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A Review of The Restless Legs Syndrome

Guillermo Paradiso, MD and Robert Chen, MBBChir, MSc, FRCPC, Division of Neurology and Krembil Neuroscience Centre, Toronto Western Research Institute, University Health Network; University of Toronto, Toronto, ON.

Restless legs syndrome (RLS) is a common disorder and its prevalence in the elderly is about 10%. It is characterised by unpleasant, difficult-to-describe sensations in the lower limbs and an irresistible desire to move the legs. The symptoms typically worsen in the evening and at night and often result in sleep disturbance. Idiopathic RLS is often familial. Secondary RLS may occur in several medical conditions, such as uremia and iron deficiency. Most patients with RLS also have periodic limb movements in sleep (PLMS), characterised by repetitive flexion of the lower extremities. RLS and PLMS may be the result of a dopaminergic dysfunction and PLMS may be due to release of spinal flexor reflex pathways. Dopaminergic agents, benzodiazepine and opioids are effective in treating RLS.
Key words: restless legs, periodic leg movement, sleep disorder, dopamine.

Related Terms: Neurology-Movement Disorders, dopamine, periodic leg movement, restless legs, sleep disorder

Older People Spend Less Time Asleep

Sherene Chen See is a freelance writer from Toronto, Ontario. We regret that Sherene Chen See's articles are not available on-line.

Guidelines for treating Insomnia In The Older Person
  • Use the lowest effective dose of a single agent
  • Use intermittent dosing
  • Short-term use (do not use hypnotic mediation on a regular basis for >3-4 weeks)
  • Limited use of sedative-hypnotics (2-4 times per week)
  • Gradual discontinuation
  • Monitor for reoccurence of insomnia following discontinuation of medication
  • Avoid ultra-short-acting benzodiazepines (e.g. triazolam)

 

Age-related Decline in Melatonin Levels


Related Terms: Mental Health, sleep disorder
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