Patients toss and turn with restless legs, but don't tell

Effective treatment can control creepy-crawly sensations that hinder sleep, but afflicted patients often hesitate to bring it up.

By Susan J. Landers, AMNews staff. Dec. 15, 2003.

Washington -- A patient with restless legs syndrome is most definitely not someone whose boots are made for walking. In fact, a severe case of RLS would probably render someone too tired to walk very far.

Described as both a sleep disorder and a neurologic movement disorder, patients with RLS have an irresistible urge to move their legs when what they most desire is to sit down and rest or just drop off to sleep. Such patients may spend the night tossing and turning, unable to settle into a comfortable sleeping position.

Still, patients don't tell and physicians don't ask about sleep disorders, so the syndrome often eludes diagnosis, said Clete Kushida, MD, PhD, director of Stanford University's Center for Human Sleep Research in Palo Alto, Calif.

That's too bad, because RLS is easy to diagnose and to treat, said Dr. Kushida.

But it's also easy to understand a hesitation to volunteer information about symptoms that one patient described as feeling as though ants are crawling over his legs. Patients also describe the sensations as creeping, crawling, itching, burning, aching, pulling or tugging.

"Patients may be a little reluctant to tell their physicians about it because the primary symptoms are unusual, and they may fear that their physician will think they're crazy," said Dr. Kushida.

"A lot of people have never heard of restless legs syndrome," said Deborah A. Nichols, Northwest Regional director of Stanford's Primary Care Sleep Education Project. "They knew that Grandma or Dad had these weird feelings so they think, 'It's alright that I have them.' "