[Dr. JJ Lin] Say Goodbye to Restless Legs

Having restless legs makes sleeping feel like being fried like a fish, tossing and turning until you're about to go crazy! 60% of patients wake up 3 times a night, and those with moderate to severe cases sleep less than 5 hours a night. Treatment can effectively control the condition and improve sleep quality.

A stylish mature woman often experienced leg soreness and numbness at night, requiring patting and massage to feel better. She would often toss and turn for a long time before finally falling asleep, but the discomfort would keep her tossing and turning all night. Recently, on a long-haul international flight, just as everyone was starting to rest, this woman's legs began to feel uncomfortable again. She couldn't resist slightly lifting her skirt to massage her legs, which attracted the attention of a man sitting next to her, who assumed she was trying to seduce him. This woman's symptoms were diagnosed as restless legs syndrome (RLS). She sought help at my clinic, and after treatment, her condition improved, finally allowing her to sleep soundly through the night.

Patients with restless legs syndrome (RLS) often experience leg pain, numbness, burning, crawling, or itching sensations while trying to sleep. Symptoms are more likely to occur at night than during the day, and are particularly severe when falling asleep. Many patients need to move their legs to relieve the discomfort. After a long day, they desperately need sleep, but are repeatedly awakened by their uncomfortable legs, severely disrupting their sleep and leading to difficulty falling asleep, increased awakenings during sleep, and eventually, a fear of bedtime. Because the symptoms often occur at midnight and subside in the morning, it is jokingly referred to as the "Cinderella" of diseases. 60% of patients wake up three times a night, and those with moderate to severe RLS sleep less than five hours a night. Modern life is busy, and poor sleep is common, often attributed to stress, overthinking, anxiety, or physical ailments. Statistics show that 10% of patients complaining of poor sleep may have RLS; among RLS patients, 60% (%) wake up at least three times a night; and those with moderate to severe RLS sleep less than five hours a night.

Restless legs syndrome (RLS) can be divided into primary and secondary types. Primary RLS is related to genetics and usually presents before age 30. Treatment is effective in 80% of patients. Some patients describe dramatic changes after starting medication; symptoms disappear when medication is started, but reappear upon discontinuation. Secondary RLS is commonly seen in patients with iron deficiency anemia, dialysis patients with kidney disease, and pregnant women.

In my clinic, I have encountered cases of family heredity: a man in his 60s came to the hospital for help. When he described his symptoms, his daughter, who was in her 30s and accompanied him, was surprised to find that she also had the same symptoms. She also thought of her 6-year-old daughter, who would often cry and complain of foot pain every night before going to bed. She wondered if her daughter had also inherited restless legs syndrome.

In addition, it is common to see couples visiting the clinic together. They complain to me that they can't stand their partner not sleeping at night, constantly moving around, kicking the blankets, and banging on the bed, making it impossible for them to sleep, or they complain that they have to massage their partner's feet every day, which makes them very tired.

Some patients, unsure which specialist to consult, end up visiting numerous hospitals. Often, people initially mistake it for arthritis and see an orthopedic specialist, only to find muscle relaxants ineffective. They then turn to rehabilitation specialists for electrotherapy, heat therapy, and back stretching, experiencing temporary symptom relief, but these treatments offer little long-term improvement and only exacerbate their anxiety and restlessness. Some even develop depression and seek psychiatric care, where sleeping pills help them sleep, but the leg symptoms persist. Others consult family medicine, geriatrics, and rheumatology specialists, eventually visiting every department without finding a solution, or resorting to folk remedies such as bloodletting, traditional prescriptions, or topical plasters.

Several international medical efficacy studies have shown that patients with primary restless legs syndrome (PRS) can effectively control their condition with treatment, resulting in longer sleep duration, improved sleep sufficiency, reduced sleep interruptions, and decreased daytime sleepiness. This treatment for PRS is covered by National Health Insurance.

Dr. Lin Junjie, Department of Neurology, Tri-Service General Hospital