Restless leg syndrome is a neurological disorder characterized by a feeling of restlessness in one or both legs, with an urgent need to move them. What are the characteristics of this disorder and how can it be tackled? We talk about this topic with Dr. Lara Fratticci, neurologist at Humanitas.

The restless leg syndrome mainly affects women and its manifestation can be alternating and therefore it is not always easy to diagnose, especially if the symptoms are mild.


The link with insomnia

Patients who suffer from it report a feeling of discomfort in one or both legs (also involving the arms in the most serious cases) with the indifferent need to move them, for example if you are sitting for too long. The feeling of restlessness improves if the patient moves or massages his legs.

The disorder often occurs in the evening, when the patient tries to fall asleep, and can also occur at night.

“The need to move the legs to relieve them tends to worsen at night and at night due to a physiological reduction in evening levels of dopamine, a decrease that is even more significant in those suffering from this disorder. The dopaminergic system in the subcortical site, in fact, consists of neurons that control movement; a dysfunction of this system qualifies the syndrome and its symptoms, which improve with the intake of dopaminergic drugs. Those who suffer from this syndrome also tend to be affected by insomnia because the restlessness of the lower limbs finds relief only with movement, forcing the patient to get out of bed, thus affecting the quality of rest at night,” explains Dr. Fratticci.


Primary and secondary forms

This neurological disorder may have primary or secondary form. In the first case, the syndrome is familial or idiopathic and the cause is therefore unknown.

Less frequently, restless leg syndrome is secondary in form and it is therefore associated with other diseases, disorders or conditions, such as kidney failure, type 2 diabetes, peripheral neuropathies such as those related to uremia and diabetes, and changes in the extrapyramidal system such as spinal cord injury.

Other triggers can be iron deficiency anemia, pregnancy (especially in the third trimester) and neurodegenerative diseases such as Parkinson’s disease.


What to do in case of restless leg syndrome?

The diagnosis is made during a neurological examination, without the need for instrumental examinations. In cases where it is possible to identify the cause of the disturbance, direct action is taken.

The therapy is pharmacological, with the use of antiepileptic drugs, hypnotics, opiates and dopaminergic agents. The non-ergoline-related agonist class of dopamine receptors is generally used, the intake of which has a particular effect on sleep quality.


It is also a good idea to ensure good sleep hygiene and the following tips can help:

  • Take a hot bath or shower before you sleep.
  • Reduce the intake of caffeine or alcoholic beverages that interfere with sleep.
  • Dedicate yourself to a relaxing activity before you sleep.
  • Slightly massage your legs once into bed.
  • If symptoms occur during the night, get up and take two steps at home without insisting on staying in bed.