limbs; during sleep they often toss and turn, get out of bed and walk from side to side, or shift from foot to foot. This activity helps stop the symptoms of restless legs syndrome, but as soon as the patient goes back to sleep, or simply stops, they return. A characteristic feature syndrome is the manifestation of symptoms at the same time, on average it reaches its maximum severity in the period from 12 am to 4 am, the minimum occurs from 6 to 10 am.

IN advanced cases, at long absence treatment, the circadian rhythm of restless legs syndrome disappears, symptoms appear at any time, even while sitting. This situation significantly complicates the patient’s life - it is difficult for him to withstand long trips in transport, work at the computer, attend cinemas, theaters, etc.

Due to the need to constantly move during sleep, over time, the patient begins to experience insomnia, which leads to rapid fatigue and drowsiness during the daytime.

Diagnostics

Basic diagnostic methods:

Blood test for iron, magnesium and folic acid levels. Helps to determine the deficiency of the listed elements, which may be provoking factors of pathology.
Electroneuromyography is a method of studying nerves and muscles using special equipment. In this case, sensitive sensors are connected to different areas body and diagnose the degree of electrical excitability of a particular muscle group.
Polymonography - A complex approach, allowing to diagnose motor activity during sleep. Special sensors record awakenings and muscle activity. Unlike electroneuromyography, the person is in a sleeping state.

How to treat restless leg syndrome?

A certain algorithm for the treatment of restless legs syndrome has been developed, which includes a number of procedures. This includes:

help from a psychotherapist;
folk remedies and homeopathy;
drug therapy;
physiotherapy and exercise therapy;
self-help, bedtime ceremony.

Once the diagnosis is made, comprehensive treatment of Ekbom's disease can begin.

Drug treatment

IN cases of lung During the course of the disease, only these measures may be sufficient, and the disease will recede. If they do not help, and the disease causes persistent disruption of sleep and vital functions, then they resort to medications.

Medicines used for illness:

Dopaminergic drugs (preparations containing L-DOPA - Nakom, Madopar, Sinemet; dopamine receptor agonists - Pramipexole Pronoran, Bromocriptine). These are the first-line drugs of choice; treatment begins with them. For medications containing L-DOPA, the initial dosage is 50 mg levodopa 1-2 hours before bedtime. If this is not enough, then after about a week the dose is increased by another 50 mg. The maximum dose is 200 mg. Dopamine receptor agonists have an effect comparable in effect to L-DOPA drugs. Pramipexole is prescribed starting from 0.125 mg, the dosage can be increased to 1 mg, Bromocriptine - from 1.25 mg (up to 7.5 mg), Pronoran - from 50 mg (up to 150 mg). If one dopamine receptor agonist is ineffective, it is advisable to replace it with another.
Benzodiazepines. Among this chemical group, Clonazepam (from 0.5 mg at night and up to 2 mg) and Alprazolam (from 0.25 mg to 0.5 mg at night) are most often used. Benzodiazepines have a greater effect on sleep than on discomfort and periodic movements in the legs, so they are considered “backup” drugs for the treatment of restless legs syndrome.
Anticonvulsants (Gabapentin, Neurontin, Carbamazepine) and opioid drugs (Tramadol, Codeine, Dihydrocodeine, Oxycodone). These drugs are used as a last resort only if dopaminergic and benzodiazepine drugs are ineffective or produce significant side effects. Gabapentin is prescribed in increasing dosages, starting with 300 mg and reaching a maximum dose of 2700 mg (stopping at the dose that has an effect). The entire dose is taken at night in one dose. Tramadol is taken 50-400 mg at night, Codeine - 15-60 mg, Dihydrocodeine - 60-120 mg, Oxycodone - 2.5-20 mg. These narcotic drugs are used only in particularly severe cases of restless leg syndrome because they can be addictive.

Willys disease is insidious in that often patients require long-term use drugs, so the doctor tries to select the minimum dosages of drugs to relieve symptoms and have a gentle toxic effect on the body.

It is especially difficult to treat pregnant women. IN similar cases the specialist tries to identify and eliminate the cause of the disease. In most cases, the fault is the lack of trace elements, especially iron. This condition is normalized after a course of iron-containing drugs. If more serious disorders are detected in the body, doctors advise eliminating the symptoms of restless legs syndrome in pregnant women. non-drug methods, A small doses medications (usually Clonazepam or Levodopa) are prescribed for a short period of time and only in extreme cases.

Additional techniques

As a complement to drug therapy and proper lifestyle in the treatment of Ekbom syndrome, physiotherapeutic procedures are used, which include:

Vibromassage.
Reflexology is a method in which special needles are inserted into specific points on the body.
Magnetotherapy is the use of magnetic fields that have anti-inflammatory, analgesic and decongestant effects.
Darsonvalization of the legs - using a special device, a high-frequency, rapidly decaying current is applied to a certain part of the body.
Lymphopress is the creation of pressure on the lymphatic system in order to normalize metabolic processes in the body and increase the tone of the veins of the lower extremities.
Mud applications - a method using therapeutic mud. When used, blood circulation improves, the movement of red blood cells improves, and metabolism is normalized.

