Restless Legs Syndrome (RLS)
What Is It?
Neurological sensorimotor disorder with uncomfortable sensations in the legs (creeping, crawling, tingling, aching) that worsen at rest or at night and are relieved by movement. Significantly disrupts sleep.
How Is It Diagnosed?
Four diagnostic criteria: (1) urge to move legs with uncomfortable sensations; (2) worse at rest; (3) improved by movement; (4) worse in evening/night. Rule out iron deficiency, uremia, neuropathy, and medication effects.
How Is It Treated?
First-line: iron supplementation if ferritin <75 ng/mL. Dopamine agonists (pramipexole, ropinirole, rotigotine patch) - effective but risk of augmentation. Alpha-2-delta ligands (gabapentin enacarbil, pregabalin). Lifestyle: exercise, sleep hygiene.
Tests and Imaging Typically Needed
Serum ferritin (target >75), CBC, BMP (creatinine), glucose, TSH, folate. Polysomnography if PLMD or sleep apnea suspected.
Approximate Self-Pay Costs
Office visit: $95-$150. Ferritin: $20-$35. Iron supplements: $5-$10/month. Pramipexole (generic): $10-$30/month.