"The restless legs syndrome is neither psychological nor nervous, it is neurophysiological"

Some live restless nights and wake up in the middle of the night with an urgent desire … to do some stretching. The "restless legs syndrome" is indeed part of the list of disruptive sleep, which, alongside crying baby, sleep apnea, heat, insomnia affect four French in ten, according to the National Institute of Sleep and vigilance.

The name of this syndrome will surprise those who have never experienced this awakening brutal and unpleasant, as if your legs were demanding on the spot to play sports. Tingling, itching, tingling, electric shocks that divide your nights, its forms can be varied and more or less regular and important. Should we do more sports? Take cold showers to improve circulation? 20 minutes interviewed
Patrick Lemoine, former psychiatrist and sleep specialist, author of Sleep! (Hachette) to try to understand this amazing syndrome.

What happens in our body when we feel these impatiences?

We must distinguish impatience, when more the day ahead, the more your legs need to walk, so wake up. And what we call the syndrome of nocturnal periodic movements of the lower limbs, which are also called restless legs, is the same thing, but it is when we sleep. And these two symptoms are very often badociated [pour 80 % des patients].

Is it common?

This chronic condition is widespread. Between 7% and 11% of French people feel this impatience during the day, around 5% suffer from the periodic nocturnal movement syndrome, women being more often affected than men. And it's correlated with age. From the age of 60, it is even more widespread. It's unpleasant, it tired, it can even depress. But, do not panic, it does not matter and there is no risk of complications. On the other hand, it is an unknown disease. Besides, we've only been talking about it for about fifteen years.

Can it have a serious impact on everyday life?

In the maximum form, it can be the four members, but it is rare. The minimum is just the big toe. It becomes annoying when the movements, tingling touch the calves, knees, hips, there are people who jump all night … And wake up exhausted. The problem is that sometimes people are not aware of it. In general, patients tell us in consultation that they are tired and that they have cramps, but do not make the connection. Because some movements will wake them, others not. It is often the spouses who put the bug in the ear and explain that the patient runs the marathon at night, but does not realize it! Other patients, on the other hand, are woken up all night by this unpleasant feeling. The only thing that calms them is the cold, walk on the tiles, go out at night on the balcony, I had a patient who put his feet in the fridge … It can become a night of hell.

What are the causes of these restless legs?

We do not yet know all the mysteries of the legs without rest. But we know that it is a deficiency of dopamine, a neurotransmitter, which causes these movements. It's neither psychological nor nervous, it's neurophysiological. In general, it is a problem of transformation of the
tyrosine in dopamine because of iron deficiency. This explains why many pregnant women in late pregnancy suffer from this syndrome, the baby appropriating iron. Otherwise, in general it is a hereditary syndrome. The genes have not yet been isolated, but experts are convinced that there is a genetic susceptibility. This syndrome can also be caused by drugs, including antidepressants and neuroleptics. Another avenue to explore is often badociated with sleep apnea.

Are there treatments?

Yes, knowing that the priority is to determine the causes. So you have to consult to quantify things. If it is because of the pregnancy, the restless legs will disappear after delivery and when the mother has resumed her iron reserves. If this happens outside of pregnancy, we can start with a blood test to check that it is not due to a lack of iron and if so, supplement with iron. If that's not it, we can do a recording of sleep, because sometimes the movements do not awaken them. Otherwise, the clbadic treatment is to take dopamine agonists, who do the job of dopamine. And the good news is that it's very effective: usually, in a night or two, nine out of ten patients really feel better. The bad part is that you can not do without it, so it's a treatment for life. I miraculously insomniacs for years! If acupuncture can sometimes relieve, it does not change the substance of the problem.

This has nothing to do with heavy legs?

No. It may be similar, but it's not the same mechanism at all. Heavy legs, it is a problem of venous return, sometimes due to edema, for the legs without rest, it is a neurological problem.