nightwalkers - Restless Legs Syndrome Foundation
Transcription
nightwalkers - Restless Legs Syndrome Foundation
A publication of the Restless Legs Syndrome Foundation I n s e a r c h o f a g o o d n i g h t’ s s l e e p NIGHTWALKERS Madison Regional Meeting It was an unusually warm and sunny Sunday morning in October for the Madison Regional Meeting in Wisconsin. RLS Foundation staff and volunteers arrived early and prepared a conference room at the Alliant Energy Center of Dane County. When the welcome address began at one o’clock, the room was nearly filled. The program began with Dr. Phil Becker giving an introduction to the disorder most in the audience deal with on a daily basis. Dr. Becker’s introduction segued into the presentation on treatment options. Knowledgeable Board Chair-Elect, Jacci Bainbridge, PharmD, provided detailed information on the pros and cons of many pharmaceutical drugs on the market. After a short break, the audience resumed to hear an inspirational and humorous talk on learning to be resilient and keeping laughter in your life from motivational speaker and author, Vicki Snyder. The audience participated by performing laughter exercises, completing a quiz on resiliency, and informing those around them what some of the positives in their lives were. The room roared with laughter and everyone left with new ideas and motivation. “There’s something to be thankful every single day,” Vicki expressed. “Living with a chronic condition doesn’t mean life has to be negative. I believe in laughing as much as possible. It truly is the best medicine.” At the conclusion of the meeting, questions were answered and support was offered via the panel discussion. Audience members were able to ask specific questions to RLS experts and everyone walked away with valuable knowledge. The audience members didn’t just leave the Madison Regional Meeting with a folder full of new information; they also left with a changed perspective, new friendships, and support. In just one afternoon, we were able to reach out and connect through experiences. We hope you’ll join us at the next RLS Regional Patient Meeting. continued on page 5 FALL 2010 Inside NightWalkers Support Group Spotlight.........8 In the News.............................9 Support Groups.....................10 Ask the Doctor.......................15 Bedtime Stories......................19 RLS & Chinese Medicine Book Excerpt: 100 Questions & Answers about RLS Medications for RLS page 2 page 4 page 17 www.rls.org RLS Foundation News Restless Legs Syndrome and Chinese Medicine By: Xue Yan, MD Xue Yan, MD, spent six months between March 2010 through September 2010 studying and doing research in the Sleep Medicine Division of the Neurology Department of Vanderbilt University Medical Center as a visitor under the State Scholarship Fund supported by the China Scholarship Council (CSC). The Theory of Traditional Chinese Medicine With a long and remarkable 2,000-3,000 year history, Traditional Chinese Medicine (TCM) has formed a unique system to diagnose and cure illness. In TCM, the understanding of the human body is based on the holistic understanding of the universe. The integrity of the human body and the relationship between the body and the environment are emphasized. The major theories of TCM include the Yin-yang, the Five Elements, and Zang Fu organ theory. Chinese philosophy uses yin and yang to represent a wider range of opposite properties in the universe. The system of Five Elements (wood, fire, earth, metal, and water) is used for describing interactions and relationships between phenomena. Zang Fu, is a concept that describes the functions of the organs of the body and the interactions that occur between them. RLS in TCM Theory According to TCM, the external cause of RLS is initiated by external wind, external cold, and external damp, which then result in the block of meridian (channels along which the energy, or Qi, of the psychophysical system is considered to flow); Qi (vital force providing the energy needed for organs to perform their physiological functions); and blood. The internal cause of RLS is concluded as deficiency of liver and kidney, and deficiency of Qi and blood. It is interesting that in Western medicine, two of these concepts were also recognized as pathogenetic to RLS, mainly the role of renal failure and anemia. The excessive movements of the legs can be interpreted as being a manifestation of internal wind, a condition that is associated with liver blood deficiency. The strange leg sensations described are attributed to blood deficiency or blood stasis. According to Western medicine, iron and folate deficiency, as one main cause of RLS, would be a clear indication of blood deficiency. The fact that the disorder occurs more notably at night and disturbs sleep, suggests the Wei Qi (defensive energy) that circulates at the surface of the body during the day fails to fully return to the interior at night -- a problem that is usually attributed to a fluid deficiency of the internal organs, such as yin deficiency or blood deficiency of the liver. 2 NightWalkers The fact the symptoms are primarily in the legs is said to be a deficiency of the liver-kidney system. The liver-kidney system is said to deteriorate as we age, so this relationship may also explain the prevalence of RLS among the elderly. Sleep disturbance, as a common aspect of the disorder, may implicate deficiency of the heart. This could explain the current Western concept that RLS is linked to cardiovascular disease. Also, kidney essence is related to familial conditions, and there appears to be a genetic link to RLS. Chinese Herbs in Treating RLS CMT primarily involves tonifying the deficiencies and promoting blood circulation. The deficiency syndrome appears to mainly involve the liver and kidney (possibly also the heart), and the stasis mainly involves the blood and Qi. Herbal remedies can be recommended to relieve the uncomfortable sensations of RLS. Some of these therapies, most of which are herbs, are as follows*: coix seed, atractylodes lancea and rhizoma zingiberis recens for dispelling exopathogens; Chinese angelica root and white peony root for nourishing blood of the liver and heart; rehmannia, cornus officinalis and semen ziziphi spinosae for nourishing the liver and kidney; astragalus root and radix codonopsis for reinforcing Qi; angelicae radix, caulis spatholobi and achyranthes for nourishing blood and promoting blood circulation. Achyranthes also have the effect of directing the blood flow to the lower body. According to modern research, angelicae radix can affect dopamine, y-aminobutyric acid (GABA) and serotonin receptors. Chaenomeles fruit can release the leg muscles and tendons of the limbs; the traditional pair of white peony root and licorice root are typically used to reduce uncomfortable sensations, also in deficiency syndromes. White peony root has also been identified to have the effect of vasodilating, improving distal circulation of the body, regulating, and improving the blood circulation of the limbs. It is interesting that vasodilators were amongst the agents recommended by Ekbom for the treatment of RLS in 1960. continued on page 16 www.rls.org From the Director’s Desk NightWalkers is the official publication of the Restless Legs Syndrome Foundation Board of Directors Janice E. Hoffmann, Chair Roberta Kittredge, Vice Chair Jacquelyn Bainbridge, PharmD Norean V. Dreier, Treasurer Diana F. Bartlett Carol Ciluffo John Dzienkowski Régis Langelier, PhD Carolyn Mohn Kathy Page Matthew A. Picchietti Linda Vedders Robert (Bob) H. Waterman, Jr., Chair Emeritus Medical Advisory Board Christopher J. Earley, MD, PhD, Chair Phillip M. Becker, MD Mark J. Buchfuhrer, MD, FRCP(c), FCCP Jeffrey S. Durmer, MD, PhD Brigit Högl, MD Daniel Picchietti, MD Michael H. Silber, MB, ChB Penny Tenzer, MD Mary L. Wagner, MS, PharmD Arthur S. Walters, MD John W. Winkelman, MD, PhD Scientific Advisory Board James R. Connor, PhD, Chair Michael Aschner, PhD Michael Brownstein, MD, PhD Marie-Francoise Chesselet, MD, PhD Christopher J. Earley, MD, PhD Emmanuel J. Mignot, MD, PhD Jacques Montplaisir, MD, PhD, CRCPc Pamela Pierce-Palmer, MD, PhD Neil Risch, PhD Joseph S. Takahashi, PhD George Uhl, MD, PhD Executive Director Georgianna Bell NightWalkers is published in the winter, spring, summer, and fall. “Ask the Doctor” questions, “Bedtime Stories,” address changes, contributions, and membership inquiries should be sent to: NightWalkers, RLS Foundation 1610 14th St NW Suite 300 Rochester, MN 55901 The RLS Foundation does not endorse or sponsor any products or services. ©2010 Restless Legs Syndrome Foundation Editor: Gina Depuydt Medical Editor: Mark Buchfuhrer, MD, FRCP(C), FCCP Warning and Disclaimer Persons suspecting that they may have RLS should consult a qualified healthcare provider. Literature that is distributed by the Restless Legs Syndrome Foundation, including this newsletter, is offered for information purposes only and should not be considered a substitute for the advice of a healthcare provider. www.rls.org Several months ago the RLS Foundation issued a CALL TO ACTION to our members of the RLS community. The situation was urgent: the Food and Drug Administration (FDA) had failed to approve the gabapentin pro-drug Horizant for the treatment of RLS. Your response to the FDA Division of Neurology Products was – in a word – remarkable! Many of you who wrote to Dr. Russell Katz at the Division of Neurology Products sent me copies of your letters. Below are just a handful of excerpts from heartfelt letters that were sent to the FDA. Georgianna Bell Executive Director, RLS Foundation “I am an 80-year-old man who has suffered with RLS for about ten years. Gabapentin was prescribed to me eight years ago. It relieved my symptoms enough for me to get a good night’s sleep. I don’t understand how you can summarily dismiss approval of gabapentin because RLS is not a life threatening condition. Have you considered the suffering caused by RLS?” – William “I have lived with RLS for thirty years. Please do not diminish or dismiss the suffering and disruption experienced by RLS suffers. Poorly treated RLS has a serious impact on victims’ lives. Please give serious consideration to new medications and treatments. Evaluate them as you would any new drug that might relive a serious disease.” – Mary “I am 84-years-old and have had RLS for forty years. I wish I had kept a list of the many drugs that were prescribed to me over the years – that didn’t work. RLS might not cause death, but it can cause suicides because it is so frustrating. I strongly urge you to approve the new medication for the treatment of moderate to severe RLS.” – Lillian In addition to the many letters sent to the FDA, the RLS Foundation (in collaboration with the International RLS Study Group) contacted the FDA to learn more about how we could educate and influence RLS-related decisions. I am excited to share our progress with you. After a productive discussion with the FDA Office of Special Health Issues, the RLS Foundation was invited to nominate two to three individuals to serve as Patient Representatives who will provide active participation in formatting FDA regulatory policy for either medical products under review or Advisory Committees. In addition, we are in the early stages of planning a workshop with three goals: to more clearly define RLS as a disease; to study factors that worsen the disease (e.g. use of dopamine agonists that cause symptom worsening augmentation); and to study factors that improve the disease (e.g. iron therapy). Our goal for this event will be to involve FDA staff in the planning and to promote common understanding of the complex nature of RLS, as well as to hopefully identify new treatment modalities that will alter its course and significantly improve outcomes. Sincerely, Georgianna Bell Executive Director Fall 2010 3 Book Excerpt Book Excerpt: 100 Questions & Answers About Restless Legs Syndrome While the RLS Foundation does not endorse products, we try to share what is available to help our members with ideas, encouragement, and support. This book is designed to provide education on RLS. Whether you are a newly diagnosed patient or a loved one of someone with RLS, this book offers essential information and comfort. 