Onset of RLS symptoms
Although occurring in very young children, onset of RLS is more typical in the 45+ age group. Usually, at this age, symptoms continue and often increase in severity. For some however, RLS can be intermittent, with symptoms decreasing significantly or even disappearing for a period of time. People with a milder form of RLS may experience their symptoms fairly consistently in later life, but for limited periods. However, for those who begin symptoms in young adult life, or as a child, the condition can become chronic and increase in frequency and severity as they grow older.

For those with associated conditions the onset may be more sudden, but the symptoms may also remit when, or if, the condition is resolved. Such conditions include: iron deficiency anaemia, diabetes, alcoholism, rheumatoid arthritis, kidney failure and Parkinson's Disease.

Number of people with RLS
Surveys in Western countries have shown the prevalence of RLS symptoms range from 5% to 10% of the adult population. A higher incidence is reported among women, ranging from a small excess to almost double the number of women to men. Enquiries and letters sent to RLS Australia show a predominance of women who are seeking help.

Genetic factors
Studies show that approximately 50% of sufferers have a family history of the disorder. C linical surveys of large groups of RLS patients, has demonstrated that the prevalence of developing RLS symptoms for those with family history, is three to five times greater than in the population without RLS.

Timing of RLS symptoms
In the majority of cases, the urge to move the legs as well as the unpleasant sensations, appear to be worse in the evening or night than during the day. For many, the symptoms only occur at night. This tendency is associated with our body’s biological clock, the circadian rhythm (from the Latin circa diem, meaning about a day). Change of light caues a rise in the hormone melatonin, which triggers the process of lulling our bodies to sleep.

Researchers do not fully understand why the symptoms are so linked with the circadian rhythm but they have revealed a peak of RLS restlessness between the hours immediately after midnight and a decrease in the late morning, around 10am to 11am.

BEWARE AUGMENTATION
If a person using a dopamine therapy notices their symptoms occurring earlier in the day, they should be wary of a condition known as ‘augmentation’. A side effect for 65% to 80% of patients taking a drug in the dopamine precursor classification, is that the RLS symptoms start to appear earlier in the day. At first the drug provides good relief but after a few weeks or months, the sensations begin earlier and earlier, often intensifying in severity. Many increase their drug dose to deal with the worsening symptoms, but this will often lead to even stronger augmentation and rebound of symptoms.

Pregnancy and RLS
It is quite common for women to complain about RLS symptoms when pregnant. Now we understand the vital role that iron deficiency plays in the suspected cause of RLS, it is not surprising that the pregnancy makes some women vulnerable to RLS by depleting their stores of iron. Folate deficiency too, may be another contributing factor.

RLS in children
Studies from the 1990s suggest that RLS may occur more in children than previously thought. In three retrospective studies it was discovered that about 40% of adults confirmed onset of symptoms prior to age 21. It is very difficult to describe RLS sensations, and even more so for children. It is thought that the RLS discomfort in some children may be misdiagnosed as “growing pains”.

Recent research suggests that RLS may be quite common in children who present with cognitive and behavioural difficulties, especially attention-deficit hyperactivity disorder (ADHD) and oppositional behaviours. Unfortunately, treatment is difficult as drug therapy is not a preferred option, especially in young children. One clinic suggests strict limit-setting to promote a good sleep schedule; restriction of caffeine (especially cola drinks); and tests to check iron status.

Click here to download the Children and RLS brochure.

If you do not have Adobe Acrobat Reader you can download it here.

Access Economics RLS Report
RESTLESS LEGS SYNDROME: COSTS OF THE MOST COMMON MEDICAL CONDITION MOST PEOPLE HAVE NEVER HEARD OF

Report by Access Economics Pty Ltd for restless Legs Syndrome Australia, April 2005

This report is a companion piece to Access Economics (2004), Wake Up Australia: Value of Healthy Sleep, prepared for Sleep Health Australia, which conservatively summarised and estimated the costs and burdens of all sleep disorders in Australia, and provides a useful contextual environment for this study. It is important to note that RLS was not included in the prevalence estimates of that study which, rather, was conservatively based on prevalence of Obstructive Sleep Apnoea (OSA), insomnias, Periodic Limb Movement Disorder (PLMD) and narcolepsy. Thus the prevalence and costs estimated in this study for RLS are largely additive to those estimated for sleep disorders in Access Economics (2004).

Useful links for RLS information

Sthn California RLS support group
http://www.rlshelp.org./

Jill Gunzel’s RLS Rebel
http://members.cox.net/gunzel/index.html

Baltimore Night Walkers group
http://www.baltimorenightwalkers.com/

We Move
http://www.wemove.org/

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