In a routine round, some patients complained that I couldn’t sleep at night, hoping that I could prescribe sleeping pills."Auntie, is your symptoms difficult to fall asleep, still sleepy, and shortly?" I asked a few more words and wanted to know more about her sleep.
"It’s very difficult for me to fall asleep. Every time I want to lie down and rest, my feet feel weird. It seems that there are bugs climbing and itchy. I have to kick and move.One point. I always wanted to move my feet like this, and I couldn’t calm down at all. How could I sleep? "The aunt complained that she was deeply disturbed.
This is the typical manifestation of uneasy leg syndrome.
What is restless legs?
The uneasy leg syndrome is a kind of peripheral neuropathy that combines abnormalities and non -autonomous movements, mainly in the lower limbs.Can be divided into two categories:
Origin: The cause is unknown.
Secondaryness: Due to other diseases; such as lack of iron, pregnancy, Parkinson’s disease, peripheral neuropathy, or chronic renal failure.
The incidence of patients with kidney dialysis is about 12 ~ 25%, that is, each four kidney friends have one person to bear the suffering of unshakable legs, and the lesion rate is much higher than that of ordinary people.
Patients often describe that their feet or calves have itching, numbness, burning, soreness and other different sensations. They are even like a little worm climbing on it. It is especially easy to occur when resting or sleeping at night.This discomfort, but if the movement stops and stops moving, the itchy discomfort will come back immediately.Symptoms usually last for several minutes to a few hours, which seriously interfere with the rest of the patient, making it difficult for people to fall asleep or even cause insufficient sleep.
It is necessary to exclude diseases that also cause discomfort in lower limbs, such as muscle soreness, poor vein blood background, calf cramps, etc., and then evaluate whether the patient has the following symptoms:
In addition, nearly 80 % of the restless leg patients are also combined with sleep cyclical limb dynamics.
Symptoms are usually when they are about to fall asleep, and they will unconsciously pull up the foot plate upward and the calves will be pumped. It lasts about 2 to 4 seconds at a time, but it will occur in less than a minute (twitching every 20 to 40 seconds to twitchOnce), in severe cases, even more than a thousand times a night.
If the patient merges these two syndrome at the same time, when lying flat every night to sleep, he constantly wants to move his legs and jets because of the abnormal sensation of the lower limbs.Wake up many times, the poor sleep quality can be imagined.
Studies also pointed out that compared with no one with the restless legs, the quality of life is poor, emotional is more anxious, it will be easier to doze off during the day, and even the risk of cardiovascular disease and related mortality.
For why some people have uneasy legs, some people have it?The exact reason is not very clear.
Studies have found that nearly 40 % of patients have related family history. Based on this, it is speculated that uneasily legs may be a genetic disease. If there are certain pathogenic genes in the body, they may cause uneasy legs.
In addition to heredity, the reasons that are currently considered to cause unbelievable legs are as follows:
Insufficient dopamine secretion in the brain
Excessive garsine in the brain
Insufficient iron in the brain: Because iron is an important auxiliary factor for dopamine synthesis in the brain, if the lack of iron may indirectly lead to insufficient dopamine manufacturing.
The number of opium receptors in the brain decreases
As mentioned earlier, the probability of restless legs in dialysis patients is much higher than that of ordinary people. Therefore, it is speculated that excessive uremia accumulates in the body, which may cause uremia uneasy legs.
It is also found clinically that after receiving kidney transplantation, many dialysis patients have healed uneasily legs and cyclical limbs of sleep; there may be causal relationships between uremia and restless legs.
There are currently two categories that are considered more effective healing drugs:
Dopamine receptor promotion agent
GABA Structural Alternative
One of the many factors that cause restless legs are inadequate or low -functional dopamine secretion or low function. Therefore, the use of dopamine receptor promotion agents can strengthen the effect of dopamine in the brain and achieve the effect of treatment.
Clinical manifestations include: the onset time of Bingying legs from the original evening or evening to the daytime will also have discomfort symptoms. When lying down, the symptoms will appear faster than before. Except for this discomfort, other parts of the body such as the upper limbs are upper limbs.There are also similar symptoms, the duration of medicinal effects after taking the medicine has become shorter.
If the above symptoms occur, the medication must be temporarily stopped or replaced with a longer -acting drug format.
When the patient is complaining that it is difficult to fall asleep due to restless legs, you can also consider sedative sleeping drugs, such as clonazepam and other people to sleep after taking medicine.Anomaly and other neurological symptoms.
Finally, patients with primary uneasy legs or renal failure, such as secondary uneasy legs, must adjust their living habits moderately to avoid irritating substances such as smoke, alcohol, coffee;Sports, massage legs, and hot baths, etc., can also help relieve symptoms.