100 Questions & Answers About Restless Legs Syndrome by Sudhansu Chokroverty, MD, provides authoritative, practical answers to the most common questions asked by patients. This easy-to-read book is a complete guide to understanding symptoms, diagnosis, treatment, post-treatment quality of life, and much more. Including actual commentary from patients, 100 Questions & Answers About Restless Legs Syndrome is a resource for anyone coping with the physical and emotional turmoil caused by this condition. Sudhansu Chokroverty, MD, FRCP, FACP, is currently Co-Chair of Neurology for Clinical Neurophysiology and Sleep Medicine, and Program Director of Clinical Foundation Website Update The RLS Foundation’s website is a great place to keep up with what is current on RLS. The latest news is posted on the front page of our website at www.rls.org. We also have a “Youth Initiative” webpage. Do you need more information on pediatric RLS? Wondering where your teenager can find support? Visit www.rls.org/youth today. Remember, by joining our “Online Community” with your email address, you will become an RLS Efriend and receive an email each month discussing breaking news and announcements for the RLS community. We know many of you do not have Internet access. Rest assured that anything of importance will be presented in NightWalkers. You will not miss out! 4 NightWalkers Neurophysiology at the New Jersey Neuroscience Institute at JFK Medical Center, Edison, NJ. He is also Professor of Neuroscience at Seton Hall University School of Graduate Medical Education, South Orange, NJ, and Clinical Professor of Neurology at Robert Wood Johnson University Medical School, New Brunswick, NJ. 100 Questions & Answers About Restless Legs Syndrome is available at http://www.jblearning.com. _______________ “Today we know a great deal about RLS—but not exactly what causes RLS or which part of the nervous system, if any, is affected. It is generally thought that RLS is a disorder arising from the central nervous system (CNS), even though no specific structural abnormality has been identified. Is the problem located in the cerebral hemisphere (the main part of the brain), the brain stem (the lower part of the brain, which is connected to the main portion of the brain and controls vital functions such as circulation, respiration, and sleep), or the spinal cord…?” How to Spot a Scam The RLS Foundation recognizes there are many sites online dealing with RLS. One quick and easy way to spot a scam or untrustworthy site/product is by simply reading carefully. The neurological disorder nearly 10% of the American population lives with night after night is restless LEGS syndrome. There is no such disorder as restless LEG syndrome. If you spot this error, do not trust the information. For more quick facts on restless legs syndrome, see the RLS Foundation’s Frequently Asked Questions page at www.rls.org/faq. www.rls.org RLS Foundation News Madison Regional Meeting continued from page 1 Evaluations were gathered from meeting attendees and included comments such as: ________________ “I enjoyed all of it. The meeting reinforced some of what I knew and gave me information on new medications coming.” ________________ “I liked the diverse speakers. I didn’t know about so many medication side-effects. It was great to close on a positive and humorous note!” ________________ “The presentations were helpful. I learned RLS is more prevalent than I thought and that it’s more common in women. ________________ I’m going to share this information with my general doctor. He needs a better understanding of this disorder.” Thank you to our speakers at the Madison Regional Meeting: Philip M. Becker, M.D. Dr. Becker is president and founding partner of Sleep Medicine Associates of Texas, P.A. Since 1987, he has served as Medical Director for the Sleep Medicine Institute at Presbyterian Hospital of Dallas and is a Clinical Professor in the Department of Psychiatry at the University of Texas Southwestern Medical Center at Dallas. His primary specialty is in psychophysiologic functioning as it relates to sleep disorders and research, having a special interest in restless legs syndrome. He has published over 60 articles, chapters, and abstracts on a variety of sleep disorders as a Medical Advisor to the RLS Foundation. Jacquelyn L. Bainbridge, BSPharm, PharmD, FCCP Dr. Bainbridge received her doctorate of pharmacy from the University of Colorado School of Pharmacy, where she subsequently completed a specialty residency in neurology. She currently serves as a Professor at the University of Colorado Denver School of Pharmacy, Department of Clinical Pharmacy and Department of Neurology. She is a frequent lecturer on topics of neurological and pharmacological interest in the areas of restless legs syndrome, multiple sclerosis, epilepsy, migraine, neuro-protection, chronic pain disorders, and movement disorders. She is the Chair-Elect of the Board of Directors for the RLS Foundation. Dr. Bainbridge has been elected as a Fellow of the American College of Clinical Pharmacy (FCCP) and won several student preceptor and teaching awards. ________________ “I met a lot of nice people who were very friendly. The question and answer panel was very interesting.” ________________ “What was the best part of the program? Realizing I am not alone.” www.rls.org Vicki Snyder, Motivational Speaker Vicki Snyder has been the CEO (Chief Enthusiasm Officer) of Communication Connection for the past 13 years. Ms. Snyder blends her education as a human resource professional and experience in management and customer service by offering upbeat, interactive keynote speeches and workshops. Certified laughter leader, author, and speaker, Ms. Snyder has been privileged to speak to organizations such as Mayo Clinic (Minnesota & Arizona) and Kraft Foods. Fall 2010 5 Complementary Corner Can Melatonin Help Symptoms of RLS? By: Dr. Norma Cuellar, RN Melatonin is a hormone secreted by the pineal gland in the brain. Everyone has melatonin in their bodies. Melatonin is important in the “circadian pattern” of your sleep because it controls your sleep and wake cycle. The normal cycle of melatonin is much like any hormone in our body, having peaks and valleys in a 24-hour period. The levels of melatonin begin to rise from mid to late evening and remain high throughout the night, resulting in sleep onset and maintenance. In the morning, our body stops making melatonin, and it causes us to wake up. This trigger to stop making melatonin is initiated by light exposure including the sun or bright lights. As we age, our bodies secrete less melatonin, thereby causing problems related to our circadian pattern of sleep. Many studies have examined the effectiveness of taking melatonin to help sleep. Few studies have identified that melatonin actually helps with sleep. Melatonin is helpful in resetting the circadian clock – or getting your body into a natural rhythm of when to begin the rise of melatonin to induce sleep. This is helpful, for example, in people who travel throughout different time zones or work rotating shifts. Melatonin has not been shown to be helpful with insomnia or improving sleep onset. How melatonin helps you fall sleep Some people believe that when someone takes melatonin, a placebo effect occurs. Does taking a pill to help you sleep in fact make your brain believe that it is time to go to sleep? This placebo effect is a very strong mechanism and has explained many reasons why people get effects from different medications. In persons with RLS, melatonin levels are no different than in people who do not have RLS.1 In fact, melatonin has been shown to inhibit dopamine release. Taking melatonin may restrain dopamine release, which may worsen symptoms of RLS. When melatonin was given to hamsters, over a 9-week period, dopamine levels were decreased by 50%.2 In humans, melatonin was found to worsen symptoms of RLS in the evening and during the night.3 More recently, 8 persons with RLS were found to have worsening symptoms of RLS after receiving melatonin.4 Conclusion Melatonin is a hormone and as any hormone, it should not be taken lightly. Careful consideration should be made when 6 NightWalkers starting this over-the-counter medication. If you are taking melatonin and continue to have symptoms of RLS, you may want to speak to your physician to consider tapering yourself off of the melatonin if you take it on a daily basis. Since melatonin is considered a hormone, Dr. Norma Cuellar, RN tapering yourself off of the medication Assistant Professor, University of over time is recommended. You should Pennsylvania School of Nursing keep a sleep diary as you change your medication uses. ______________________________________________ 1. Tribl, G., Waldhauser, F., Sycha, T., Auff, E. & Zeitlhofer, J. (2003). Urinary 6-hydroxy-melatonin-sulfate excretion and circadian rhythm in patients with RLS. Journal of Pineal Research, 35, 295-296. 2. Garcia-Borreguero, D., Serrano, C., Larrosa, O. & Granizo, J. (2004). Circadian effects of dopaminergic treatment in RLS. Sleep Medicine, 5, 413-420. 3. Michaud, M., Dumont, M. Selmaoui, B., Paquet, J, Fantini, M. & Montplaisir, J. (2004). Circadian rhythm of RLS: relationship with biological markers. American Neurological Association, 55, 372-380. 