Folk remedies in the fight against RLS

To alleviate the condition of restless legs, a lot of tips are described. traditional medicine that can be used together with complex treatment:

Bay oil. Add 30 g of bay leaf to 100 ml of olive oil and let the liquid brew in a dark place for about 2 weeks. With the resulting tincture, you should do a foot massage every night before going to bed.
Soothing tea. This drink will help improve sleep, calm and relax your muscles. You will need a mixture of valerian roots, oregano and mint herbs. Additionally, you need to wash 10 rose hips. You can use both dried and fresh versions. Next, you need to place rose hips and 1 tsp in the kettle. mixtures of herbs. Then pour 400 ml of boiling water over everything and let stand for at least 40 minutes. You need to take this tea 2 hours before bedtime for a month, 1 glass.
Horseradish tincture. Pour crushed roots and leaves of horseradish with alcohol or vodka and leave for 4–5 days in a dark place. Rub your feet regularly with this product.
Healing bath. It is necessary to prepare a decoction of wormwood, rosemary and linden. All herbs need to be mixed and 3 tbsp. l. pour 1 liter of boiling water. Cook for 15 minutes. Then judge, filter and add the liquid to foot bath. For 3 liters of water you need 1 liter of decoction. The temperature must be at least 38 degrees. Exposure time 15 minutes. Such baths should be done every other day for a month.
Golden mustache tincture. Rub the lower limbs with pharmaceutical tincture before going to bed.
Hawthorn infusion. Brew 1 tbsp. l. hawthorn berries with a glass of boiling water and drink the drink shortly before bed. This will calm you down nervous system and will help relieve discomfort in the legs.

You should not self-medicate, especially if you are not sure of your diagnosis! Consult a doctor who can confirm or refute your suspicions of restless legs syndrome, and also recommend how to cope with the pain.

Treatment at home

At home, you can completely follow all the measures that will reduce the symptoms of the disease to a minimum.

It is imperative to create your own sleep schedule - fall asleep and wake up at the same time. If a patient suffers from neuropsychiatric disorders, the doctor will definitely advise training the mind.
Physical exercise. Moderate physical activity has a positive effect on the condition of the legs. During the day and before bed, it is useful to do exercise therapy, walk, do Pilates, swimming, yoga or stretching. But it's too much active species sports can provoke an increase in symptoms, so running, jumping, football and volleyball are contraindicated for people suffering from Willis disease.
Contrasting douches. Take contrasting foot baths, alternating cold and hot water.
Hobbies. At home you can find something to do: drawing, knitting, reading. Concentration helps relieve stress.
Systematic foot massage. Rubbing the lower extremities before bed can reduce discomfort and make it easier to fall asleep.

You can take cream or resort to the folk remedies that we indicated earlier. Be sure to avoid caffeine-containing products. Eat iron-containing foods and sleep in cotton socks. Some sources talk about the benefits of wearing sheep wool socks. Don't overeat at night. Having received a boost of energy, it will be more difficult for the body to fall asleep.

Prevention

There is no consensus among patients on how to get rid of unpleasant attacks in the legs at night. Each patient has his own methods and means. We can only note that to reduce night attacks it is useful to carry out preventive measures:

Cancel late dinner, do not go to bed on a full stomach;
Yoga or Pilates classes;
Swimming;
In the autumn and spring, taking vitamins;
Change your working position frequently, take breaks with small gymnastic exercises;
Walk outside before bed;
Wear only cotton clothes, no synthetic materials. Feet should always be warm.

Generally specific prevention There is no hereditary form of restless legs syndrome. The main preventive measures are aimed at treatment primary diseases, which over time can lead to the development of polyneuropathy and disruption of the dopaminergic system.

Restless legs syndrome affects people of all ages, but more often than others it occurs in middle-aged and retired people, as well as pregnant women in the second and third trimester. Research has found that up to 10% of the world's population suffers from RLS of varying severity.

Kinds

There are two types of disease:

Primary (idiopathic).
Symptomatic.

Idiopathic restless legs syndrome — the most common type of pathology. It is characterized by earlier manifestation (in childhood). There are family cases of the problem. According to various sources, the frequency of such cases can reach 30-90%. Genetics have discovered a connection between the formation of pathology and disorders in the structure certain chromosomes. Scientists have come to the conclusion that the idiopathic form is a pathology that occurs under the influence of many negative factors in the presence of a genetic predisposition.

