Can these symptoms be so severe as to drive someone to have suicidal thoughts? Acute exacerbation of RLS symptoms is a notable feature of this disease that is encountered by most RLS specialists who see a large number of such patients. This exacerbation could be spontaneous, without any obvious triggers, or it could be triggered by iron deficiency, change of lifestyle (e.g., retirement and being more inselected, relative inactivity during hospitalization), use of certain medications (e.g., antihistamines, antinausea drugs, or antidepressants; see Question 82), or associated medical conditions. During these acute exacerbations, RLS symptoms become intense and frequent, may be present throughout the day, and may reach the “unbearable” point. In fact, many patients describe these symptoms as “torture.” Similar severe symptoms may also occur in advanced stages of the illness due to disease progression.
There are numerous anecdotal reports of RLS patients going to the emergency room of a hospital to seek relief of these intense symptoms. Listen to Brian’s description of his own experience
Brian’s comment:
I believe that I have had Restless Leg Syndrome for over 30 years. I can remember having the symptoms as a teenager, but not knowing what it was. My parents often told me that it was growing pains and that they would subside as I matured. However, when I was 30 years old, I had secured a job that required that I walk up to five miles every day. This was when RLS started to affect my sleep; I would rarely make it through the night without one or more severe episodes. As a result I found that I was unable to get a good night’s sleep, and I was constantly tired. My mother who also has RLS would tell me that cheese was the cause of my leg problems. I stopped eating cheese but the RLS did not subside. I applied lotions, creams, and anything else that I thought could possibly stop the ever present feelings I had in my legs. On occasion, the RLS became RAS, Restless Arm Syndrome. On countless nights, I was unable to control both my arms as well as my legs. I had noticed over the years that my RLS became unbearable while on vacations. Because my wife and I travel, and many times a large amount of walking is required, the RLS was particularly bad. At night the bed sheets felt like sand paper against my skin.
RLS became so debilitating one night that I had to be driven to the hospital. The RLS started soon after my wife and I had finished dinner at a central New Jersey restaurant. My wife was driving because I simply could not sit still. Finally it got so bad that I got out of the car and ran the last mile to the hospital. After waiting what seemed like hours, an emergency room doctor spoke to me. To my amazement the doctor could not pinpoint what exactly was happening to me. I couldn’t sit, nor could I stand in one place for more than a few seconds. Finally, after hours and hours they sent me home no better than I was when I first entered the hospital. The remainder of the night was a blur. A few years later the exact same incident occurred. I was brought again to the emergency room and again a doctor examined me. This time, however, the physician knew what was causing my legs to jump uncontrollably but had no way to stop the problem. Finally after a few hours the doctor gave me a shot which would eventually knock me out.
As I left the ER I remember thinking that this was going to be part of my life for the rest of my life, but that was not the case. My wife who witnessed the suffering I had experienced for seventeen years began to research RLS on her own. After reading several books about the topic she kept seeing the name of a prominent doctor specializing in the treatment of RLS. Fortunately for us he had an office at a local hospital, and we made an appointment post haste. After speaking with his team, it was determined that I first take a sleep disorder test. The results were startling. It was the conclusion of the doctors that I had sleep apnea and a severe case of RLS. Tackling the RLS was the number one goal. The physician prescribed a drug called Mirapex. I was a bit skeptical because I was already taking a drug called Requip. Requip worked very well, however, the longer I took Requip, the more it seemed I needed to increase the dosage. I have been taking Mirapex for over a year and I have not had to increase the dosage. My thanks go out to the physician and his team who gave me my life back.
Many patients who have experienced these unbearable symptoms affecting sleep and mood night after night have had suicidal thoughts on certain occasions, particularly those with severe depression (see Question 82). There are, however, no adequate scientific studies to verify these anecdotal reports of suicidal thoughts and desperate measures undertaken to relieve these symptoms in the occasional patient. There is one report attesting to the potential for injury in patients with uncontrolled RLS. In this case, an elderly woman with uncontrollable RLS spent most of the night standing and walking. On several occasions, she fell and sustained occasional bone fractures. Another report involves an elderly woman with RLS who was admitted to the hospital on an emergency basis with severe pain in her legs, which was relieved dramatically by use of epidural (outside the lining covering the spinal cord) morphine (a very strong narcotic).
The utter frustration and desperation of many patients with RLS are vividly described as personal testimonials in a book published in 2006: Restless Legs Syndrome: Relief and Hope for Sleepless Victims of a Hidden Epidemic by Robert Yoakum. Yoakum is a victim of this miserable disease himself (see Question 100