4. Whittom, S., Dumont, M., Petit, D., Desautels, A., Adam, B., Lavigne, G. & Montplaisir, J. (2010). Effects of melatonin and bright light administration on motor and sensory symptoms of RLS. Sleep Medicine, 11, 351-355. Restless Legs Syndrome Foundation 1610 14th St NW Suite 300 Rochester, MN 55901 Phone: 507-287-6465 Fax: 507-287-6312 Email: rlsfoundation@rls.org www.rls.org CANADA The Canadian RLS Foundation accepts donations and sends tax receipts for Canadian citizens. Please send to: RLS Foundation, Inc. 1581-H Hillside Ave, Suite #409 Victoria, BC V8T 2C1 In Canada, our nonprofit tax identification number is: 88018 7109 RR0001 www.rls.org News from the Development Chair When you visit www.rls.org, you are greeted with the following message: “The Restless Legs Syndrome Foundation is a non-profit organization providing the latest information about RLS. The goals of the Foundation are to increase awareness, improve treatments, and through research, find a cure for RLS, a condition which severely affects the lives of millions of individuals.” People come to the RLS Foundation’s website for one reason; they are looking for answers. Questions range over many topics, but the underlying question is always – “How do I deal with RLS on a daily basis?” If you Google “Restless Legs Syndrome” you get 669,000 results. “Restless Leg Syndrome” gets you 1,110,000 results while “RLS” has 15,000,000. Whichever way you type it in, the rls.org website is either the top or second to the top result. There is a reason for that. The RLS Foundation is the most reliable source available for information about RLS. We can find answers about medications and effects, what might trigger our RLS, coping mechanisms, current research, clinical trials, and where to find support in our area. Kathy Page 2010 Development Committee Chair I came to the website about 10 years ago with the same questions as everyone else. I was desperate for answers. And on my visit to www.rls.org, I found more than answers; I found I was not alone. The discussion board introduced me to others who understood what I was going through. Here were people who didn’t tune me out or tell me I was crazy when I tried to explain what I was feeling. Here were people who needed me as much as I needed them. Later, I was thrilled to be able to meet some of my new online friends at the second National Patient Meeting in Long Beach, CA in 2004. I met other friends by becoming involved with different committees and groups of the Foundation. These friends have sustained me during some very dark hours. They have become some of the most important and cherished people in my life. By becoming a member, “talking” on the discussion board, or volunteering your time to the Foundation, you will find that you are not alone. At the very least, you will find an organization that cares about you as a person; that works diligently to get quality, reliable information out to you; that keeps the Foundation goals always in the forefront. It will take all of us, whether we know each other or not, to make the Foundation’s goals come to fruition. Those goals belong to all of us. Never feel that what you have to offer is too small or not enough. Whatever you can do will make a difference. Remember, there just might be someone else out there who would benefit in a connection with you as much as you with them. Honor Roll Kathy Page 2010 Development Committee Chair A Memorial or Tribute Gift Have you considered telling your family about the RLS Foundation’s Memorial / Tribute option? These gifts will provide support for an organization that you or your honoree are passionate about while also letting them know they are appreciated by you. With a memorial gift of any denomination, the RLS Foundation offers a variety of recognition options. Consider using a memorial or tribute gift for a special occasion. Is there any better way to express your support to the RLS Foundation while honoring those who make a difference in your life? www.rls.org The RLS Foundation is sincerely grateful for the donations we have received in memory and in honor of the following individuals*: Honoraria Charlie Saladin Dorothy Field Roberta Kittredge John Morris Rita Berlin Brodie Lamb M. Lynn McCracken David Milne Gloria Rotkin Jonathan Titman Memorials John Bachman Edna Birbaum Betty Brown Mary Corby Curtis Hardin Irwin Klein Merlyn G. Law Wava Mills Adele Minervino Dawn Parsons Marion Perrault Norman Perry Alba Siciliano Elizabeth “Bill” Tunison Aubrey Workman * Begining 7/17/2010 and ending 10/31/2010 Fall 2010 7 Support Group Spotlight Questions with Charlene Program Assistant Seema Dhindaw had a chance to talk with RLS Support Group Leader, Charlene Travelstead. Charlene leads the Lake Havasu RLS Support Group in Arizona. Her Support Group’s contact information can be found on page 10. Seema: Why did you become a Support Group Leader (SGL) and how long have you been a SGL for the Foundation? Charlene: It was three years this past April. I had RLS really bad and knew if I just touched one person, then I would accomplish what I set out to do. I knew what it was like and I wanted to be there for others living with RLS. Seema: How has RLS impacted your life and the lives of your loved ones? Charlene: It has really made me realize just how many people out there have this horrible disorder. And that makes me want to be sure they are not alone. My husband has been very supportive at times when my RLS was at its worse (and that means he was supportive a lot). I wanted to be the strong support for those who do not have that. Seema: What has been some of your most memorable moments or events as an SGL? Charlene: The one most memorable moment was when Lynne Kaiser, Support Group Leader for Dallas, Texas, spoke at our Support Group Meeting in August 2009. The impact she left with me and my Group is something we will never forget. To this day, my Group still talks about that meeting. If I could arrange another time for Lynne to hold another joint meeting, I would do it in a heartbeat. Seema: What do you hope to accomplish in your Support Group in the next year? And what do you hope the Foundation will be able to accomplish? Charlene: My goal and hope is to get the awareness out to more people who are suffering with RLS. My hope for the Foundation is that they are able to fund the research that will lead us all to a cure for RLS. 8 NightWalkers Seema: What advice do you have to other leaders on effective strategies to insure a successful meeting? Charlene: My advice is to make sure you make the meeting interesting for both you and your audience. If the topic doesn’t interest you, it may not interest an audience. Also, always take time for your people and let them Charlene Travelstead, RLS Support Group Leader know this meeting is for Lake Havasu, Arizona them. The point of this volunteer position is to support others. It is important to make that the focus. Planning is also an important aspect. I plan meetings three times a year – in April, August, and December. I always contact my Support Group members at least one month before each meeting. I am not the kind of person to send them one notice. I send four or five reminders. I realize that people are busy and they have thanked me numerous times for these reminders. Seema: What do you enjoy most about being a Support Group Leader? Charlene: I love the fact that I have helped people understand I will always be there for them. I am ready with the information and tools from the RLS Foundation to really make a difference in lives. I am glad I can be that person to others. My experience being a SGL has been the best thing that I have done. Help Us Make NightWalkers Even Better The Restless Legs Syndrome Foundation strives to ensure we supply all interested individuals with the most reliable RLS information available. Please send any suggestions, corrections, or article ideas to us at rlsfoundation@rls.org. Assist us in continuing to make NightWalkers personally useful for all who live with RLS. www.rls.org In the News Treat RLS with a Patch Treatment of moderate to severe restless legs syndrome: 2year safety and efficacy of rotigotine transdermal patch. Högl B, Oertel R, Kohnen R. BMC Neurology. September 2010. Background: In the last few years researchers have recommended using non-ergot dopamine agonists (pramipexole, ropinirole, rotigotine, and sumanirole) as a firstline treatment for RLS. Rotigotine has been formulated as a once-daily transdermal patch which has been used successfully for Parkinson disease. Research: The researchers in this study wanted to determine how safe and how effective the rotigotine patch would be for RLS. There were 295 patients included in this study. The average age was 58 years old, and 66% were females. The patients used the patch daily for two years. A total of 190 patients completed the study. The results of this study showed that 34.5% of the patients had skin reactions to the patch during the first year, but this dropped to 16.4% the second year. The most common medication side effects were nausea (0.9% of patients) and fatigue (2.3% of patients). After using the patch for two years, there was a significant improvement in the four RLS rating scales used (the International Restless Legs Syndrome score, RLS-6 scale, CGI score, and Quality of Life-RLS score), and 95% of the patients rated that after using the rotigotine patch their symptoms improved either “much” or “very much”. Bottom Line: The rotigotine patch, while not currently available in the United States, appears to be a safe and effective medication for the treatment of RLS. New Questions: Will this medication be sold in the United States again soon? (It was initially sold as Neupro in the United States, but it was pulled off the market due to the patch not delivering the medication evenly.) Light Therapy for RLS Use of near-infrared light to reduce symptoms associated with restless legs syndrome in a woman: a case report. Mitchell U. Journal of Medical Case Reports. August 2010. Case: The researchers in the case report wanted to see if nearinfrared light (NIL) would be beneficial for RLS. NIL is currently used to increase circulation and decrease pain in people with neuropathy and has been used for wound healing as well. In a previous study, three patients who were being treated with NIL for their neuropathy reported that their RLS had improved or was eliminated in the process. This prompted the researchers to conduct this case study. www.rls.org www.rls.org A 69-year-old female with RLS for over 30 years had been treated with many approved and off-label medications for her symptoms for years without benefit. Her score on the Restless Legs Syndrome Rating Scale (0-40 point scale) was 27 at baseline. This score placed her in the “severe” category. The patient was treated with NIL in 30-minute treatment sessions three times a week for four weeks. After the end of week one, her RLS Rating Scale was 14. After week two, her score was down to two. After week three, her score was only one. She reported that she was completely symptom-free at the end of four weeks. However, her symptoms gradually returned during week three post treatment. At week four post treatment, her score was 15. New Questions: Will there be a larger study to validate this one case report? If this is beneficial, will home treatment be available? A Link Between RLS and ADHD Restless legs syndrome as a possible predictor for psychiatric disorders in parents of children with ADHD Steinlechner S, Brüggemann N, Lencer