Restless leg syndrome, also called Ekbom's syndrome, is a condition that has long been misdiagnosed and misunderstood, but 5 to 10 percent of Americans suffer from this malady. The incidence of RLS increases with age; seniors are more likely to have RLS than are younger adults or children.

Patients have described their RLS symptoms as pulling, searing, drawing, tingling, bubbling or crawling beneath the skin, usually in the calf area, causing an irresistible urge to move the legs. These sensations can occur not only in the lower legs, but they can also affect the thighs, feet and even the upper body. Restless arms may be the first symptom of RLS.

Episodes of RLS most often occur between 10 p.m. and 4 a.m., being at their worst right after midnight. They typically occur at 30- to 60-second intervals. They usually ebb by morning, although as the condition progresses, people may begin to experience symptoms during the day. At night the unpleasant sensations and the resulting uncontrollable urge to move the legs can often disturb sleep. Ignoring the need to move the legs usually only allows tension to build until they jerk uncontrollably, thus making it difficult to sit through classes or meetings.

About 6 percent of Americans also experience periodic limb movement disorder. As with RLS, episodes usually occur during the night, peaking at around midnight. Leg muscles involuntarily and repetitively contract and jerk every 20 to 40 seconds during sleep. However, unlike RLS, contractions in PLMD usually do not awaken the sleeper. PLMD should not be confused with hypnic jerks, which are brief and sudden movements that occur just as people are falling asleep and jolt them awake.

A 2003 study funded by the National Institutes of Health and the RLS Foundation was conducted by autopsy of brains only from patients who had RLS. While the findings showed no unique pathological changes as seen in Parkinson's and Alzheimer's diseases, it appeared that the cells in a portion of the mid-brains of the RLS patients did not get enough iron. The study suggested that the missing iron may cause a misfiring of neural signals to the legs causing the creepy-crawly sensation. The researchers cautioned that the study's conclusions do not suggest that a patient with RLS has a dietary iron-deficiency and requires supplements. Although some patients have found temporary relief by taking iron supplements, it is vitally important that any supplement therapy be managed by a physician.

It is interesting to note that medications used to lessen RLS symptoms have included those designed to treat Parkinson's disease. Conversely, medications such as the following can worsen RLS symptoms: calcium-channel blockers (used to treat high blood pressure and heart conditions), most anti-nausea medications, some cold and allergy medications, major tranquilizers (including haloperidol and phenothiazines) and the antiseizure medication phenytoin. Beware, too, of drugs used to treat depression.

Anything that gives the jitters to the general population is going to negatively affect the senior with RLS. Caffeine-containing products, including chocolate and beverages such as coffee, tea and soft drinks should be avoided. Alcohol, smoking, obesity, heavy metal toxicity and diabetes will aggravate RLS.

Many patients who want to avoid using yet another drug have been able to relieve or lessen their symptoms by walking, stretching, taking a hot or cold bath, massaging the affected limb, applying hot or cold packs, using vibration, performing acupressure and practicing relaxation techniques (such as biofeedback, meditation, or yoga).

Some patients are getting relief by taking iron, vitamin B or folate. Because the use of even moderate amounts of some minerals (such as iron, magnesium, potassium, and calcium) can impair the body's ability to use other minerals or can cause toxicity, one should use mineral supplements only on the advice of a healthcare provider.

Getting enough sleep is important. If nighttime sleep is too erratic, daytime naps can help until the RLS has lessened. Be sure that RLS is the problem; other conditions can mimic RLS, such as muscle diseases, joint conditions, nerve problems and circulation difficulties. Feeling the need to shift frequently is a common sign of arthritis.

Many adults can trace back their first symptoms to childhood when they were told their discomfort was "growing pains." The RLS Foundation says that neurologists and specialists in sleep medicine seem to be the physicians who know the most about RLS. More information is available also from the Restless Legs Syndrome Foundation at their toll-free number, 877.463.6757. Ask for a copy of its publication, Living with Restless Legs. The foundation also offers NightWalkers, a quarterly newsletter. RLSF can provide a list of local support groups.