Restless legs syndrome: a literature review

Restless legs syndrome (RLS) is a common sensorimotor neurological disorder that significantly disrupts sleep and is associated with an increased risk of chronic noncommunicable diseases. RLS is considered a common movement disorder, occurring approximately 50 % more frequently in women and in individuals of European descent. The etiology of the disease remains unknown. The pathophysiology of RLS is also not fully understood. Dopaminergic dysfunction is a key feature of RLS. Since its discovery, the role of iron deficiency has been emphasized, not iron levels in the peripheral blood, but rather its concentration in the central nervous system. The hyperdopaminergic state in RLS can lead to decreased endogenous opioid levels, which may contribute to impaired sensory processing. Overexpression of the estrogen signaling pathway has been confirmed in patients with RLS. RLS is characterized by an uncontrollable and distressing urge to move the legs and other body parts, often accompanied by unpleasant and irritating sensations. Symptoms often appear or worsen in the evening and at night and are relieved by voluntary movement. Currently, the diagnosis of RLS is based on the clinical picture, and therefore criteria have been developed for a more objective diagnosis. Non-pharmacological treatments include sleep hygiene, moderate-intensity exercise, yoga, leg massage, progressive compression devices for the lower extremity muscles, and avoiding factors that aggravate RLS. The development of new medications for the treatment of RLS has been somewhat delayed due to a limited understanding of its pathophysiology. Dopaminergic agonists, α2δ calcium channel ligands, and opioids are used in the treatment of RLS. The disorder is under-recognized by physicians and often remains undiagnosed. RLS is a treatable disease, but the risk of augmentation during drug therapy makes it necessary to develop effective non-drug treatment methods.

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