R. European Archives of Psychiatry and Clinical Neuroscience. September 2010. Background: There is some research that suggests a link between RLS and symptoms of Attention Deficit Hyperactivity Disorder (ADHD). There is evidence that persons with ADHD have a higher rate of other psychiatric diagnoses. Evidence also suggests persons with RLS have higher rates of psychiatric disorders (specifically depression and anxiety). Research: Since both RLS and ADHD appear to have a genetic component, the researchers in this study wanted to evaluate parents of ADHD children to determine if the parents had RLS and/or a psychiatric disorder. There were 37 parents (25 mothers and 12 fathers) of 26 children with documented ADHD that were included in this study. All parents and children were evaluated for RLS by three movement disorder specialists, and those who were suspected to have RLS had additional evaluation to rule out other continued on page 12 Glossary In the News CGI Score: The Clinical Global Impressions (CGI) scale is a well-established research rating tool applicable to all psychiatric disorders that can easily be used by practicing clinicians. Fall 2010 9 RLS Support Group Network United States ALABAMA Contact: Provides timely email and/or phone support Shoals Area Coretha Downs 256-247-3171 ARIZONA Lake Havasu Charlene Travelstead 928-453-9019 LakeHavasu@rlsgroups.org San Luis Obispo Nancy Hair 805-545-7998 SanLuisObispo@rlsgroups.org Southern California Janis Lopes 714-633-0123 SoCal@rlsgroups.org Morningside Lola Scavo 714-256-5722 Morningside@rlsgroups.org FLORIDA Greater Gainesville Area Carol Massey 352-485-1975 Gainesville@rlsgroups.org Gulf Coast Louis Siegel, MD 941-536-0475 GulfCoast@rlsgroups.org South Florida Ira & Lillian Kaufman 561-883-5956 BocaRaton@rlsgroups.org Contact: Payson Beverly Davis 928-468-6626 Beverly@rlsgroups.org Contact: South Sacramento Amy Jaynes 916-682-5209 Amy@rlsgroups.org Spring Hill Bill & Betty Kinahan 352-200-5440 SpringHill@rlsgroups.org Tucson Area Jane Anderson 520-760-5039 Tucson@rlsgroups.org Ventura Area Dave Hennerman 805-766-2035 Ventura@rlsgroups.org Tallahassee Area Richard Wilson 850-443-5414 tallahassee@rlsgroups.org ARKANSAS Contact: Arkansas John Graves 501-565-0341 LittleRock@rlsgroups.org COLORADO Denver Marge Fuhr 303-494-4913 Denver@rlsgroups.org Treasure Coast Mary Lou Mennona 772-546-0750 TreasureCoast@rlsgroups.org Contact: Ozark Carol Mallard 870-481-5640 Carol@rlsgroups.org CALIFORNIA Coachella Valley Charmaigne Menn 760-285-2231 CoachellaValley@rlsgroups.org Marin County Carol Galloway 415-459-1609 MarinCounty@rlsgroups.org Monterey Bay William Schramm 831-484-9058 MontereyBay@rlsgroups.org Oakland Ron Bishop 510-652-4667 Oakland@rlsgroups.org Sacramento Area RLS Support Group Wesley Doak Sacramento@rlsgroups.org 877-895-8706 10 NightWalkers Kay Hall 303-741-6190 Denver1@rlsgroups.org CYBERSPACE Affiliated Online Support Group Jodi Judson rlssupport@yahoogroups.com http://health.groups.yahoo.com/ group/rlssupport/ Donna McLellan RLS_Insomnia_Support_ Group@yahoogroups.com Online Discussion Board Moderators Ann Battenfield rlsfmods@rlsgroups.org Susan Burns rlsfmods@rlsgroups.org Betty Rankin rlsfmods@rlsgroups.org DELAWARE Contact: Greater New Castle/Kent Betsy Lacinski 302-292-2687 Betsy@rlsgroups.org Contact: North Florida/South Georgia Ed Murfin 904-573-8686 Jacksonville@rlsgroups.org GEORGIA Atlanta Area Lorne Ebel 770-252-6776 Newnan@rlsgroups.org HAWAII Honolulu Terry White 808-293-2955 Hawaii@rlsgroups.org ILLINOIS Contact: Central Illinois Vernon Copeland 217-793-1703 Vernon@rlsgroups.org Champaign-Urbana Liz Jones 217-586-3851 Champaign@rlsgroups.org Contact: Southern Illinois Gail Sesock 618-942-7143 Gail@rlsgroups.org INDIANA Indianapolis Area Diane Weissenberger 317-842-0764 Indianapolis@rlsgroups.org IOWA Central Iowa Delila Roberts 515-597-2782 CentralIowa@rlsgroups.org Elaine Tucker 515-733-2299 CentralIowa1@rlsgroups.org Contact: Thelma Bradt 515-243-9553 Thelma@rlsgroups.org KANSAS Kansas City Nora Walter 913-268-8879 KansasCity@rlsgroups.org South Central Kansas John LaFever 316-773-5195 CentralKansas@rlsgroups.org KENTUCKY Restless in Southern Kentucky Ken McKenney 877-700-4070 SoKentucky@rlsgroups.org LOUISIANA Capitol Area Bonnie Hymel 504-469-4938 BatonRouge@rlsgroups.org New Orleans Bonnie Hymel 504-469-4938 NewOrleans@rlsgroups.org MAINE Southern Maine Sally Breen 207-892-8391 SoMaine@rlsgroups.org Seacoast/Southern Maine Chicago Southland Régis Langelier, PhD Bonnie Linder Chicagosouthland@rlsgroups.org 207-351-5352 SeacoastMaine@rlsgroups.org MARYLAND Riderwood Edie Range 301-586-0410 Maryland_Riderwood@rlsgroups.org MASSACHUSETTS Contact: South Shore / Cape Cod and Islands Sheila Connolly 508-790-7640 Sheila@rlsgroups.org MICHIGAN Metro Detroit Michael Fiorillo 248-495-0141 MetroDetroit@rlsgroups.org Western Michigan Neva Warsen 616-532-1698 WesternMichigan@rlsgroups.org MINNESOTA Southern Minnesota Norah Nainani 507-369-5308 SouthernMN@rlsgroups.org MISSISSIPPI Central Mississippi Stan Phillips 601-267-0156 CentralMississippi@rlsgroups.org MISSOURI Central Missouri Kathy Page 660-368-2382 CentralMissouri@rlsgroups.org Mid-Missouri Kay Day 573-897-4950 MidMissouri@rlsgroups.org NEBRASKA Greater Omaha Linda Sieh 402-832-5177 Omaha@rlsgroups.org NEVADA Contact: Las Vegas Annie Flader 702-396-2812 LasVegas@rlsgroups.org NEW HAMPSHIRE Contact: Upper Valley Night Walkers Gail Richens 603-643-2624 UpperValley@rlsgroups.org www.rls.org RLS Support Group Network Seacoast Roberta Kittredge 603-926-9328 Seacoast@rlsgroups.org NEW JERSEY Central New Jersey Elizabeth Rochette 973-715-3868 NewJersey@rlsgroups.org South Jersey Dot Quill 609-522-9401 SoJersey@rlsgroups.org NEW MEXICO Rio Ranchos/Central NM Meg Lindsey 505-715-0325 CentralNM@rlsgroups.org NEW YORK Moving in Manhattan & Long Island Michael Haltman NewYorkMetro@rlsgroups.org 516-338-7500 Contact: Western NY Lee Fischer 716-741-1560 Lee@rlsgroups.org OHIO Mid Ohio Shirley Thomas 304-485-7665 MidOhio@rlsgroups.org Maumee Valley Patricia Phelps 419-877-5012 MaumeeValley@rlsgroups.org NE Ohio RLS Support Group Mark Kaletta NEOhio@rlsgroups.org 216-337-6891 Southwestern Ohio Jan Schneider 937-429-0620 SWOhio@rlsgroups.org OREGON Lane County Yvaughn Tompkins 541-682-5318 LaneCounty@rlsgroups.org www.rls.org Umpqua Valley Lynn McCracken 541-672-3078 Umpqua@rlsgroups.org Valerie Boggs 541-817-4511 Umpqua2@rlsgroups.org Portland Delores Butterworth 360-892-5907 Portland@rlsgroups.org PENNSYLVANIA Pittsburgh North Alice Maxin 724-295-4117 PittsburghNorth@rlsgroups.or Moscow Hopefuls Ethel Rebar 570-842-3443 MoscowHopefuls@rlsgroups.org RHODE ISLAND Southern Rhode Island Lisa Cugini 401-322-3017 RhodeIsland@rlsgroups.org SOUTH CAROLINA Contact: Greater Charleston Jack Kingston 843-388-8006 Jack@rlsgroups.org Midlands June Metts 803-771-7809 Midlands@rlsgroups.org TEXAS Greater Dallas Lynne Kaiser 972-422-0816 Dallas@rlsgroups.org Greater Houston Helen Simons 713-468-4192 Houston@rlsgroups.org Katy Cyndi Moore 832-466-1200 Katy@rlsgroups.org VIRGINIA Central Virginia Pamela Hamilton-Stubbs, MD 804-273-9900 CentralVirginia@rlsgroups.org Contact: Southwest Virginia Annette Price 540-544-7454 SWVirginia@rlsgroups.org Lynchburg Area Patty Arthur 434-384-9013 Lynchburg@rlsgroups.org Tidewater Area Barbara Carlson 757-625-8391 TidewaterVA@rlsgroups.org WASHINGTON Colfax Area Linda Peterson 509-397-3834 Colfax@rlsgroups.org Eau Claire James Alf 715-514-1840 EauClaire@rlsgroups.org Sheboygan Robert Pamenter 920-892-7373 Sheboygan@rlsgroups.org West Bend Karen Borresen 262-306-7373 WestBend@rlsgroups.org Canada ALBERTA Calgary Karen Shillingford 403-532-2534 Calgary@rlsgroups.org Contact: Seattle & Vicinity Roger Winters 206-755-2526 RogerW@rlsgroups.org BRITISH COLUMBIA North Vancouver Karen Norvell 604-792-8729 NorthVancouver@rlsgroups.org Skagit County Charlotte Spada 360-293-7328 SkagitCounty@rlsgroups.org Vancouver Island Marilyn Flynn 250-732-2777 VancouverIsland@rlsgroups.org Spokane Teresa Kincaid 509-999-8234 Spokane@rlsgroups.org Tacoma Area Al Ruff 253-222-5232 Tacoma1@rlsgroups.org Whidbey Island Eva Fluesmeier 360-678-3693 WhidbeyIsland@rlsgroups.org WEST VIRGINIA Contact: Wetzel County Janet Forni 304-455-2073 Janet@rlsgroups.org WISCONSIN Plover Area Jenelle Splinter 715-342-1281 Plover@rlsgroups.org South Central Wisconsin Roger Backes 608-276-4002 Madison@rlsgroups.org ONTARIO Contact: Brantford Gwen Howlett 519-753-1028 Gwen@rlsgroups.org LOOKING FOR LEADERS Whether you’ve recently discovered that you have RLS or have had RLS for years, you can become a Support Group Leader. Many major cities, and even entire states, lack a Support Group to provide advocacy, education, and support to the millions of people who are living with RLS. The RLS Foundation provides assistance to you in starting and maintaining your group. If you are considering becoming a Leader, please contact the RLS Foundation by phone at 507-287-6465, by email at rlsfoundation@rls.org, or at www.rls.org. Show your support of the RLS Foundation by purchasing RLS merchandise. Check out www.rls.org/store today! Simcoe Muskoka RLS Support Group Janet Westall Simcoe@rlsgroups.org 705-721-0569 Contact: Hamilton Wendy Lowden 905-387-5392 Wendy@rlsgroups.org London Heather McMichael LondonOntario@rlsgroups.org Ottawa Carol Connolly 819-459-2655 Ottawa@rlsgroups.org Toronto RLS Support Group Armand Gilks Toronto@rlsgroups.org 416-322-8000 Fall 2010 11 International Restless Legs Groups The following independent groups, located outside of the U.S., work in cooperation with the RLS Foundation. AUSTRALIA Warriewood - Sleep Disorders Australia Beverly Yakich 02-9415-6300 nicc@mail.com AUSTRIA Austrian Support Group Waltraud Moldaschl 0664/2633100 w.moldaschl@gmx.at FINLAND Helsinki - Levottomat jalat-RLSry Markku Partinen, MD, PhD markku.partinen@rinnekoti.fi www.uniliitto.fi FRANCE AFSJR Guy Bourhis 02-38-34-32-80 afsjr@wanadoo.fr www.afsjr.fr GERMANY Munich Deutsche Restless Legs Vereinigung Ilonka Eisensehr eisenhome@yahoo.de www.restless-legs.org NETHERLANDS Zaanstad - Stichting Restless Legs c/o Ms. Joke Jaarsma 31-20-679-6234 joke.jaarsma@stichting-restless-legs.org www.stichting-restless-legs.org In the News In the News continued from page 9 were also evaluated by three psychiatrists (two of whom did not know if the parent had RLS or not) who performed thorough in-person and medical history reviews to determine if there were any psychiatric disorders. Finally, a questionnaire was used to determine if any other family member not included in the study may also have a psychiatric disorder. The results of this study showed 11 of the 37 (30%) parents and 9 of the 26 (35%) children had evidence of RLS. None had been previously diagnosed with RLS. Twenty-nine parents (76.0% of the mothers and 83.3% of the fathers) were diagnosed with one or more psychiatric disorders, including ADHD. Mothers of children with ADHD had higher rates of depression, anxiety, and ADHD, while fathers had higher rates of personality disorders. Those