Episode 34

Restless

Early in my career as a medical student, I was convinced that some “diseases” were just being made up by drug companies to move products - that there was no way this could possibly be real - boy, was I wrong!

In this episode, I review one of the most common disturbances that can interfere with your ability to fall asleep: Willis-Ekbom disease, also known as restless legs syndrome.

Restless legs syndrome/Willis-Ekbom disease is characterized by a discomfort in the body, typically the legs, often described as an urge to move that may or may not be associated with odd sensations in the effected part of the body. This urge to move occurs during periods of physical rest, especially in the evening and night time. The urge is temporarily or partially alleviated by getting up and moving around. 

Multiple lines of evidence, including blood work, cerebrospinal fluid, non-invasive imaging studies, autopsies, and animal models, all point to brain iron deficiency as the underlying culprit. 

Even if there is enough iron in the body to satisfy the blood's needs (ie, not anemic), there may not be enough left over to share with the brain. This can disrupt several chemical pathways in the deep structures of the brain. 

In addition to several non-pharmacological interventions including exercise, massage, vibratory stimulation, and warm baths, iron replacement (both oral and intravenously) has been shown to significantly improve symptoms of restless legs/Willis-Ekbom disease. 

If restlessness is keeping you awake at night, consider scheduling an appointment with your trusted healthcare providers or local accredited sleep center to find out if iron may be of benefit for you.