SSD3377 - SECTION 7: INFORMATION THAT INDICATES RESTLESS LEG SYNDROME
Section 7: Information that Indicates Restless Leg Syndrome
DSM-5 Code: G25.81
Prevalence = 5.5%
Can this disorder legitimately be diagnosed by a Master’s level clinician? No. This disorder, when suspected, calls for a referral to a sleep specialist for diagnosis and treatment.
Restless Leg Syndrome is a disorder in which the person experiences discomfort in his/her legs (most commonly) and/or arms (more infrequently) creating a powerful urge to move in order to make the discomfort go away. This occurs most commonly when people with this problem lie down or sit for extended periods of time. Most patients with this disorder also experience rhythmic leg movements during their sleep, called Periodic Limb Movement Disorder (PLMD) (G47.61). (Mayo) Both problems interfere with sleep.
As noted in an earlier section, there are a couple of questions that the clinician should include in any sleep disturbance assessment that are specifically designed to seek out information about the possible presence of RLS:
- h) Has anyone ever told you that you move your legs or arms a lot when you are sleeping or trying to go to sleep?
- i) At times when you are sitting or lying down, do you ever have a feeling of creeping, crawling, aching, pulling, searing, tingling, bubbling, or crawling in your arms or legs that creates an urge to move around in order to relieve the discomfort?
Clinicians may be more likely to uncover direct evidence of RLS than sleep apnea in the course of interviewing a client, since the discomfort experienced with RLS can be evident to the client in a waking state. If the clinician finds evidence of RLS, a referral to a sleep specialist is indicated. The sleep specialist can then determine whether PLMD is also present. PLMD will not be evident to the client, since it will occur when the client is in various stages of sleep. However, PLMD will interfere with a client’s sleep and contribute to the kinds of problems that occur with sleep deprivation.
There is no known cause for RLS, nor is there any cure. Treatment includes stress reduction and the introduction of a couple of medications to help control symptoms. (Mayo) If a mental health clinician suspects RLS, based upon assessment of the signs and symptoms, a referral to a sleep specialist should be implemented. The sleep specialist will outline the treatment plan to be undertaken and what role the mental health clinician will have in supporting the patient as they address this problem.