RLS diagnosis challenges

RLS is often underdiagnosed or misdiagnosed. There are no specific tests to identify RLS, which can make diagnosis tricky. Some people with RLS never seek medical attention because they worry they won't be taken seriously. Fortunately, RLS expert and neurologist Daniel Lee, MD, has found that increased awareness of the disease is a step in the right direction.1-3

How do doctors diagnose RLS?

When diagnosing RLS, doctors usually look for the following criteria1,4:

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An overwhelming urge to move legs, arms, or other body parts

Typically, this urge is accompanied by uncomfortable sensations, often described as creepy-crawly, aching, or tugging.

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Sensations begin when at rest

The pain and discomfort usually begins when you're sitting or lying down.

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Movement brings temporary relief

Getting up and moving around—whether by stretching, walking, or pacing—typically lessens symptoms, for as long as you’re in motion.

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Symptoms get worse at night

Most people with RLS see their symptoms worsen or only occur during evening hours.

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Symptoms aren't solely caused by another underlying condition

Doctors first want to rule out other underlying behavioral or medical conditions that could account for symptoms such as pregnancy, kidney failure, or iron deficiency.

Referral to a specialist

Because RLS can make it difficult to sleep, doctors sometimes refer patients to a sleep specialist. This may involve an overnight stay at a clinic for a test called a sleep study. A sleep study allows doctors to monitor your sleep and rule out or diagnose another sleep disorder such as sleep apnea or narcolepsy. Note: A sleep study is not required to diagnose RLS.3

Next steps: Do I have RLS?

If you're experiencing the symptoms of RLS, make an appointment with your doctor. He or she will evaluate your medical history and talk to you about your symptoms. Your doctor may also conduct a physical exam and order blood tests to determine if other factors, like kidney disease or iron deficiency, could be causing your symptoms. You can expect to be asked questions similar to these5:

  • How would you describe your symptoms?
  • What time do symptoms usually occur?
  • When are symptoms most severe?
  • Do symptoms interfere with your sleep?
  • What is your nightly routine?
  • What times do you go to bed and wake up?
  • Are you tired during the day?
  • Does anyone else in your family have similar symptoms?
  • What medications do you take?
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Preparing for your appointment

Before your visit, consider keeping a diary of your symptoms. It can give your doctor a clearer picture of your symptoms and help reveal any patterns or symptom triggers. Try incorporating your symptom diary into your routine by filling it out before you go to bed and when you wake up each day.5

Bring your symptom diary to your appointment along with any key medical information such as medications you've taken or are currently taking for your symptoms. Some people find it helpful to bring along a friend or family member for support. Be sure to write down any questions you have about your symptoms and how to manage them.3

Questions to ask your doctor

Here are some questions to help get you started3:

  • 1. What is the most likely cause of my symptoms?
  • 2. Could my symptoms be related to other health conditions?
  • 3. What tests do I need?
  • 4. What treatment options are available for RLS?
  • 5. What lifestyle modifications might improve my symptoms?
  • 6. Where can I find a support group for people with RLS?

Remember, your doctor is your partner in managing RLS. Be open and honest about how the condition affects your daily life so you can get the treatment you need.5

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