Am Fam Physician. 2001 Mar 15;63(6):1048.
to the editor: Restless legs syndrome (RLS) is an often unrecognized but common disorder encountered in family practice. It is more common than diabetes mellitus, with significant symptoms occurring in 5 to 15 percent of the population and 25 percent of patients older than 65 years.1 In the 1999 Omnibus Sleep in America Poll,2 only a small percentage of persons with significant symptoms of RLS were diagnosed by their primary care physician.
A major reason for this is that, although RLS was definitively described in neurology literature in 1945,3 it has not been prominently published in family practice journals. That's why I was pleased to see the article and editorial about RLS in American Family Physician.4,5 With more information such as this, family physicians can be in a better position to recognize this frequently disagreeable and rest-robbing disorder. However, our patients are equally uninformed about RLS, and the vast majority suffer in silence during the evening hours and in bed, not realizing they have an actual medical disorder that can be readily treated. They do not share their problem with their family physician for years or until it is truly agonizing. Patient education in the office is the primary tool we have to change undertreatment of this syndrome.
A simple RLS questionnaire and a one-page brochure have been very useful in my practice to discover which of my patients have RLS; moreover, they help toward a shared decision regarding medical treatment. In addition, an RLS patient log can help track our patient over the years. Because RLS occurs in approximately 50 percent of first-degree relatives,6 the education brochure is sent home with the patient to give to their family members. Frequently, it is discovered that a parent has had RLS symptoms for many years. Once treated, both patients and parents are grateful for our efforts.
The Restless Legs Syndrome Foundation serves as support and an educational source for patients. In addition, it is an up-to-date information source for physicians. On request, the Foundation will furnish a complimentary annual medical bulletin, bibliography and brochures.
Restless Legs Syndrome Foundation, Inc.
819 Second St., SW
Rochester, MN 55902-2985
Web address: http://www.rls.org.
For a free patient brochure, call toll-free:
1. Lavigne GJ, Montplaisir JY. Restless legs syndrome and sleep bruxism: prevalence and association among Canadians. Sleep. 1994;17:739–43.
2. Johnson E. 1999 Omnibus sleep in America poll. Washington: National Sleep Foundation. Retrieved October 2000, from: http://www.sleepfoundation.org/publications/1999poll.html.
3. Ekbom KA. Restless legs: a clinical study. Acta Medication Scand. 1945;158(suppl):1–123.
4. Restless Legs Syndrome: Detection and management in primary care. National Heart, Lung, and Blood Institute Working Group on Restless Legs Syndrome. Am Fam Physician. 2000;62:108–14.
5. Wellbery CE. Getting the facts on restless legs [Editorial]. Am Fam Physician. 2000;62:51–2.
6. Trenkwalder C, Seidel VC, Gasser T, Oertel WH. Clinical symptoms and possible anticipation in a large kindred of familial restless legs syndrome. Mov Disord. 1996;11:389–94.
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