What causes a restless body

Psychiatry, Psychosomatics & Psychotherapy


Relaxation impossible: Restless legs syndrome disturbs sleep

The legs twitch, uncontrollably and often even unknowingly: the so-called restless leg syndrome is particularly noticeable at night. Research into the cause can help.

When you make yourself comfortable on the sofa in the evening or cuddle up in bed, your body usually relaxes. With around ten percent of the population, however, it is different: As soon as they rest, they get sensory disturbances in their legs and feel an unnatural urge to move. "The symptoms that those affected suffer from are called Restless Legs Syndrome, which means restless legs syndrome," explains Lilo Habersack. The Munich resident suffers from the disease, RLS for short, and is the chairwoman of the German Restless Legs Association.

RLS is a relatively common disease that was first described over 300 years ago, she explains. For a long time it was regarded as a mere disturbance of wellbeing, since at first glance it does not go hand in hand with major health impairments. "In 1945 the Swedish neurologist Karl-Axel Ekbom then dealt with the disease in more detail and gave it its name," says Claudia Trenkwalder, chief physician at the neurological Paracelsus Elena clinic in Kassel. After that, they intensified research into RLS. But there are still unanswered questions.

Basically, the symptoms of RLS are quite concise. Those affected suffer from abnormal sensations in the legs and rarely in the arms as well. These are neurological in nature, always occur in physical calm and concentrate on the evening and night hours. "Most of the time people talk about a feeling of restlessness, with some feeling it as tingling or twitching, while others say it is pulling, itching or burning," says Habersack. In addition to these sensory disorders, there are sometimes stabbing or cramp-like pains. In addition, the sick feel an urge to move, because the symptoms can be alleviated by movement.

In addition, leg movements can often be observed at regular intervals in those affected, says Werner Cassel from the Marburg Sleep Medicine Center. “These are involuntary jerks that occur every 20 to 40 seconds. Since this mainly happens during sleep, those affected often don't know anything about it. " However, every twitch leads to a small wake-up reaction (arousal) that disturbs sleep.

How much the syndrome is noticeable varies from person to person. For most of them, it first shows up between the ages of thirty and forty. At first, symptoms tend to be mild and come on in flares. "In the majority of cases, the symptoms then increase in intensity over time and become chronic until they are finally present in many people every night," explains Wolfgang Oertel from the German Society for Neurology.

This not only means a high level of suffering, it can also be dangerous. Because restless legs often cause severe sleep disorders that can damage health in the long term. "If there is a lack of sleep, the organism cannot regenerate sufficiently, which can lead to depression and weaken the immune system, for example," says Cassel. Sleep deprivation and arousals can also be a risk for the cardiovascular system: studies have shown that they promote high blood pressure and heart failure.

A neurologist or sleep specialist can help

The right place to go if you suspect RLS is a neurologist or sleep specialist. If the person concerned actually suffers from RLS, the choice of therapy depends not only on the extent and type of symptoms, but also on its cause. According to the current state of research, RLS is caused by a disruption in the transmission of certain messenger substances - in particular the so-called dopamine - in the brain and spinal cord. "This can be genetic or triggered by factors such as iron deficiency, kidney dysfunction or drugs such as antidepressants," explains Trenkwalder.

If there is an external cause, for example the restless legs were triggered by medication, RLS disappears again as soon as the factor is switched off. Where this is not the case, one can only treat symptomatically. This is possible through external applications such as massages or cold foot baths and certain movement exercises. It can also help avoid RLS-aggravating factors such as coffee or alcohol.

Patients who, despite these measures, suffer severely from their disease should consider drug therapy. Dopamine substitutes, for example, can be considered, explains Oertel. In principle, they would have a good success rate and few side effects. If they do not help or the symptoms worsen and shift to an earlier time of the day, you sometimes have to switch to other active ingredients, for example opioids. Sometimes they cause the body to relax again when the head wants it to.

Source: dpa