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Tuesday, July 7, 2015

Nighttime Nuisance

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Neurological disorder causes sleep deprivation

When you don’t have a good’s night sleep, you’re not yourself. You may feel groggy, irritable or even sick if your body isn’t resting the way it should be. For those suffering with restless leg syndrome, sleep can become more of a nuisance than a time for rejuvenation.

Restless leg syndrome, also known as Willis-Ekbom disease, is a neurologic disorder causing a painful or restless sensation in all extremities, not just legs. This urge usually occurs at night.

“When this becomes moderate to severe, it affects the ability to sleep or rest, which can result in poor work performance,” said Dr. Randy del Mundo of Willis-Knighton Internal Medicine Specialists.

Because RLS is a neurological disorder, there’s still much to be learned about the disease.

Del Mundo said RLS tends to have familial or inherited tendencies, especially if the disease is contracted before age 40.

He said females tend to be affected more than males. Other diseases can also affect one’s ability to have RLS, like diabetes. Patients on dialysis or who are pregnant also have a bigger possibility of having RLS.

“The theory is that a lack of iron in the brain may translate to a dopamine inability to use this neurotransmitter,” Mundo said, explaining patients with RLS probably don’t have enough iron.

This lack of iron affects dopamine, a neurotransmitter, causing the restless or painful feeling in extremities. Because a lack of iron is believed to be linked to RLS, del Mundo said people who have a reduction in central iron storage, like pregnant women, patients with anemia and patients with renal failure, are at a greater risk for RLS.

Del Mundo said patients typically come to a doctor for treatment when symptoms become moderate to severe.

“In treatment, we’re replacing what they’re lacking,” he said.

He checks patients’ iron storage to see if it is low. Medication, like pramipexole or ropinirole, that can augment dopamine, the neurotransmitter that doesn’t work correctly for those with RLS, is usually prescribed.

In addition to consulting a physician, which del Mundo recommends especially when symptoms are moderate to severe, family members can also help a loved one suffering from RLS. He recommends encouraging your loved one to reduce intake of antihistamines, like the allergy medicine Benadryl, which can aggravate RLS. Patients should also reduce their caffeine intake. Family members can encourage their loved ones to take a pre bedtime walk or bike ride. Better yet, family members can join their loved one suffering from RLS on these pre bedtime activities.

Compression stockings are another form of treatment for RLS, as they are designed to help leg ache caused by slow blood flow. Compression stockings are available through a doctor or pharmacy.

If a patient is on dialysis, reducing hours spent on dialysis (if possible), can also alleviate the symptoms of RLS.

In addition to discomfort, the main concern for those suffering from RLS is a lack of restful sleep.

“A recent study showed that sleep deprivation could lead to early mortality,” del Mundo said. According to a 2010 study from the University of Pennsylvania and published in Sleep Medicine Review, sleep duration and mortality have a strong relationship.

As early as 1964, researchers found that people who sleep seven hours a night have the lowest risks for mortality.

If you have pain or restlessness in your extremities that’s not allowing you to get a good night’s sleep, reach out to your doctor. Catching Zs is more important than one might think.

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