Dr. John Winkelman discusses populations most at risk for restless leg syndrome

John Winkelman, MD, PhD, Medical Director, Sleep Disorders Clinical Research Program, Massachusetts General Hospital, discusses risk factors for restless legs syndrome (RLS) and the importance of disease awareness.


Are certain populations most affected by RLS?

Restless legs syndrome has strong genetic components, so some populations will be more vulnerable to RLS than others. Women are about twice as likely as men; Northern European populations have a much higher prevalence of restless legs syndrome than other populations.

Restless legs syndrome is much more common with age. Young children get it, so probably 0.5% of children will have restless legs syndrome. They usually have symptoms of growing pains, which is probably restless leg syndrome. But it’s much more common as people get older. It is also more common in certain specific populations: pregnant women, dialysis patients and people with iron deficiency. These populations are [at] prevalence of RLS much higher than in general population, probably all related to iron deficiency, but not systemic iron deficiency, but brain iron deficiency.

What should patients watch out for to get an RLS diagnosis earlier?

Awareness of Restless Leg Syndrome has increased dramatically over the past 25 years. So at this point many people have heard of Restless Leg Syndrome, most doctors know what it is. So awareness is the number 1 thing, not just saying, “Well, that’s how I am, I can’t sleep, I have to walk, I have these uncomfortable feelings in my legs; mom the had, grandma had, it’s just our family.” It must be recognized as a medical condition. It is a neurological disorder. Awareness is therefore going to be number 1.

I think in children, growing pains should be strongly suspected in restless legs syndrome, and in populations at increased risk. menstruating women [who experience] heavy periods, frequent periods, blood loss, and possibly a vegetarian [with] low iron, low brain iron, they will be more at risk. If you’re in a high-risk population, just thinking about diagnosis—the secret of medicine that we were taught early on is that if you don’t think about diagnosis, you can’t make a diagnosis. If you don’t know the diagnosis, you can’t think about it, so raising awareness is the number 1 thing.

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