parents diagnosed with RLS did have higher rates of psychiatric disorders, specifically ADHD, agoraphobia, and other anxiety disorders. NEW ZEALAND Nelson - Convenor of Richmond RLS Support Group Tom Marston 0064-03-5486398 trm@clear.net.nz Bottom Line: Based on this study, if a child has ADHD, their parents have higher rates of psychiatric disorders. If a child has ADHD, and the parent has RLS, the parent has a greater chance of having ADHD, agoraphobia, and/or other anxiety disorders. Spanish Association of Syndrome of Anxious Legs (AESPI) President Esperanza Lopez Maquieira C/O Alberto Alcocer 19 1 º D, 28036-Madrid (Spain) Tel. 986712547/609373923 www.aespi.net New Questions: Do the psychiatric disorders develop because of the RLS (i.e. lack of proper sleep leading to depression and anxiety) or would this occur even if the RLS was well treated? Does the severity of RLS correlate with the chance of having a psychiatric disorder? Is there a shared mechanism between RLS and ADHD that could be used to treat one or both conditions? SPAIN Montserrat Roca contacto@aespi.net www.aespi.net 34-93-202-38-39 SWEDEN Stockholm Sören Hallberg rls@restlesslegs.nu +46+240-281 25 Sten Sevborn stensevborn@telia.com +46+411-52 57 SWITZERLAND Zurich, Wil, Aarau Support Group Switzerland Dr. J. Mathis mathis@insel.ch www.restless-legs.ch Anni Maurer 056-2825403 auskunft@restless-legs.ch 12 NightWalkers RLS and Narcolepsy Restless legs syndrome is frequent in narcolepsy with cataplexy patients. Plazzi G, Ferri R, Dauvilliers Y. Sleep. May 2010. Background: Narcolepsy is a chronic disease characterized by excessive daytime sleepiness (EDS). Patients with narcolepsy experience extreme fatigue during the day and may possibly fall asleep at inappropriate times. Cataplexy is a brief, but sudden, loss of muscle tone, and can be as mild as minor loss of facial muscle tone to a full body collapse. Cataplexy frequently affects people with narcolepsy. Patients with narcolepsy with cataplexy have very disturbed nighttime sleep (vivid nightmares, frequent waking, periodic limb movement during sleep, and obstructive sleep apnea for example). Research: The researchers in this study wanted to determine how common RLS is in patients with narcolepsy with cataplexy. There were 184 narcolepsy with cataplexy patients and 235 agematched control patients without narcolepsy in this study. All patients were evaluated in-person by a sleep disorder expert to ascertain demographics, medical history, medication history, sleep habits, sleep disorders, and a detailed RLS history (if symptoms were present based on the International RLS Rating Scale). The results of this study showed the control group of patients had an RLS prevalence of 3.0% (7 of the 235), but the narcolepsy with cataplexy group had an RLS prevalence of 14.7% (27 of the 184). The RLS history, such as age of onset, severity score, and family history, was almost identical between the two groups. The patients with narcolepsy with cataplexy who were older, had higher iron levels, and who had sleep paralysis (one manifestation of cataplexy), seemed to have higher rates of RLS. Bottom Line: Based on this study, there appears to be a higher rate of RLS in patients with narcolepsy with cataplexy. New Questions: Typically, people with low iron levels have an increased chance of RLS, but in this study the opposite was true for those patients with narcolepsy with cataplexy. Why is this and what could this tell us about the mechanisms of how RLS works? Glossary In the News Agorphobia: a fear of open or public places. Cataplexy: a brief, but sudden, loss of muscle tone. www.rls.org # Cut along this line to return the order form. R L S F O U N D AT I O N M E R C H A N D I S E O R D E R F O R M Circle color, size, and indicate quantity for each item. Complete shipping information on reverse side. Item Description **NEW** 100% cotton 5.8 ounce relaxed dyed t-shirt. Coverseam stitched collar. Double-needle stitched sleeve and bottom hem. Available in lipstick, grasshopper, wave, coffee bean, and port. Sizes Color M L XL XXL grasshopper M L XL XXL wave M L XL XXL coffee bean M L XL XXL port M L XL XXL butter S M L bluebell S M L light blue S M L **NEW** It's a polo for the ladies! This polo features 100% Peruvian Pima cotton. With a feminine fit, its delicate Ycollar, two-button placket, DuraPearl buttons, and rib knit cuffs will keep you classy and spreading the word at the same time. Available in royal blue or butter. royal blue S M L butter S M L Ladies' sweatshirts. 100% ringspun combed cotton dyed fashion hood or crew. 8 ounce french terry. Feminine fit. Vpatch with slit on hood. Raglan sleeves. Wide rib knit cuffs and waistband. Pouch pocket on hooded sweatshirt. Hooded sweatshirt available in blueberry and crew sweatshirt availabe in navy. blueberry S M L Ladies' tee. 100% ringspun 6 ounce interlock cotton ladies' luxury t-shirt. Coverseam stitched set-in collar. Double-needle stitched sleeve and bottom hem. Available in butter, bluebell, and light blue. Price lipstick XL XXL XXL XL $40.00 navy S M L XL M L XL $50.00 navy M L XL pacific blue M L XL XXL black M L XL XXL heather M L XL XXL navy M L XL XXL $12.00 $15.00 heather www.rls.org $12.00 $32.00 french blue Spread the word about RLS in this 100% cotton heavyweight 6.1 ounce men's longsleeve t-shirt. Taped shoulder to shoulder. Coverseam stitched collar. Double needle stitched sleeves and bottom hem. Relaxed fit. Available in navy and heather. Total $22.00 **SALE** Look great and stay warm in this three-season jacket available in both men’s and women’s sizes! Men’s jacket is navy. The women’s jacket is available in french blue. (Was $75) **NEW** Here's something for the men in your life! 100% cotton heavyweight 6.1 ounce men's t-shirt. Coverseam stitched collar. Double needle stitched sleeves and bottom hem. Relaxed fit. Available in pacific blue, black, and heather. Quantity M L XL XXL Fall 2010 13 R L S F O U N D AT I O N M E R C H A N D I S E O R D E R F O R M To order, circle color, size, and indicate quantity for each item. Item Description Color It's a polo just for men. This polo features 100% Peruvian Pima cotton. There is additional yarn in the collar and cuffs for a neater appearance and greater durability. With stretch tape shoulders for extra strength, three-button placket, Dura-Pearl buttons, and rib knit cuff, you're sure to make a statement. Available in Blue or Tan. blue Sizes M L Price XL Quantity Total XXL $32.00 M tan cigar L XL XXL L XL XXL Men's 100% ringspun cotton hooded sweatshirt. Two-ply hood. Front pouch pocket. Ribbed cuffs and doubleneedle stitching throughout. Available in cigar and slate. $40.00 slate M L XL XXL blue M L XL XXL This microfiber shell is lined with mesh for breathability and warmth. Windproof and water resistant, it feaures 2 zippered side-entry pockets and high-quality ribbing at the waist and cuffs. Available in blue and navy. $66.00 M navy L XL XXL indigo Embroidered logo baseball-style caps in indigo, butter, or natural with blue bill. $12.00 butter natural/blue Our fleece blanket is soft on the budget, but sturdily constructed with blanket stitch hem to guard against fraying. The easy-to-carry strap makes it perfect for events. 13.5-ounce, 100% spun polyester fleece; dyed-tomatch blanket stitch hem; dimensions: 50" x 60. Available in royal blue and navy. royal blue $25.00 navy Method of Payment: Please send your order to us at: RLS Foundation • 1610 14th St NW, Suite 300 Rochester, MN 55901 Ship To: _____________________________________ Shipping/Handling: Subtotal ____________________ I have enclosed a check payable to RLS Foundation. Please bill $______________ to my Name Visa MasterCard Discover Am. Ex. _____________________________________ _____________________________________ Street Address (Cannot ship to P.O. boxes) Credit Card Number _____________________________________ City State Zip Code ______________________________________ _____________________________________ Email 14 NightWalkers ____________________ Total ____________________ *Shipping costs: Free for Members Orders $1.00 - $23.00 = $6.00 Orders $23.01+ = Free Name as it appers on the card _____________ Expiration Date Phone (needed for shipping) ______________________________________ Shipping* For quicker processing: Fax: 507-287-6312 Email: rlsfoundation@rls.org View more merchandise on www.rls.org/store www.rls.org Ask the Doctor Q: I am a 71-year-old female who has had RLS since childhood. My doctor put me on a low dosage blood pressure drug and said we needed to address my lack of sleep before I had a stroke. He put me on Tylenol #3 (once nightly). I have slept through the night since. I am up to 2.5 pills per night and have been taking Tylenol #3 for five years. What is the long-term effect of Tylenol 3? I would like to know how I can keep from becoming addicted to this drug. A: Codeine in Tylenol #3 is a low potency opioid which can help RLS symptoms but can be addicting in higher dosage used frequently. You seem to be doing fine on your current dosage but you should check with your doctor before increasing your dosage or deciding to stop it. While your current dosage is not that high, acetaminophen in Tylenol #3 can injure the liver in high dosage. Acetaminophen is present in many over the counter medicines so check the content labels. Robert Werra, MD Q: Does electricity or static electricity affect symptoms? Has this ever been studied? A: The only studies that involve electricity are electromyography and nerve conduction studies of RLS patients. These sorts of studies demonstrate the resting and active electrical activity of muscles in the legs, and the ability of nerves to conduct electricity. Theses studies are generally concerned with other potential conditions that may mimic (or are associated with) RLS such as neuropathy, neuromuscular diseases, and cramps. As far as I know, there are no studies of electricity used to treat symptoms. Jeffrey S. Durmer, MD, PhD Q: I have RLS and Parkinson disease. When the pain in my legs became unbearable, I agreed to take Sinemet. Two hours is the longest I can sleep. When I had an MRI done to the spine, the pain completely vanished. The technician said others had the same experience. Could the MRI have affected my RLS symptoms? A: In a literature search there were no articles addressing magnetic field force affecting RLS. Moreover, since RLS causation comes primarily from the brain, spinal MRI would be unlikely to affect RLS. However, there is still much unknown, so enjoy your relief, and I will alert my Radiology colleagues. As a sidelight, Sinemet is a relatively short lasting medicine. You might consult your physician about a longer acting medicine if your RLS becomes a problem again. Robert Werra, MD www.rls.org Q: Can a person with RLS have symptoms in the groin and hip area? Naval area? I have such and it is painful at times. A: Yes. Although we call it Restless Legs Syndrome, the underlying etiology for primary RLS is believed to involve the central nervous system (brain and spinal cord). The central nervous system controls sensations and movements of the entire body. So while the symptoms of RLS most often affect the legs, it is possible for patients to experience symptoms anywhere in the body. Some studies suggest that up to 50% of patients may experience arm symptoms at some point in time. A smaller percentage may notice RLS symptoms in the abdomen, chest, hip, and tongue. Even “phantom limb” RLS has been reported. Jeffrey S. Durmer, MD, PhD A: RLS symptoms can occur anywhere in the body, although they always start first in the legs. As the disease progresses, symptoms usually spread to the arms but can occur in any other body parts. To be sure that your other body part symptoms are due to RLS, you should feel relief with movement. Mark J. Buchfuhrer, M.D Q: A friend told me that a neurologist could give me a shot (akin to a cortisone shot) to relieve my RLS symptoms for six months or so. Is this true? I have a lot of trouble with the disorder. A: I am not aware of any long-acting RLS shot. However, since you are having a lot of RLS trouble, I suggest you check with your physician about this and other RLS treatments. Robert Werra, MD Q: I am an 80-year-old woman. I have had RLS for many, many years and take Lyrica. About eight years ago, my legs started aching mostly from the knee down. The pain has worsened, and it is difficult to walk. I have good circulation in my legs – no blockages. Could the pain I have be associated with my RLS? I never thought so, but the nights are terrible. A: Although RLS can cause actual leg pain and can worsen with age, it should be improved with walking, at least temporarily, and not make it difficult to walk. Other conditions including neurologic and spinal conditions may be causing your problem. Your physician can help you pursue other non RLS causes. Robert Werra, MD continued on page 16 Fall 2010 15 Ask the Doctor Ask the Doctor continued from previous page Q: I have had RLS for 40 forty years. I had reconstructive knee surgery and for four to six weeks my RLS in that particular leg drove me crazy. Similarly, a friend who is rarely bothered by RLS had hip replacement and her legs bothered her constantly. Why would this be? A: This phenomenon is not well understood, but many RLS patients complain of significant worsening of symptoms after trauma or surgery. Further research is necessary to figure out why this occurs. Mark J. Buchfuhrer, M.D A: The exacerbation of RLS symptoms following surgery is anecdotally reported by many RLS patients. There are many potential reasons why this may be the case including post-operative blood loss, underlying iron deficiency, sleep loss due to pain, rebound following pain relief medications, prolonged bed rest and/or immobility, and peripheral sensory-motor nerve damage. Although this topic is not widely studied, there are reports in the medical literature of spinal anesthesia causing transient RLS*. The underlying mechanism is not clear, but it does seem that susceptible individuals (perhaps genetically predisposed people) may be at risk for RLS exacerbation or emergence following a surgical procedure. Jeffrey S. Durmer, MD, PhD *Högl B et al. Transient restless legs syndrome after spinal anesthesia: a prospective study. Neurology. 2002 Dec 10;59(11):1705-7. Q: I suffer from restless feet, not legs. Are feet and legs combined? Are there others with restless feet problems instead of restless legs? A: Dr. Ekbom, who originally described and named RLS in 1945, stated that RLS does not occur in the feet rather only in the legs. However, I have seen many patients with RLS in the legs and feet and a few with RLS only in the feet. Mark J. Buchfuhrer, M.D Q: I am an 83-year-old woman who had been physically very active (five mph walks plus aerobics each day) until a hip replacement three years ago made most exercising very painful. About five years ago a neurologist introduced me to Mirapex .125, which quickly advanced to .250, .375, and now I take at least .5 to alleviate my RLS symptoms. Along with the additional dosage, I have gained 40 lbs in the past year and a half. I am very concerned about whether Mirapex may be involved in my weight gain. My caloric intake is about 1250 per day. I tried switching to Requip, but it makes me nauseous and caused augmentation even into my forearms! A: I could find no medical literature linking Mirapex in higher dosage with major weight gain. With your 1250 calorie daily intake, the gain is very puzzling and should be pursued with your physician for other serious causes. Low thyroid state-hypothyroidism with abnormally low metabolism can cause weight gain and be a serious condition. Moreover, there are several other effective RLS medications that may not have been tried. Robert Werra, MD Restless Legs Syndrome and Chinese Medicine continued from page 2 Acupuncture and Moxibustion in Treating RLS Acupuncture, an ancient Chinese medical therapy used in the prevention and treatment of disease, is another useful nonpharmacological therapy for treating RLS. It involves inserting needles into specific points (acupoints or Xue Wei) on the human body to bring about its therapeutic effects. Several kinds of acupuncture methods, such as body acupuncture, auricular acupuncture, scalp acupuncture, electro-acupuncture, laser acupuncture, acupressure, acupoint injection therapy (injection of drugs into acupoints), and/or a combination of the approaches are used in the treatment of RLS. The mechanism of acupuncture treatment for RLS is still ill-defined. According to TCM theory, acupuncture regulates the function of internal organs and rebalances body energies by stimulating certain acupoints. It restores the balance between Yin and Yang and regulates Qi (the essence) and blood so that integral unity can be maintained and miscellaneous diseases cured. Acupuncture also induces relaxation and an overall feeling of calm. 16 NightWalkers Although most of the literature declared that acupuncture had a good effect in treating RLS without side effects and dependence, there is still insufficient evidence to support this hypotheses. There is a lack of well-designed randomized controlled trials. More research needs to be conducted to determine the effects of acupuncture on RLS. Moxibustion, an ancient TCM practice, can also help to control RLS symptoms. Moxibustion is the utilization of the mugwort herb, or "moxa," to stimulate the points on the body used during acupuncture. Stimulating these points can help to energize or align one's Qi, and also can induce a smoother blood flow, which will reduce the urges of RLS. *The herbs mentioned on page 2 are summarized from 76 articles about TCM treatment for RLS (both in English and Chinese). Nine of them are clinical trails with control and three of them with randomization. Future work needs to be done to fully evaluate the efficacy of the preparation. www.rls.org Medications for RLS The following information was compiled by Dr. Jacci Bainbridge, PharmD, FCCP and reviewed by members of our Medical Advisory Board. The content of this document is offered for informational purposes only and no products are endorsed by the RLS Foundation. It is very important to talk to your healthcare provider before administering any medication changes. This is not a complete list. Kinds of Medications There are many non-medical therapies to relieve some restless legs syndrome (RLS) symptoms, but many individuals with more frequent or severe RLS request information on medications available and helpful to assist in relief. There are six categories of drugs that have been found helpful for RLS. They are dopaminergic agonists, hypnotics (benzodiazepines/nonbenzodiazepines), opioids, nonopioids, antiepileptic drugs, antidepressants, iron, and others not specific to a category. insomnia, and compulsive behaviors (rare, but potentially devastating). Other Dopaminergics Sinemet® (carbidopa/levodopa) • May not be a first line option in this class of drugs for many patients. • Controlled Release (CR) may be better than Immediate Release (IR) for RLS if Sinemet is an option for the patient. Any levodopa drug should not be used on a daily basis due to a very high risk of augmentation. Of the levodopa preparations, the CR version may be best, but should still be used with extreme caution. • IR Sinemet can be very useful for intermittent use for patients with mild RLS as it works very quickly (within 15-30 minutes on an empty stomach) and may not cause augmentation when taken on an intermittent basis. It is important to understand that only two of the following medications have been FDA approved for the treatment of moderate to severe RLS. The other treatments listed have been known to provide some relief when used “off label.” In the United States, the regulations of the FDA permit physicians to prescribe approved medications for other than their intended indications. This practice is known as off-label use. May cause drowsiness, dizziness, or lightheadedness. Effects may be worsened if taken with alcohol or other medicines. Dopaminergic Agonists Requip® (ropinirole) • One of only two FDA approved drugs for the treatment of RLS. • Requip XL (ropinirole extended release) has not been FDA approved for the treatments of RLS. Mirapex® (pramipexole) • One of only two FDA approved drugs for the treatment of RLS. • Mirapex ER (pramipexole dihydrochloride extended release) has not been FDA approved for the treatment of RLS. Other Benzodiazepine Hypnotics Klonopin® (clonazepam) • Generally not recommended due to multiple metabolites and a very long half-life of 40 hours. Valium® (diazepam) • Not generally recommended due to a very long half-life. Non-FDA-Approved Dopaminergic Agonists Apokyn® (apomorphine) Parlodel® (bromocriptine) Dostinex® (cabergoline) *Neupro® Patch (rotigotine) * Currently not on the market in United States, but may be in 2011-2012. The side effects of dopaminergic drugs tend to be nausea, vomiting, orthostatic hypotension (a temporary lowering of blood pressure (hypotension) due usually to suddenly standing up), hallucinations, augmentation* of symptoms, www.rls.org Benzodiazepine Hypnotics Restoril® (temazepam) Halcion® (triazolam) Xanax® (alprazolam) The side effects of hypnotics tend to be constipation, urinary complications, dizziness, falls, and some cognitive dysfunction. Non-Benzodiazepine Hypnotics Ambien® (zolpidem) Lunesta® (eszopiclone) Sonata® (zaleplon) Generally the nonbenzodiazepine hypnotics are well tolerated, but some patients have reported headaches, dizziness, and vivid dreams. Fall 2010 17 Augmentation is defined as a worsening of RLS symptoms that occurs after starting a medication to treat RLS. Particularly with dosage increases, RLS symptoms may occur earlier in the day, spread to body parts other than the legs, be more intense, and begin after a shorter period of rest or inactivity than before treatment. In addition, jerking of the limbs, either while awake or asleep, can intensify. It is as if the medication were having the opposite effect than it did initially. Opioids Codeine OxyContin® (oxycodone) Dolophine® (methadone) Darvon® (propoxyphene) Levo-Dromoran® (levorphanol) Dilaudid® (hydromorphone) Vicodin® (hydrocodone and acetaminophen) Opana® IR or ER (oxymorphone) Duragesic® Patches (fentanyl) MS Contin® (morphine, controlled-release) Demerol® (meperidine) Talwin® (pentazocine) Non-opioid Analgesics Although tramadol is technically not an opioid, it is often classified with opioids. Ultram starts out as a non-opioid analgesic but is converted to an opioid after metabolism in the liver. Ultram® (tramadol) The side effects of opioids tend to be constipation, dizziness, falls, nausea, vomiting, and sometimes loss of efficacy over time. There may be fewer side effects reported with Ultram. Antiepileptic/Anticonvulsant Drugs Depakote® (valproic acid) Tegretol® (carbamazepine) Lamictal® (lamotrigine) Neurontin® (gabapentin) Lyrica® (pregabalin) Topamax® (topiramate) Gabitril® (tiagabine) Side effects can include sedation, blood count abnormalities, rash, weight gain, edema, tremor, dizziness, and some cognitive dysfunction. 