A photograph of legs in bed.

If you’ve ever been reading a book, watching TV, or trying to get to sleep at night and felt a powerful need to move your legs, you may have experienced the characteristic symptom of restless legs syndrome (RLS), also known as Willis-Ekbom disease, a condition that can be tricky to treat properly.

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People may describe the sensation itself as creepy-crawly, jittery, or electrical. But the hallmark of RLS is “the uncontrollable urge to move the leg, that comes on at rest [while awake],” says Suzanne Bertisch, M.D., a sleep physician at Beth Israel Deaconess Medical Center and an assistant professor of medicine at Harvard Medical School.

Such symptoms may affect as many as 7 to 8 percent of all U.S. adults, with 2 to 3 percent of people having cases severe enough to require medication.

Yet experts say they still have much to learn about the condition. In time for Restless Legs Syndrome Awareness Day, here are three things you should know.

Symptoms Can Be Confusing

People with RLS may report a number of symptoms, including nighttime leg jerks and fatigue. But to officially diagnose RLS, your doctor will ask you to confirm that you have an uncontrollable urge to move your legs that arises when you’re inactive (sitting or lying down), and that getting up and moving, such as to walk or stretch, helps subdue the feeling. To receive that RLS diagnosis, the need to move has to occur or be most severe in the evening.

Your doctor will also need to rule out a number of other conditions that mimic some of RLS’s symptoms, Bertisch says. For instance, people with nerve damage (neuropathy), a common complication of diabetes, may experience numbness, tingling, or burning in their legs. Some with arthritis may find that uncomfortable feelings in their joints are helped by moving around. And some people may jerk their legs during sleep but have no RLS while they’re awake—a phenomenon known as periodic limb movements of sleep.

And though many cases of RLS have no known cause, some are triggered by certain medical conditions that your doctor may want to rule out, including pregnancy, kidney disease, and diabetes.

If you have RLS symptoms, it’s likely that your doctor will want to test the iron levels in your blood. The relationship between iron and restless legs syndrome isn’t fully understood, according to Bertisch, but for some people, correcting an iron deficiency may help.

Don’t take iron supplements without talking to your doctor, however. Too much iron can cause gastrointestinal symptoms or, in certain vulnerable people, can damage the liver and other organs.

Lifestyle Strategies May Help

For a lot of people with mild to moderate RLS symptoms, a number of lifestyle or habit changes can make a big difference. Regular moderate exercise can reduce symptoms in some people, though over-exercising, to the point of pain or aching in joints and muscles, can exacerbate RLS.

Planning ahead works for many people. Try doing active chores or going for a walk during the evening if that’s when symptoms usually occur. Or engage in a mentally distracting activity such as putting together a crossword puzzle, knitting, or talking with a friend, suggests the American Thoracic Society.

Also useful: Consider reducing your consumption of alcohol and caffeine, which can set off symptoms. 

And pay attention to the amount of sleep you're getting; RLS often interferes with slumber, and insufficient sleep itself can trigger restless legs symptoms, Bertisch says.

To compensate, people may turn to over-the-counter sleep medication, usually an antihistamine—but that’s ill-advised. “Antihistamines are actually thought to make RLS worse,” Bertisch says. Instead, try other techniques for getting a good night’s sleep.

Certain other medications, including several types of antidepressants, can worsen RLS as well. Talk with your doctor about other options for easing depression.

RLS Drugs Can Have Serious Side Effects

Considering medication for RLS? Not everyone needs it, experts say. Symptoms can be mild and occasional and can be well-managed with lifestyle strategies alone. 

“If it doesn't really bother a person, then they do not need to be treated,” says Brian Koo, M.D., director of the Yale Center for Restless Legs Syndrome.

And unlike the common sleep disorder known as obstructive sleep apnea, which can increase the likelihood of heart attack and stroke, RLS has not been linked to other health risks, Koo says.

But if lifestyle changes aren’t enough to keep RLS from negatively affecting your day-to-day life, consider drug therapy. (You may want to work with a doctor experienced in treating the condition, Koo says. The Restless Legs Syndrome Foundation carries a directory.) Be aware, though, that the pharmaceutical treatments for RLS carry the risk of side effects, and that none of them work for everyone.

Dopamine agonists, such as pramipexole (Mirapex and generic), ropinirole (Requip and generic), and others—also used to manage symptoms of Parkinson's disease—for instance, can be effective for many at reducing RLS symptoms. Taken at too high a dose, or over too long a time period, though, they can backfire, eventually worsening RLS effects. In rare cases, they can also lead to impulse-control disorders, such as excessive gambling or hypersexuality.

Some drugs for controlling seizures and treating nerve pain, including gabapentin (Neurontin and generic), gabapentin enacarbil (Horizant), and pregabalin (Lyrica and generic), are also approved to help ease RLS symptoms. These can cause weight gain and drowsiness and worsen depression, and may lead to dependence.

Some doctors prescribe low-dose opioids such as oxycodone (OxyContin and generic) and hydrocodone (Vicodin and generic) for severe RLS that has failed to respond to other treatment. But it’s important to know that any opioid use can have myriad side effects and carries a risk of addiction.