The symptomatic form manifests itself no earlier than in adulthood (after 45 years) and is a consequence of concomitant pathologies of the body - metabolic disorders, diseases of the nervous system and blood vessels of the lower extremities. , but after childbirth the symptoms disappear.

Causes of restless legs syndrome

To appoint a competent and successful treatment important to install the right reason development of pathology:

Genetics. In the idiopathic form without concomitant pathologies of the nervous system and other diseases of the body, the cause is always poor heredity. Primary restless legs syndrome, when properly diagnosed, is detected quite early - before the age of 30.
Associated pathologies. The cause of RLS may lie in dysfunction of the nervous system, which reduces dopamine metabolism in the central nervous system. Factors that cause such disorders include kidney failure, diabetes, and brain injury. The syndrome can also develop with diseases such as multiple sclerosis, Parkinson's disease, pathologies of the cardiovascular system. Once these causes of RLS have been established, there is no point in fighting the symptoms; correct therapy underlying disease.
Pregnancy. According to statistics, symptoms of restless legs syndrome occur during pregnancy in 15-20% of cases. The reason for this is the provoking factors that accompany pregnancy - hormonal changes in the body, increased load on the lower limbs due to weight gain, neurological disorders due to increased nervousness and worries about the unborn baby.
Bad habits. Both primary and secondary forms of RLS can occur with alcohol abuse, smoking, and drinking in excess of drinks with a high caffeine content (energy drinks, coffee, strong black tea). Any bad habits affect the entire body as a whole, and to a large extent this effect also affects the functioning of the nervous system.
Medications. A side effect after taking a number of medications can be the development of RLS. Such drugs primarily include those that contain caffeine (analgesics), as well as antidepressants, antipsychotics, antiallergic drugs, and antiemetics.

Doctors note that recently restless legs syndrome has become an increasingly common pathology among all segments of the population. The reason lies in the very way of life of people - increased stress, constant tension, work associated with both long-term sitting position and with increased physical activity.

If you notice symptoms of RLS, you need to take immediate action. The pathology will not go away on its own; it requires identification of provoking factors, their elimination and further treatment of the disease.

Symptoms of RLS

Restless legs syndrome is characterized by the following symptoms:

The occurrence of painful sensations in the lower extremities, expressed in the form of itching in the legs, twitching of nerve endings, pain. Patients cannot accurately describe the pain factor: some complain of aching pain, others of spontaneous pain. different parts legs The sensations are smooth, they are not concentrated at one point all the time and change localization, flowing from one place to another.
RLS is characterized by the manifestation of symptoms only when the legs are at rest, most often when the patient falls asleep. Due to the constant desire to change the position of the body, the brain cannot go into sleep mode and turn off the nervous system, so chronic insomnia occurs. Such symptoms (selective in time of onset) are called circadian - occurring with a certain rhythm. In the morning and afternoon hours the symptoms do not bother the patient, he can take a little nap, but good sleep he still doesn't have enough.
Unpleasant sensations disappear with the movement of the lower extremities, hence the name of the pathology. To get rid of the irritating factor, patients begin to jerk their legs, change their position; with obsessive pain, a person can get up and start walking around the room, but as soon as he goes back to bed, the symptoms return.
Involuntary movements of the lower extremities sometimes occur even in a state of complete sleep. If the patient manages to fall asleep and enter the slow-wave sleep phase, he may continue to unconsciously jerk his limbs. Such movements may occur only a few times, or may last throughout the night, depending on the severity of the disease.

From the above, it is clear that restless legs syndrome is expressed in one striking symptom - unpleasant sensations in the limbs in a state of complete rest. But these sensations are subjective; no doctor will give a typical picture of their manifestation. During a neurological examination of patients with RLS symptoms, physicians most often do not detect specific focal pathology, sensory impairment, or reflex distortion. This means that the pathology itself does not manifest itself in any way at the time of examination, which makes it difficult to diagnose.

Diagnosis of the disease

It is worth noting that, despite its prevalence, the diagnosis of “restless legs syndrome” (the causes and treatment are described in the article) is not given to every patient with characteristic symptoms. The problem is the difficulty of diagnosing the disease. The correct conclusion is made only in 8–10%; in other cases, patients are treated for neurological pathologies. If insomnia occurs due to discomfort in the legs before going to bed, it is important to contact a highly qualified specialist - a somnologist. Somnology studies specifically sleep disorders, so the doctor will be able not only to determine the root cause of insomnia, but will also prescribe related examinations from other specialists, which is not always done, for example, by a neurologist.

It is important to collect a family history before making a diagnosis. If a factor of chronic insomnia is identified among close relatives of the patient, there is a high probability of an idiopathic form of the disease caused by a hereditary predisposition. In this case, a geneticist will be involved in making a diagnosis.

Women with characteristic symptoms take a pregnancy test, since hormonal changes in the body are often the cause of the problem.