1610 14th St NW Suite 300 Rochester MN 55901 Phone 507-287-6465 Fax 507-287-6312 rlsfoundation@rls.org • www.rls.org 18 NightWalkers Tricyclic Antidepressants Elavil® (amitriptyline) Pamelor® (nortriptyline) Side effects can include constipation, urinary dysfunction, dry mouth, dizziness, falls, and cognitive dysfunction. Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) Cymbalta® (duloxetine) Side effects can include headache, nausea, insomnia, diarrhea, and dry mouth. Other Drugs The drugs below are generally not used because of their side effect profile. Literature on their benefit is very old and clinical experience does not demonstrate any important effect on RLS. Liorasel® (baclofen) Catapres® (clonidine) Side effects can include constipation, sedation, seizures (rare), and some cognitive dysfunction. Conclusion RLS is a common and an under-diagnosed, treatable condition that can have significant effect on quality of life. RLS onset can occur in childhood, although prevalence increases with age. When choosing medications, dopamine agonists are first line therapy. It is important to remember the availability of generic medications could dramatically increase the number of patients who get treatment for RLS as well as save money in cost. *A complete handout on augmentation is available from the RLS Foundation The Restless Legs Syndrome Foundation is dedicated to improving the lives of the men, women, and children who live with this often devastating disease. The organization’s goals are to increase awareness of restless legs syndrome (RLS), to improve treatments, and, through research, to find a cure. www.rls.org Bedtime Stories Bedtime Stories are the opinions of the authors only and not of the RLS Foundation, its employees, or its Board of Directors. Publication in NightWalkers does not imply endorsement by the RLS Foundation. Therapies and results described in Bedtime Stories reflect the experiences of individuals and cannot be generalized to everyone with RLS. It is important to talk to your healthcare provider and investigate concerns such as safety, efficacy, and cost before making any changes to your treatment regimen. Stories may be altered for length or clarity. O dd how medicines affect different people in different ways. A past comment in “Bedtime Stories” said Tylenol made a woman’s RLS worse. I take Tylenol for arthritis and it doesn’t bother my RLS, but when I take Advil (ibuprofen) it makes my legs worse. Starr I I have found that FD&C yellow #5 frequently sets off my RLS. It is a synthetic food coloring used in a lot of foods we eat. Examples include soups, candies, drinks, cereals, cakes, chips, and mustard. Frequently when my RLS starts up unexpectedly, all I have to do is look at what I ate earlier that day. I also suspect red food colorings are another culprit. Allen have found relief with methadone as prescribed by my doctor at Mayo Scottsdale. I’ve seen letters from others who have also found it the only medication that works. I’ve been taking it since 2003 with great success. I have tried other medications, but nothing gives me nightly relief like methadone. My last sleep study showed no movements! Jane hank you for sending the new Special Accommodations Cards with my membership renewal to attempt to alert airlines of the special needs of RLS patients. This is very helpful! Michael A I very heartfelt thank you to the folks at RLS Foundation for the article on RLS & Iron in the Spring 2010 edition of NightWalkers. I have switched to red meat (grass-fed beef and buffalo) and a multivitamin with iron, and for the last two weeks I have not had to get out of bed and pace! Two weeks may not be long enough to say the added iron is a guaranteed “fix,” but even one night’s sleep is a blessing. Isabella Medical Editor’s Note: Oral iron therapy typically takes many weeks or months to help RLS symptoms for patients who do benefit from this therapy. I am in my 70's and have suffered from RLS forever. I am happy to report that I have not had Restless Legs for over 30 days. My wife is ecstatic and is able to enjoy a perfect night’s sleep without my thrashing about. When I visited my neurologist early this summer he suggested that I try Requip XL (24 hour slow release ropinirole). After some trial and error I am enjoying 100% relief 24/7. My new regimen is as follows: Before my evening meal I take 3 mg ropinirole HCL. When I retire I take 2 mg Requip XL and "Shazam" no RLS. Dick www.rls.org T have suffered with sleep apnea and RLS for around 30 years. In March I purchased a Contour Adjustable Bed. Since then I have not had the miserable nights I was so accustomed to. I have told many friends about this as and I am very curious to know if others have had similar experiences using these beds. I certainly feel it has worked so well for me. Anna T he best thing to do when your RLS acts up is to put on warm pants and use a hot water bottle on your lower back and buttocks. The heat helps a lot. Vera I take oxycodone and Mirapex for my RLS. I must say I put off taking the oxycodone for the longest time, but then I got desperate and tried it and it certainly did help. My doctor told me that chances are slim that I would get addicted since I am taking it for a medical reason. It is not worth suffering with RLS. Lorraine Fall 2010 19 Charitable Giving Stock Gifts Deciding to donate to the Restless Legs Syndrome Foundation – or any nonprofit organization – can mean more than writing a check. Turning the strong sentiment you have for RLS into a meaningful and satisfying contribution takes careful planning. The RLS Foundation wants to help ensure your philanthropic goals are achieved. Before grabbing your pen and writing out a check, you may want to consider other ways to give. For instance, if you donate appreciated stock (that has been held for more than one year) from your investment portfolio, this could result in income tax benefits for you. This is due to specific rules about certain stock gifts to private foundations. If the stock donated appreciated in value since its purchase, you may be eligible for a charitable deduction equal to that of the stock’s market value. There are also instances where the stock doesn’t have to appreciate if you donate directly to the nonprofit organization. There are certain limitations and rules for this kind of giving, but it is all easily distinguished and navigated by a professional advisor. Some such limitations are that your gift must be donated before year-end (December 31) to be valid for the tax return of that year. Charitable giving options are not limited to stocks. The RLS Foundation also has a brochure covering estate, planned giving and wills. This brochure and more information about giving options are available at www.rls.org/publications or by contacting the Foundation directly via phone (507)287-6465 or email: rlsfoundation@rls.org. Exciting Property Offer The RLS Foundation receives gifts and donations of all kinds. One such extraordinary gift was a timeshare in Austria. We are gracious for having the opportunity to raise funds through the sale of this property and extend the offer to you, our loyal members. The Property Located in Alpenland Sport Hotel-St. Johann, the timeshare resides in Austria’s prime skiing area. Surrounded by mountains and meadows, it offers year-round vacationing with skiing, hiking, climbing, or visiting Salzburg’s rich cultural highlights. Alpenland features 128,000 square feet of resort space with 137 guest suites. Decorated in traditional alpine, it combines modern recreation and old-world style. It has been called one of the world’s greatest ski and summer recreational areas. All suites feature breathtaking views of the Austrian Alps. Other amenities include hot tub, indoor pool, refreshment car, terraces, tennis court, sauna, steam bath, massage room, four restaurants, a nightclub, slopes, and a fitness center. Underground parking creates a convenient way to unload for your vacation. Timeshare Details The property is located in St. Johann im Pongau, Salzburg Austria. Alpenland is about 37 miles from Salzburg. Price includes biannual (even years) with one-week floating. Timeshare is one bedroom, one bath that sleeps up to four. There is an annual maintenance fee of about $31.00 USD per month. Asking price is $4500 USD. Consider purchasing an unbelievable getaway while supporting an important cause in your life! Correction: In the Summer 2010 issue one healthcare provider in our listing was incorrectly addressed. Please note that Dr. Rachel Morehouse, MD is located in Saint John, New Brunswick, Canada. Her full contact information is available in our online directory at www.rls.org/hcps. 20 NightWalkers www.rls.org Clinical Trials Tugging, burning, creepy-crawly, pulling: A research study is being conducted locally to evaluate an investigational medication for RLS. If you have symptoms of RLS call 1-888-651-3959 or go to www.RLS-SleepStudy.com. Qualified participants will receive free study-related exams and study medication. Does it ever feel like insects are crawling inside your legs? You may qualify for a research study if you are over 18 and have had RLS symptoms for at least six months. Research includes free studyrelated exams and study medication. Located in Salisbury, N.C. For more information, contact Kathy Gray at 704-637-3145 or kathygray@2sleepy.com. Peninsula Sleep Center is actively involved with research and clinical trials to evaluate new treatments for RLS. In most cases you will be paid for your time and travel. Please call 650-636-9396 (option 4) or email research@peninsulasleep.com if you are interested. Dr. Lori Lange and a team of graduate researchers at the University of North Florida are conducting a web-survey study on the impact of ongoing physical symptoms in the lives of patients. Patients must be at least 18 years of age, have experienced ongoing or intermittent somatic symptoms for more than three