Is RLS Primarily a Disorder of Wakefulness or of Sleep?

Restless leg syndrome (RLS) is a common sensorimotor disorder characterized by an abnormal sensation mainly in the legs causing an intense urge to move them repeatedly. It is prevalent in nearly 10% of the population. The sensory symptoms occur at rest, are relieved by movement and are predominantly experienced at night. Some features of RLS manifest in the evenings in a restful awake state, leaving one to wonder whether it is also a disorder of wakefulness or a 24-hour disorder. From various studies, there appears to be two distinct mechanisms for RLS symptoms-a hyperdopaminergic state responsible for the sensory-motor symptoms and a hyper glutamatergic state causing enhanced arousal. From this perspective, RLS can be called a disorder both of wake and sleep. Newer revelations will definitely help us to treat RLS more effectively and improve the quality of life of these patients.