The simple idea
You lie down to sleep and feel "I HAVE to move my legs." You move them — relief. You settle — and it returns. Four features spell it out:
- Urge to move the legs
- worse at Rest (inactivity)
- worse in the Evening/night
- Relief with movement
People describe it as crawling, pulling, tingling, or aching — often hard to put into words. It can be linked to iron deficiency, pregnancy, kidney disease, and some medicines.
An important look‑alike: akathisia
If a patient on an antipsychotic says "I can't sit still," don't assume restless legs. Akathisia is a medication‑related whole‑body inner restlessness — different from the leg‑focused, rest‑and‑night pattern of RLS. (You met akathisia in the Clinical book's antipsychotics section — here just know the two can be confused.)
| Restless legs | Akathisia | |
|---|---|---|
| Where | the legs | whole body |
| When | rest, evening / night | any time |
| Usual cause | iron, pregnancy, kidney, meds | a medication (e.g. antipsychotic) |
| Movement | relieves it | doesn't settle it |
Quick check ✅
- What four words capture the RLS pattern?
- Why be cautious calling "can't sit still" on an antipsychotic RLS?
Remember this 🌟
Where we're going next → Our final part covers the highest‑stakes topics of all — safety, addictions in depth, and the main treatments (Part 5).