Restless Legs Syndrome in the Elderly Population

Restless Legs Syndrome in the
Elderly Population
A Guide To Help You Control and Manage Your RLS
Restless legs syndrome (RLS) is a sensorimotor condition
that can interfere with sleep as well as rest-related waking
activities. Various treatments can help control RLS
symptoms, but as yet there is no cure. Studies suggest
prevalence among elderly individuals (over the age of 65).
While RLS effects both men and women, a higher
perceentage of those living with RLS are women.
Many of us will find ourselves in some way managing
the care of an elderly loved one at some point in our
lives. In a 2005 study it was suggested that a little over
80 percent of seniors were living with family. Similarly,
in 2006 a study found that about 7.4 percent of
Americans aged 75 and older lived in nursing homes.
Family members often attempt the best care options for
their aging loved ones, but often do not have the
professional or medical background to assume care. This
can make it difficult to know when a senior’s ailments
coincide with an undiagnosed disorder such as RLS.
Changing Sleep Patterns
Advancing years bring about a multitude of physical
and mental changes. Sleep patterns are not exempt
from these changes. Elderly individuals may find
themselves needing less sleeping hours at night, for
instance; many whom then later nap during daytime
hours. A common complaint seems to be insomnia,
which drastically effects daytime productivity. Be on
the lookout for caffeine, alcohol, and some medications
that may be interfering with sleep.
The consequences of sleep disorders such as RLS are
more threatening for the elderly than the general
population. Sleep loss or the use of some medications
have the potential to lead to falls and accidents. Daily
exercise and exposure to daylight seem to hold the
greatest potential for improving quality of sleep.
www.rls.org
RLS Patient Sleep Diary
A common way to discover if your loved one is
suffering from RLS symptoms is by keeping a sleep
diary. By keeping track of information such as waking
time, hours of sleep, number of times waking during a
night, etc. for at least 7-14 consecutive days, you may
discover similarities or patterns to discuss with a
healthcare provider. One such sleep diary is available
from the RLS Foundation upon request or by visiting
www.rls.org/publications.
RLS Elders & Surgery
There are special considerations for an individual with
RLS having surgery. A complete brochure on this topic
is available from the RLS Foundation upon request or
at www.rls.org/publications. When consulting with a
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Your healthcare provider should conduct a careful medical history and physical exam to rule out
other possible causes for your symptoms. The diagnosis of augmentation requires that you
demonstrated at least some positive response to the prescribed dopaminergic medication, that
other possible causes for a worsening of symptoms have been ruled out, and that there has been
a consistent change in your symptoms.
surgical team, it is important to inform them of RLS.
Substances that should not be given to an RLS patient
include:
• Neuroleptic agents
• Tricyclic, tetracyclic, or selective serotonin
reuptake-inhibiting antidepressants (except as part
of current therapeutic regimen)
• Opioid antagonists (naloxone, naltrexone, Talwin NX)
• Antiemetic agents with dopamine-antagonist
properties
Professional Management of Elderly Patients
When nursing or acting as a caretaker in a setting such
as a nursing home, there are several key factors to keep
in mind when admitting or treating an elderly
individual. Nurses in these settings need to be educated
that RLS, depending on its severity, can cause severe
sleep loss in patients.
Pamela M. Pierce ARNP, PhD, FAAN is a Nurse Educator
for the Bay Pines Veterans Health Administration.
Dr. Pierce suggests a list of opportunities hospital and
long term care nurses have to identify undiagnosed RLS
or improve care for those living with RLS.
• Query each patient about symptoms of RLS upon
being admitted. Sleep patterns are important and
should be included in admission databases.
• Asses patients with difficulty sleeping, especially
those who actively pace or move about at night.
• Do not stereotype irritable or pacing patients as
“difficult” before exploring the possibility they are
suffering from RLS symptoms or other sleep disorders.
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Phone 507-287-6465
Fax 507-287-6312
rlsfoundation@rls.org • www.rls.org
16 NightWalkers
• Inform the patient’s healthcare provider if you
uncover any history or symptoms of RLS so a
treatment plan can be implemented.
• Oversee sleep hygiene that can interfere with sleep
activity such as reducing caffeine, encouraging mild
physical activity, or providing activities to reoccupy a
patient’s mind.
• Monitor the occurrence of side effects from
medication and carefully check for drug interactions.
• Provide safety for RLS suffers by keeping the bed in
a low position, providing non-skid shoes, etc.
Common Drug Options to Treat RLS
The RLS Foundation does not endorse any products or
services. The following is for information purposes only.
Medications used to treat RLS fall into four major
classes: dopaminergic agents (i.e. Requip, Mirapex),
sedatives (i.e. Ambien, Klonopin), anticonvulsants (i.e.
Neurontin, Epitol), and pain relievers (i.e. Percocet,
Vicodin). You should never add or adjust medications
without speaking to a healthcare provider.
Summary
Sleep is necessary for good quality of life at any age.
Caring for someone with RLS can be difficult at times,
but hopefully, diagnosis can lead to proper management
of symptoms. In turn, a better night’s sleep may be
gained for all involved.
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