Patients are prescribed blood tests to detect a lack of minerals and vitamins, diabetes mellitus, and iron deficiency anemia. The doctor may also order tests to detect spinal cord tumors, problems with the heart, kidneys and lungs, and thyroid function.

After the results are obtained, special examinations:

An electroencephalogram can detect neurological disorders. Eg, convulsive syndrome often confused with RLS;
electroneuromyography provides the ability to assess the quality of conduction of nerve endings;
Polysomnography helps to identify pathology in its uncharacteristic course, detects movements of the limbs in any phase of sleep, and not only when the patient falls asleep and when he is simply at rest. The same technique allows you to determine the severity of the disease. No more than 20 movements within an hour indicate mild form pathology, over 60 - about its severe course.

To make an accurate diagnosis, your doctor may prescribe special dopaminergic medications. If, after taking a course of such drugs, the patient reports the disappearance of symptoms, it means that it was restless leg syndrome that was bothering him. This diagnostic is based on the study of RLS and the establishment of a direct connection between this pathology and the number of dopamine receptors involved in the transmission of nerve impulses.

Drug treatment

Therapy is highly individual for each patient, but general principles on how to treat restless legs syndrome still exist:

Dopaminergic medications. The main effect of this group of drugs is aimed at the peripheral nervous system. Levodopa is most often prescribed as a drug for the treatment of Willis disease. Taking the medication is sometimes accompanied by muscle spasms, nausea, and dizziness.
Benzodeazepines - Diazepam, Mirapex and others. Medicines whose main effect is a hypnotic and sedative effect. The drugs do not treat restless legs syndrome itself, but they help to significantly improve the quality of sleep and reduce anxiety. Medicines are highly addictive; even after curing the disease, patients cannot sleep normally all night without taking the drug. Other side effects include daytime sleepiness and decreased concentration and alertness.
Vitamins - multivitamin complexes containing folic acid, magnesium, iron, vitamins C, E, group B are recommended for patients with mild forms of pathology, pregnant women and the elderly, since discomfort in the lower extremities is sometimes provoked by a banal deficiency useful substances in organism.
Anticonvulsants are prescribed individually for severe disease, when basic therapy does not give a positive result.

Only the attending physician can prescribe drug treatment! Uncontrolled use of drugs can lead to depletion of the nervous and cardiovascular systems, mental disorders, and impaired psychomotor functions.

Treatment at home

Treatment for restless legs syndrome can begin before your appointment. drug therapy folk remedies that can temporarily relieve symptoms, relieve sleepless nights:

Soothing decoctions and tinctures of motherwort, valerian, lemon balm, linden. These folk remedies, in moderate quantities, can help relieve tension, relieve fatigue, eliminate spasms and cramps of the lower extremities, and improve the quality of sleep. Decoctions are taken before bed, half a glass, and tinctures - 20-25 drops.
Laurel oil helps relax the muscles of the limbs, relieves spasms, and has a warming effect. Crushed bay leaves should be placed in a dark glass container and poured vegetable oil. The container is placed in a cool, dark place for 5 days. The oil is rubbed into the feet with light massage movements before going to bed.
Lemon juice and vinegar. Rubbing vinegar or vinegar on your feet before bed will help get rid of discomfort. lemon juice. This must be done carefully so as not to burn the skin.
Foot baths with hot water will help alleviate restless legs syndrome and soothe muscles, especially if the work involves standing on your feet for a long time during the day. You can add a decoction of chamomile, calendula, nettle, and sage to the bath. The water temperature should be tolerable for your feet, not too hot. The duration of the procedure is 10-15 minutes before bedtime.

The above folk remedies provide a temporary effect when the symptoms of the disease often worsen due to increased fatigue and tension in the legs, but for the full treatment of the disease, medical assistance is required.

If restless legs syndrome occurs in a mild form, simple preventive measures will help get rid of the discomfort before bed:

Establishing a specific night sleep routine. If a person finds that discomfort occurs late in the evening before going to bed, you can try changing your daily schedule so that you can sleep longer in the morning. Have a good sleep contribute to a comfortable pillow, the right orthopedic mattress, exclusion of external irritating sounds, cool room.
. Hiking in the evening, swimming and yoga help restore strength and calm the nerves.
Quitting bad habits and caffeine consumption. If you suffer from RLS, you will have to exclude from your diet not only coffee and black tea, but also any other products containing caffeine, such as energy drinks, chocolate, cola. Alcohol and nicotine also increase symptoms.
Foot massage. Regularly rubbing your lower limbs with oils before bed can help relieve discomfort and make it easier to fall asleep.
Refusal of medications, one of the side effects of which is the development of RLS.

What is restless legs syndrome? This is a serious pathology, which is impossible to get rid of on your own. An integrated approach to solving the problem is required. Only a correct diagnosis, medical support, and controlled intake of prescribed medications will allow you to cure the disease and forget about sleepless nights forever.