Friday, January 9, 2015

Restless Leg Syndrome


I thought I suffered from Restless Leg Syndrome (RLS) before it was discovered, but actually research shows it was discovered way back in the 1600s. But I did suffer from it before the medical profession paid any real attention to it - or maybe that is before the pharmaceutical companies realized there was money to be made from it? Definitely I only started hearing about it when various magical cures were being advertised on TV in the '90s. It was kind of a relief to discover that it was not my imagination and the condition actually has a name.

As a teenager, if I got really tired, my legs started feeling awful - it was like an itch deep in the bone almost. Back then I was OK once I went to sleep. But as I got older it got worse. By the time I was in my late 40s it started to invade my sleep. Once I woke up with my legs twitching, I usually had to get up and walk around to stop it, then of course, I was awake and sometimes it took me over an hour to get back to sleep. Occasionally if it is not too bad, just sticking my legs outside the covers so they get cold will work. Later I started waking intermittently during the night despite the fact that my lets were quiet. It wasn't a big problem as I was able to fall back to sleep almost immediately.

Then I was put on medication to help prevent bone loss - a drug called Evista - I wasn't aware of the fact that RLS was a known side effect, in fact the only way I found out was my RLS got much worse and I was getting only 5 hours of broken sleep every night, frequently having to get up and walk it off more than once every night. Then, on a trip home to Dublin, when I was sleeping for 8 hours, if still somewhat broken sleep I was not suffering from RLS at all, I got to thinking about it, apart from being in Ireland, the main difference was that I had forgotten my medication and didn't take any Evista the entire trip. I stopped taking that medication and started sleeping better.

I was still having the occasional bout of RLS but not nearly as frequently as before, and of course I was still waking 4 or 5 time during the night - and still do.

It was only when I started reading up on RLS for this blog that I think I figured it out. RLS is just one symptom of a disease that interferes with sleep.

According to Healthline.com RLS was initially documented in the early 1600s by Thomas Willis :
...Willis’ description of RLS: “Leaping and contractions of the tendons and so great a restlessness and tossing of the members ensure that the diseased are no more able to sleep than if they were in the place of the greatest torture.” Ironically, Willis thought the cure for RLS was bloodletting, which was used for everything from rashes to cancer in those times. However, today we know that low iron levels contribute to RLS and bloodletting was the worst possible treatment...
A study in 1996 showed that after patients sought medical help, diagnosis took 10 years or more. An international study in 2004 found that only 8 percent of patients were diagnosed properly. This article also confirmed something I had already figured out for myself, any medication that eases the symptoms only does so for a limited time especially if taken regularly. I found an over the counter drug called Legatrin which did help for little while, but soon it stopped working. I now only take it once a week, generally Friday or Saturday night, when I know that I don't have to get up in the morning. I don't sleep in, I haven't done so for as long as I can remember, but I live in hope and I do get at least one good night's sleep most weeks.

The fact that RLS is a symptom fascinated me. This report from Johns Hopkins was the one that I found most fascinating as it pinpoints higher levels of glutamate in the brains of people who suffer from RLS - glutamate, the report explains, is a neurotransmitter involved in arousal - that is not referring to sexual arousal, it refers to arousal from sleep - to be awake. Suffers of RLS get less sleep, suffer from broken sleep and tend to not be overly tired during the day despite that.

Now.. I have read a number of articles that tie lack of sleep to difficulty losing weight, or even to weight gain.

According to the Annals of Internal Medicine Journal, a study conducted by the University of Chicago Sleep Research Laboratory concluded:
Sleep curtailment decreased the proportion of weight lost as fat by 55% (1.4 vs. 0.6 kg with 8.5 vs. 5.5 hours of sleep opportunity, respectively; P = 0.043) and increased the loss of fat-free body mass by 60% (1.5 vs. 2.4 kg; P = 0.002). This was accompanied by markers of enhanced neuroendocrine adaptation to caloric restriction, increased hunger, and a shift in relative substrate utilization toward oxidation of less fat.
The amount of human sleep contributes to the maintenance of fat-free body mass at times of decreased energy intake. Lack of sufficient sleep may compromise the efficacy of typical dietary interventions for weight loss and related metabolic risk reduction.
I am overweight despite my efforts to diet and exercise, I have RLS and I sleep very little, and I sleep badly as I said, waking frequently throughout the night, because I higher levels of glutamate!

Fascinating, but I am still fat, my legs still twitch and I still don't get enough sleep, however, somehow I feel a little bit better about it all.