months, have an illness with ongoing symptoms (e.g., arthritis, lyme disease, eczema, COPD) or suffer from a chronic syndrome (e.g., fibromyalgia, IBS, CFS, MCS), or experience medically unexplained persistent symptoms (e.g., pain, fatigue, fever). If you would like to participate or desire further information, please go to: www.unf.edu/~llange/voice. If you are a healthy adult with RLS between the ages of 18-65, you may qualify for a research study of an investigational medication for RLS. Please call Southwestern Research, Inc. at 714-665-1277 to see if you may qualify for a clinical study. Qualified participants may be compensated. Jerking. Twitching. Fidgeting. This research study is evaluating a medication for RLS. Qualified participants must be at least 18 years of age, experience RLS symptoms and have trouble sleeping due to RLS. Please call 404-851-9934 or visit www.neurotrials.com. University Hospitals Case Medical Center RLS Research: You may be eligible to participate in a research study if you have RLS and are at least 18 years of age. We are investigating the possible relationship between RLS and mutation in a skin protein gene which commonly occurs in Caucasians. For this reason we are studying only Caucasians with RLS. Other exclusionary criteria may also apply. If you are interested, please contact Brian Koo, M.D. at koobri@gmail.com or (718) 813-9422. Participants will be compensated for their time. Tugging, burning, creepy-crawly? Discomfort or pain in your legs? Visit www.rls-study.com for more information on participating in an RLS research study. Are you an RLS Patient who switched to ropinirole from pramipexole? Do you have moderate to severe RLS? Go to http://clinicaltrials.gov/show/NCT00344994 for details on participating in an important RLS study. You may be eligible to participate in a research study of an investigational medication intended to help control the urge to move your legs. As a qualified participant, you may receive: investigational medication, study-related exams, as well as up to $200 in compensation for your time and transportation. To participate, you must be 18 to 85 years of age, and experience symptoms of RLS. Contact: Timothy Grant, MD or Howard Schwartz, MD for more information at (305) 279-0015 Ext. 4238. If your RLS symptoms occur at least three times a week and you are over 18 please contact Broward Research Group 954-322-1600 or email mgonzalez@browardresearch.com. Are you 18-60 years of age? Have you had RLS symptoms for at least six months? If so, you may qualify for this RLS research study. Research includes free study-related exams and study medication. If you are interested, please contact Margaret McDonald at SleepMed of South Carolina by calling 803-251-3093 or by emailing mmcdonald@sleepmed.md. Volunteers who have been diagnosed with moderate to severe RLS, are 18 to 85 years of age, and have the ability to participate in a study at Booth Gardner Parkinson’s Care Center in Washington are needed. Please contact 425-899-3126 or 425-899-3115. If you are a licensed driver age 21 to 65 and have RLS, you may qualify for a study. Call today for more information: 1-877-5-STUDY-9. If you have a physician diagnosis of RLS, you may qualify for a study being conducted by Select Physical Therapy in Denver/Castle Rock, Colorado. For more information call 303-814-2865 or email eric.dinkins@selectmedicalcorp.com. Men and women over the age of 18 with RLS are needed to participate in an inpatient research study. Participants will visit the Johns Hopkins campus in Baltimore, MD for at least two five-day stays and will have continued involvement for up to one year. Call 410-550-2252, ask about study #301. If you have been diagnosed with RLS and are over the age of 18, you may qualify for this study. Participation would include a seven-day stay at the Johns Hopkins Bayview campus, and you may continue to take your RLS medications during the study. Call 410-550-2252, ask about study #203. www.rls.org If you and/or your twin brother/sister are affected by RLS, you are invited to participate in an RLS twin study at the Center for the Study of Brain Diseases, University of Montreal, Montreal, Canada. Participation requires your consent, a blood draw, and a telephone interview. All participation material will be mailed to you. Call 514-890-8000 ext 15552 or email guy.rouelau@umontreal.ca. The use of valerian as a complementary treatment may benefit persons with RLS. If you are interested in participating in the study, call 215-898-1935. Fall 2010 21 RLS Foundation News Searching for a Family Link Because of the genetic component of RLS, we often receive questions about family studies. While the RLS Foundation itself does not conduct surveys pertaining to a specific family alone, there are studies out there – both formal and informal – that are actively looking for a link. Jesse “Pete” Hannah, Jr. is 54 years old and has lived with RLS since he was a young child. “Thinking back,” Pete started, “I couldn’t have been much older than around nine when my legs started bothering me. I didn’t know what it was, but I knew I couldn’t sit still or relax. I’m sure they were the same symptoms that I have now, but as a child you just don’t have as much trouble with it.” XXXXXX XXXXXX XXXXXX XX XXXXXX XXXXXX XXXXXX XXXXXX He knew the name of his disorder and is currently taking medication to ease his symptoms. But was there a genetic cause? He can recall seeing his mother up at night walking, rubbing her legs. “I realized my mother and aunt, her sister, had RLS. Then later in life, I learned my sons had RLS too. I have six grandkids and there are currently no signs that they are living with RLS… but the oldest is only seven.” Once Pete saw the link between the various members of his family, he began compiling questions. “Who else in my family dealt with RLS?” Pete wondered. “Once I had my questionnaire together, I took it to an upcoming family reunion. I had a few people fill it out right away and have received more via email after the reunion. I have at least eight completed surveys now. I also kept the reunion sign-in book,” he added. At the very least I now have the contact information from most of my relatives.” Pete hopes the information he collects will assist in the understanding of RLS. He is finding common themes in the surveys and is planning to pass the final data on to those studying RLS. Above is an example of a completed survey from Pete’s family study. This is for informational purposes and is not intended to be a complete scientific survey ?? 22 NightWalkers In summary, collecting family data can be a way to gain support, better cope, and learn more about RLS. Surveying is also a great way to connect with others and spread awareness about this disorder. Keep Those Questions Coming! Please submit your “Ask the Doctor” questions by email torlsfoundation@rls.org or by mail to RLS Foundation, 1610 14th St NW Suite 300, Rochester, MN 55901. Questions are chosen for print based on available space and applicability to others. Happy Holidays The RLS Foundation sends you best wishes for a beautiful holiday season and a new year full of exciting RLS advances for all members of the RLS community! www.rls.org RLS Foundation Publications Membership Quantity In addition to knowing that your membership contributions help support the research and education efforts of the RLS Foundation, you will also receive NightWalkers (the Foundation’s quarterly newsletter), a Medical Bulletin and referral form for your doctor, medical information card, business cards, chart stickers, membership card, and free shipping and handling on all publications. U.S.: $30 Canada: $30 Other international delivery: $40 Total $ Brochures Causes, diagnosis and treatment for the patient living with Restless Legs Syndrome: This brochure (formerly called Living with Restless Legs Syndrome) is written for those with RLS, family members, and others in search of more information about RLS. The brochure highlights symptoms and treatments and identifies secondary causes of RLS. (©2007) $ free Medical Bulletin: This material is intended for medical professionals and contains the latest diagnosis and treatment information. (©2008) $ free Children and RLS: Restless Legs Syndrome and Periodic Limb Movement Disorder in Children and Adolescents: A Guide for Healthcare Providers. (©2007) $ free Depression and RLS: Special Considerations in Treating Depression when the patient has Restless Legs Syndrome (RLS). (©2007) $ free Pregnancy and RLS: Vital Considerations in Treating a Pregnant Patient who has Restless Legs Syndrome (RLS). (©2006) $ free Surgery and RLS: Special Considerations for the Surgical Team when the patient has Restless Legs Syndrome (RLS). (©2010) $ free Triggers for Restless Legs Syndrome: A Guide to Help You Control and Manage Your RLS. (©2009) $ free Understanding Iron & RLS (©2010) $ free Understanding Augmentation and RLS (©2010) $ free Products RLS Awareness Ribbon Pin $5.00 $ RLS Tote Bag $10.00 $ RLS Mug $5.00 $ ______________________________________________________________ Name Address _______________________________________________________________ City ______________________________________________________________ State _______________________________________________Zip ____________ Country ______________________________________________________________ Subtotal $ Sales Tax* $ Phone ______________________________________________________________ Shipping/Handling** $ Email ______________________________________________________________ TOTAL $ * MN residents please add 6.5% ** Non RLS Foundation members please add $5.00 shipping to your order Please use the envelope in the center of this newsletter to record and mail your payment. www.rls.org Fall 2010 23 Nonprofit Org. U.S. Postage PAID Rochester, MN Permit No. 287 Address Service Requested 1610 14th St NW Suite 300 Rochester MN 55901 Phone 507-287-6465 Fax 507-287-6312 rlsfoundation@rls.org www.rls.org Searching for an RLS Spokesperson We are looking for children aged 1-17 to act as a spokesperson for youth with RLS. Picture, first name, age, and location would be used. For examples of how your child would appear in print, visit our “Faces of RLS” page. Help us spread the word! Please pass this announcement to any friends and family who have children living with RLS. Telephonic Regional Meetings NEW The RLS Foundation has begun holding Regional Meetings via conference call. The goal of these meetings is to improve health outcomes for individuals with RLS through improved understanding of the disorder, available treatment options, and information about local resource availability. Would you like to have a free telephone conference in your area led by an RLS expert? Here is your chance to submit a recommendations for a medical doctor, healthcare provider, researcher, and/or pharmacist who is knowledgeable about RLS to lead a conference. Submit your recommendations to Seema Dhindaw at dhindaw@rls.org.
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