Restless Legs Syndrome And Genetics

A common movement disorder is an uncontrollable, uncomfortable, painful sensation in legs, an urge to move them with worsened symptoms at night that can lead to insomnia. Do you know studies have shown that it is linked to genetics and runs in families? Let us dig deep into how it is related to our genes and how we can manage it.

Prevalence and impact on individuals

RLS is a common disorder in the general adult population, with a higher prevalence in females.¹  

It occurs in males and females, although females have it more. Many individuals affected are mid-aged or older, and the symptoms become more frequent and may worsen slightly with age.² A large population around the globe is affected by restless leg syndrome. It affects life by disrupting sleep length, sleep quality and alertness during the day, causing depression. It affects an individual's productivity at work and at home.  

Symptoms of Restless Leg Syndrome

• Tingling, burning, itching or throbbing in the legs 
• Urge to move your legs
• An intolerable crawling or creeping sensation in the feet

Some individuals may experience these symptoms occasionally, others have them daily. Symptoms can be mild to intolerable and worsen at night. Long flights or long train journeys are difficult. 

Sensations experienced by individuals with RLS

Sensations felt in the leg are:

• Crawling
• Creeping
• Pulling
• Throbbing
• Aching
• Itching
• Electric

Diagnosis criteria

Doctors can often diagnose restless legs syndrome based on symptoms told by the person or the person’s bed partner. A comprehensive evaluation for restless legs syndrome includes a neurological and physical exam, details about your medical and family history, a list of current medications, and discussions with your doctor about the frequency, duration, and intensity of your symptoms. ² Evaluation typically starts with a thorough history and examination, along with blood tests that may include checking iron levels at the initial presentation.³

Causes of Restless Leg Syndrome

Genetic factors

Restless legs syndrome often has an unknown cause, but it tends to run in families. 40 to 90 percent of affected individuals have a family history of RLS. The reports have at least one affected first-degree relative, a parent or sibling, and many families have multiple affected family members. The early-onset form is more likely familiar than the late-onset form, with some families showing an autosomal dominant inheritance. Restless legs syndrome in families with autosomal dominant inheritance suggests that one altered gene copy is sufficient to cause the disorder.⁴

Iron deficiency

Restless legs syndrome may be related to iron deficiency. Iron plays a crucial role in the formation of dopamine, a neurotransmitter that helps control physical movement. Researchers suspect that abnormalities in the dopamine signalling system may contribute to the symptoms of restless legs syndrome. However, the exact connection between iron deficiency, dopamine signalling, and the symptoms of the condition remains unclear.⁴

Neurological conditions

Restless legs syndrome can develop in conditions that affect the nervous system when nerves from the spinal cord to the muscles are affected. It can be a complication of diabetes and is common in individuals with Parkinsonism.

Treatment Options for Restless Leg Syndrome

If you are suffering from restless leg syndrome, there are a many things you can do to ease your pain. It can be a lifestyle change or medication. 

Lifestyle changes and self-care strategies

• Massage your legs before bedtime to help yourself relax
• Cut back on alcohol and reduce caffeine intake
• Take a hot water bath
• Try meditation techniques before going to bed
• Try to go to bed at a fixed time and get sufficient sleep
• Applying cold and hot packs may ease the symptoms

Medications commonly prescribed for RLS

• First-line management options include iron-replacement therapy If people are deficient in iron, the primary treatment is iron supplements.
• Gabapentin and pregabalin help relieve symptoms of restless legs syndrome.
• Dopamine agonists like ropinirole, pramipexole, and rotigotine treat moderate to severe symptoms.
• Opioid drugs such as methadone, codeine, hydrocodone, or oxycodone treat symptoms of RLS who do not respond well to other medications. 
• Benzodiazepine medications such as clonazepam and lorazepam treat anxiety, muscle spasms, and insomnia, help to get restful sleep²

Coping Strategies for Individuals with Restless Leg Syndrome

Sleep hygiene tips

• Following a bedtime routine
• Set a consistent sleep schedule
• Keep your room cool and comfortable
• Dim the lights an hour before sleep
• Avoid foods that can disrupt sleep
• Limit daytime naps
• Take time to relax before bed and avoid caffeine close to bedtime
• Relax your mind

Stress management techniques

• Deep breathing
• Exercise regularly
• Eat healthy: like fruits and vegetables
• Drink enough water to keep yourself hydrated
• Surround yourself with like-minded people
• Spend time in nature
• Meditate and yoga

Support groups for RLS

Different support groups are working to combat this condition such as https://www.rls-uk.org/. They provide information regarding this condition, help raise awareness and help people with restless leg syndrome.

FAQs

Is RLS hereditary?

Yes, RLS is familial in about 50% of individuals. Some have idiopathic or acquired conditions such as iron deficiency anaemia and chronic renal failure.

How can I prevent RLS?

Altering food habits is an easy way to avoid RLS. Some medicines and food substances are known to increase RLS symptoms. Caffeine intensifies the symptoms. Chocolates and caffeinated beverages such as tea, coffee, and soft drinks should be avoided. Alcohol consumption intensifies the symptoms.

Do RLS symptoms develop in other parts of the body?

Restless legs syndrome can affect arms, trunk and even face.

Summary 

Restless leg syndrome is quite common among individuals. Research has examined various genes as potential risk factors for restless legs syndrome, with many believed to be related to nerve cell development before birth. The role of these genes in brain iron levels or dopamine signalling remains uncertain. Known gene variations explain only a part of RLS risk, suggesting unidentified genes play a role in this complex disorder. Early-onset RLS is more likely to have a genetic component compared to late-onset RLS.⁴

Different studies check the link between RLS and genetics. If you are suffering from RLS, there are several ways to ease your symptoms and lead a happy life.