St. Mary's Medical Center

Spring 2015

Spirit of Women magazine is a national publication presented to women by hospitals and their physicians. The magazine provides up-to-date, evidence-based healthcare information and promotes our hospitals as leaders in women's health excellence.

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2 1 w w w. s p i r i t o f w o m e n . c o m S P R I N G 2 015 S P I R I T O F W O M E N SHUTTERSTOCK done in conjunction with a clinical evaluation to rule out other disorders and to find out if there is a treatable underlying cause. After a physical examination, for example, your physician may order a blood test to rule out some common secondary causes of restless legs such as: • anemia (low iron) • thyroid issues • vitamin B12 deficiency • renal dysfunction or disease While treating these issues doesn't always cure RLS, testing for them is a logical first step in treatment. Dr. Kosinski notes that restless leg syndrome is also related to a separate disorder called periodic limb movement. "Restless legs are more a cause of insomnia. They can make it difficult to fall asleep because it's hard to relax when you have an overwhelming urge to move," he says. "Periodic limb movements occur during sleep and affect how you function during the day." Periodic limb movements are diagnosed by doing a sleep study, with leads put on the legs or other large muscle groups to detect movement. Sleep studies may also be done if doctors suspect there are other sleep issues such as sleep apnea. FINDING RELIEF Your physician will usually start with the simplest treatments. If blood tests indicate any factors that may be contributing to RLS symptoms, those will be addressed first. Low iron is most common, says Dr. Ward, and iron supplementation may help. In addition, says Dr. Cardelli, lifestyle changes may be suggested, such as cutting back on caffeine or alcohol, which can exacerbate symptoms. Common over-the- counter medications used to self-treat sleep issues— medications with "PM" in the name—can also cause RLS symptoms, so he recommends discontinuing their use. Light exercise, warm baths, heating pads and massages may help alleviate RLS symptoms too. If lifestyle changes don't work, the next step is a class of medications called dopamine agonists. From there, more powerful medications may be prescribed. Most importantly, says Dr. Amin, don't ignore symptoms in the hope that they'll go away. "Good sleep is important, so you shouldn't suffer through your symptoms thinking nothing can be done," she says. "Whether it's medicinal or non-medicinal, there is relief available. It's important to report it to your physician so we can help improve your quality of life." • R estless leg syndrome (RLS) may sound like a minor inconvenience, but when you can't even lie down long enough to fall asleep, or find yourself jumping out of bed several times a night to stretch, the effect on your life can be major. "The problem with restless leg syndrome is that its symptoms can make it hard to sleep or disrupt sleep, and that can result in daytime impairment," says Dr. Beth Ward, a neurologist who specializes in sleep medicine at St. Luke's Hospital in Chesterfield, Mo. "That can seriously impact people's quality of life." Restless legs are more common in women than men, and often occur during pregnancy, says Dr. Robert Kosinski, director of Monmouth Medical Center's Sleep Medicine Center, Long Branch, N.J. "RLS may be more common in young adults than we realize, but is often attributed to other conditions such as growing pains or hyperactivity," he says. RESTLESS LEG SYMPTOMS The symptoms of restless leg syndrome are often described by sufferers as "hard to describe." "The way people describe RLS can vary, but it's associated with the urge to move, and the symptoms are worse when you're sedentary, relieved when you walk around," says Dr. Ward. Neurologist Dr. Dominic Cardelli says he's heard patients describe RLS as creepy-crawly. Others say it's like a drawing sensation or itching or tingling deep in the legs. The symptoms most commonly come on at rest, when driving, relaxing in the evening, or trying to get to sleep. "When you hear those types of nonspecific terms, it's pretty straightforward," says Dr. Cardelli, who practices at Riverview Medical Center in Wisconsin Rapids, Wis. "There aren't a lot of other conditions that are relieved with movement but return when [people] sit or lay back down." DIAGNOSING RLS Dr. Darshana P. Amin, a neurologist at Community Medical Center in Toms River, N.J., notes that there are two types of restless legs: primary and secondary. "With primary restless legs, there usually is no reason found and it often runs in families," says Dr. Amin. "With secondary restless legs, we may find that there is a reason and when we find it and treat it, then that may relieve the symptoms." RLS is considered a clinical diagnosis, or one that is usually made in the doctor's office on the basis of a description of symptoms. However, tests are sometimes

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