Definition and symptoms

RLS causes pulling, tension, tingling, pain, warmth and other unpleasant feelings when the legs and/or feet (less commonly in the arms and/or hands) are in a state of rest or relaxation. This pain and paraesthesia is often described very differently by RLS patients. They may occur on one side, both sides or alternate from one side to the other. Those affected by paraesthesia have an irresistible urge to move, flex muscles or stretch, as only movement relieves the pain.
Immediate relief through muscle activity is characteristic of RLS, in other words, moving the affected limbs by walking, bending the knees, cycling, periodic flexing etc. However, the symptoms return directly after a short-term improvement, usually the next time the muscles are at rest.
Pain is worse in the evenings and at night than during the day and may only occur in the evening or at night when sitting quietly or lying down (many of those affected feel pain between 10 pm and 4 am). A constant lack of sleep causes the patient to feel tired and worn down all the time, which in turn can lead to physical and emotional exhaustion. Inevitably, this has a chronic adverse effect on many areas of the patient’s life.
On the other hand, relaxing situations, boredom and limited movement can exacerbate symptoms regardless of the time of day. Common side effects of RLS include periodic convulsions in the legs or arms during sleep, where the patient is not aware of the movements. In rare cases, these symptoms may also occur while the patient is awake. These spasms often lead to unnoticed sleep disruptions due to patients repeatedly waking for short periods. The agonizing restlessness in the limbs and the irrepressible compulsion to move (for example, by walking around) often effectively prevents sufferers from falling asleep and staying asleep. The patient is not necessarily aware of the actual cause of the problem, particularly when the symptoms are otherwise relatively mild.

Causes

Restless legs syndrome is a neurological disorder with sensory disturbances and an urge to move the legs, feet and, less frequently, the arms and is often accompanied by involuntary movements.
The ICSD-2 classification system for sleep disorders classifies it as a sleep-related movement disorder. It is likely that the disorder is caused by a defect in the transmission of nerve signals. The results of scientific research indicate that there are genetic causes. A differentiation is made between idiopathic RLS (without triggering causes, but frequently running in families) and symptomatic RLS (acquired from another underlying disease). Predisposition to this condition can be inherited as an autosomal dominant trait. Genetic predisposition has now been confirmed by twin studies; however, the degree of genetic influence remains uncertain. Research is underway to locate the gene that causes the syndrome. When RLS is passed on in a family, researchers have observed a tendency for symptoms to occur earlier and with more severity in each successive generation. Examples of disorders and factors that can frequently cause RLS include:

1. Dialysis-dependent renal insufficiency
2. Thyroid dysfunctions
3. Pregnancy
4. Anaemia due to iron deficiency
5. Rheumatoid arthritis
6. Iron deficiency
7. Metabolic disorders
8. Various medications can also cause symptomatic RLS

Experience in sleep laboratories show that a large proportion (up to 20 per cent) of general sleep disorders are caused by undetected forms of RLS. Even cases attributed to other disorders, such as chronic fatigue syndrome (CFS), may sometimes be caused by RLS.

Long-term consequences

Sleep deprivation caused by the disturbance may be exceptionally severe in RLS patients. Patients may also suffer from chronic fatigue during the day, listlessness, exhaustion, difficulty concentrating, restlessness, forgetfulness and a shift in the day-night rhythm. Common delayed effects if left untreated include general performance loss, social isolation and most seriously, depression. The symptoms of pain can, as with all ongoing pain conditions, develop into chronic pain syndrome. Patients often report other symptoms that may be related to either the disturbed dopamine metabolism or the consequences of sleep deprivation. Examples include a ravenous appetite at night, intolerance to alcohol and caffeine, chronic gastrointestinal problems, tension headaches and exacerbation of RLS after exercise or due to heat or cold.

Conventional therapy

Individual treatment is based on the subjective suffering of patients. Improving sleep quality is usually the main focus. Needs-based or permanent medication is likely to be inevitable for the majority of sufferers with severe symptoms. In the secondary form of RLS, the underlying cause must be eliminated as far as possible. An iron deficiency can be easily treated with iron supplements; however, treating RLS during pregnancy can be very difficult.

The kybun principle of operation – be proactive

kybun brings movement into your daily life and does so gently without overtaxing your already fatigued body. The muscles in the feet and legs are activated to a greater extent using the rollover motion on the soft, springy material. As a result, we assume that the soothing effect of moving in the kybun shoe/on the kybun mat lasts longer than in conventional shoes. Unfortunately, we do not yet have any customer opinions on restless leg syndrome. However, since the causes of RLS symptoms can be very different, every customer will react differently to kybun training.

Application tips

• kybun training should always be adapted to the user’s condition each day. It is important for the affected individual to discover how much kybun training is helpful and when it is time for a break in order to avoid increased pain afterwards. On some days, it may well be that only short and gentle kybun shoe training is possible (or even skipping a day), while walking longer distances in the kybun schoe may be possible on other days.
  Regular walking in the kybun shoe/exercising on the kybun mat allows the body to adjust over time (stimulating blood circulation, developing stronger muscular and connective tissue and more stable joints), and symptoms will decline.

  More helpful tips:

• If you feel pain in the kybun shoe or on the kybun mat, or if your existing pain gets worse, this may be due to various reasons (e.g. an unfamiliar, more upright posture, tense muscles, movements that are unfamiliar for the body).
• We advise you to perform the kybun exercises regularly every now and again. They loosen the muscles and straighten the body. This relieves strain on the joints.
  Choose the kybun exercises that are good for you! Some customers prefer easier movements while others find the more intensive exercises helpful; this is highly individual.
• Choose a kybun shoe with a lower rebound effect. It provides you with greater midfoot stability. Ask your kybun dealer to show you the various models.
• If you feel unstable wearing the kybun shoe or are looking for an additional training device to use at home, the kybun mat is the ideal alternative. You can strengthen the foot, leg and back musculature at home on the soft, elastic springy mat. You can hold on to a fixed object if you feel unstable. The kybun mat is also available in a choice of different thicknesses (the thicker it is, the more intensive the training). Ask your local kybun dealer for advice.
• If you get very fatigued in spite of the kybun exercises, or if you feel pain or in case of lateral/medial rolling of the ankle joint on the kybun sole, we advise you to take a short kybun shoe/kybun mat break until the symptoms go away.
• Be sure to maintain an upright posture, avoid taking excessively long steps and keep your gaze forward (do not look at the floor). You should walk straight on the kybun shoe sole and correct any lateral/medial rolling of the ankle joint!
• If uncertainty or complaints arise even after you have implemented these tips, please contact a local kybun dealer you trust for advice.