Restless Legs Syndrome (RLS)

Restless Legs Syndrome (RLS), also known as Willis-Ekbom Disease, is a neurologic sleep-related movement disorder that causes uncomfortable sensations in the legs and an overwhelming urge to move them. Symptoms typically occur during periods of rest, particularly in the evening or at bedtime, making it difficult to fall asleep and remain asleep throughout the night.

Patients commonly describe sensations as crawling, tingling, pulling, aching, itching, burning, or “electric” feelings deep within the legs. Although moving the legs temporarily relieves discomfort, symptoms often return shortly afterward, creating a frustrating cycle that interferes with restorative sleep.

At The Medical Group of New Jersey, our Sleep Medicine specialists evaluate the underlying causes of RLS and develop individualized treatment plans that address both symptoms and contributing medical conditions.

Symptom Onset & Initial Evaluation

RLS symptoms frequently develop gradually and may worsen over time. Many patients initially dismiss symptoms as muscle cramps, poor circulation, or simply an inability to relax.

Common symptoms include:

An irresistible urge to move the legs
Tingling, crawling, pulling, or aching sensations
Symptoms that worsen during rest
Evening or nighttime symptom predominance
Temporary relief with movement
Difficulty falling asleep
Frequent nighttime awakenings
Daytime fatigue and sleepiness
Difficulty concentrating
Irritability or mood changes

Some patients experience symptoms in the arms or other parts of the body, particularly when symptoms become more severe.

During your consultation, your TMNJ provider will review symptom patterns, medical history, medications, family history, sleep habits, and conditions commonly associated with RLS, including iron deficiency, kidney disease, pregnancy, peripheral neuropathy, and neurologic disorders.

Diagnosis

RLS is primarily diagnosed based on clinical symptoms and medical history. A diagnosis generally requires:

An urge to move the legs
Symptoms triggered by inactivity
Improvement with movement
Symptoms worsening during evening or nighttime hours
Symptoms not fully explained by another condition

Additional evaluation may include:

Laboratory Testing

Blood work may be done to assess iron levels, ferritin stores, kidney function, vitamin deficiencies, and metabolic conditions.

Sleep Study

An overnight sleep study may be recommended when another sleep disorder is suspected, symptoms are severe, periodic limb movements during sleep are suspected, or sleep apnea may also be present.

Neurologic Evaluation

Some patients require additional testing to evaluate for peripheral neuropathy or other neurologic conditions contributing to symptoms.

Our specialists perform comprehensive assessments to ensure accurate diagnosis and identification of underlying causes.

Treatment

Treatment focuses on reducing symptoms, improving sleep quality, and correcting underlying contributing factors.

Iron Replacement

Low iron stores are one of the most common reversible causes of RLS. Treatment may include dietary modifications, oral iron supplementation, or intravenous iron therapy in selected patients.

Lifestyle Modifications

Many patients benefit from regular exercise, consistent sleep schedules, limiting caffeine intake, reducing alcohol consumption, avoiding nicotine products, and stretching and massage techniques.

Medication Therapy

For moderate to severe symptoms, medications may be recommended, including dopamine agonists, alpha-2-delta calcium channel ligands, certain anticonvulsant medications, or other sleep medicine therapies, when appropriate. Treatment is individualized based on symptom severity, medical history, and potential side effects.

Managing Associated Conditions

Treatment of underlying conditions such as iron deficiency, kidney disease, neuropathy, or sleep apnea may significantly improve RLS symptoms.

Ongoing Management & Prevention

RLS symptoms can fluctuate over time and often require ongoing monitoring. Regular follow-up visits help ensure treatment remains effective while minimizing medication-related side effects.

Long-term management may include:

Monitoring iron levels
Medication adjustments
Sleep quality assessments
Evaluation for symptom progression
Management of coexisting sleep disorders

With proper treatment, many patients experience dramatic improvements in sleep quality, daytime alertness, and overall quality of life.

Related Specialties

Sleep Medicine