Restless Legs Syndrome: Causes, Symptoms, and Who's at Risk

Restless Legs Syndrome (RLS), also known as Willis-Ekbom Disease, is a neurological disorder characterized by an overwhelming urge to move the legs, often accompanied by uncomfortable or unusual sensations. These sensations typically occur during periods of rest, especially in the evening or at night, and are temporarily relieved by movement such as walking, stretching, or massaging the legs. Despite temporary relief, symptoms tend to persist, significantly disrupting sleep patterns and overall quality of life.

Understanding the Core Symptoms of RLS

Individuals with RLS frequently describe their leg discomfort using terms like tingling, crawling, itching, pulling, or aching—sensations that are difficult to articulate but deeply unsettling. This creates an irresistible need to shift positions, stretch, or rub the limbs. Many patients report pacing around at night or constantly adjusting their legs while sitting, all in an effort to find relief. The intensity of symptoms often peaks during nighttime hours, which can lead to chronic insomnia and daytime fatigue.

Who Is Most Likely to Develop Restless Legs Syndrome?

RLS affects people of all ages, but certain groups are more susceptible. Older adults are commonly affected, as are pregnant women—particularly during the third trimester. Additionally, individuals living with chronic conditions such as type 2 diabetes, kidney failure (uremia), or peripheral neuropathy face a higher risk. While symptoms may subside after childbirth in expectant mothers, those with underlying metabolic or neurological disorders often experience long-term challenges.

Potential Causes Behind the Discomfort

Although the exact cause of RLS remains complex and not fully understood, research points to several contributing factors. One leading theory involves impaired microcirculation and peripheral nerve dysfunction. In patients with diabetes or uremia, damage to small blood vessels and nerves in the extremities may reduce blood flow and disrupt neural signaling, triggering abnormal leg sensations.

Iron deficiency is another well-documented factor linked to RLS. Even when blood iron levels appear normal, low brain iron stores—specifically involving ferritin—can interfere with dopamine production, a neurotransmitter essential for motor control. This explains why individuals with anemia or poor iron metabolism are more prone to developing restless legs.

Impact on Sleep and Daily Life

The chronic nature of RLS doesn't just affect physical comfort—it takes a toll on mental health and daily functioning. Poor sleep quality due to frequent leg movements and nighttime awakenings can result in irritability, reduced concentration, and increased risk of depression. Over time, this cycle of sleep disruption may impair work performance and personal relationships.

Recognizing the signs early and seeking proper diagnosis is crucial. Lifestyle modifications, targeted supplementation (such as iron or magnesium), and medical treatments can dramatically improve symptom management and restore restful sleep. If you or a loved one experiences persistent leg discomfort at night, especially with an urge to move, it may be worth discussing RLS with a healthcare provider.