Sex and the Risk of Restless Legs Syndrome in the General Population

Abstract

The clinical symptoms of restless legs syndrome (RLS) were first described by the English physician Sir Thomas Willis¹ in a chapter entitled "Instructions for Curing the Watching Evil" of his book The London Practice of Physick in 1685. His original description related the experience of patients: "The diseased are no more able to sleep, than if they were in a place of greatest torture."^1(p404) In later centuries, the condition was described with varying terms and generally was regarded as a form of hysteria or neurasthenia.² The Swedish neurologist Karl Ekbohm gave the comprehensive description a disease entity, "irritable legs," in 1944.³ However, it took another 50 years until standard criteria for the definition and diagnosis of RLS were published by the International Restless Legs Syndrome Study Group in 1995.⁴ These criteria include the desire to move the limbs usually associated with paresthesias or dysesthesias of the legs, a motor restlessness, a worsening or exclusive presence of symptoms at rest (lying or sitting) with at least partial and temporary relief by activity, and a worsening of the symptoms in the evening or during the night. Between 50% and 92% of patients with idiopathic RLS report a positive family history.⁵ Based on the analysis of large families, autosomal dominant inheritance is suggested.^6,7 Symptomatic forms of RLS can occur during pregnancy, in uremic patients, and in those with diabetes mellitus or anemia.⁸