Sleep Deprivation and Sleep

Restless Leg Syndrome A simple way to define Restless legs syndrome (RLS) is an overpowering urge to move limbs, especially the legs that mostly take place when relaxing or during bedtime. This neural disorder is a major causative factor of nighttime blood pressure spikes and its associated circulatory consequences which reduces sleep quality and in some cases even eliminates the possibility of sleep. This sleep deprivation causes adverse effects such as nervousness, perpetual sadness and reduced comfort of living.

Patients initially suffering from hemodialysis that develops RLS have a much higher death rate. In most cases, they suffer from disorders that are difficult to explain. This paper's objective is to educate medical personnel on the need to understand and make deductions from the patient's signs, which are the factors considered and from which a conclusion is made if a patient has RLS or some other disorder (Einollahi & Izadianmehr, 2014). Restless Leg Syndrome is a serious problem that could greatly reduce one's standard of living.

Lots of substances have successfully cured or mitigated RLS, such as ropinirole, pramipexole, rotigotine, and gabapentin enacarbil, which are all FDA approved. It is important nonetheless to consider the advantages, the serious side effects and the lasting effects of drugs aimed at curing RLS (Comella, 2014). Subjective The subject patient suffers disturbing feelings in both legs that exacerbate at night. Subject considers the situation regular and detached for ADL. Subject patient is taking low salt/ low sodium diet as instructed. Subject has suffered from Hypertension and currently suffers from hyperlipidemia.

Subject's father died from Hx of Hyperlipidemia, HTN, while subject's mother still lives, but suffers from fibromyalgia. Subject is a parent of two sons who have no health issues. Restless leg syndrome (RLS) is a nerve condition typically accompanied by symptoms such as vibrating, stretching and other disturbing feelings in the legs as well as an irrepressible desire to keep them movin, as is the case for our subject. These unpleasant feelings are more prevalent when the subject is calm and at bedtime.

When the legs are moved, the patient enjoys a moment of respite. These symptoms referred to as paresthesias (uncommon feelings) or dysesthesias (painful uncommon feelings) spans from unpleasant to annoying to agonizing. The funniest part of this disorder is that it is trigged by lying down and resting, thus almost all patients find it difficult sleeping or experiencing good sleep qualit which is what our subject also complains about. If not immediately taken care of, RLS causes general weakness and tiredness during the day.

Several RLS patients complain that the disorder has influenced their occupation, personal life and general daily activities due to its associated sleep problems. Difficulty in concentration, dullness of memory and difficulty in doing normal daily activities are the problems faced by RLS patient which are some of the things out subject is also complaining bout.

Travelling is also affected and it could lead to depression (NINDS, 2010) Objective RLS has no particular test, however, it can be identified in these four ways: • Problems are prevalent during bedtime and disappears in the morning; • Irresistible desire to move diseased legs or arms, a situation commonly accompanied by paresthesias or dysesthesias; • Pains initiated when at rest, relaxing or asleep; and • Pains that are reduced when the legs are moved and doesn't resurface until the movement stops.

The doctor paid great attention on the subject's/patient's account of signs, causative and relieving actions and whether problems were prevalent or rare during the day. Bodily and nerve tests combined with details form the patient's clinical history and present medications also proved useful. Rate of occurrence, length of occurrence and sharpness of associated pains together with its relation to sleep, sleep deprivation or productivity during the day were the questions posed to the patient.

Other possible conditions were dismissed via lab examinations like blood tests which show iron and vitamin shortages and other body conditions related to RLS. A possible scenari tested was the identification of other reasons for sleep problems (such as sleep apnea) by carrying out sleep assessment such as polysomnography (an examination based on a person's brain waves, heart rate, respiration, and limb movements at night). This situation could affect the successful treatment of RLS. In this research, though, little or no effect on RLS treatment was recorded.

Assessment In 2014, fixed criteria for a clinical diagnosis of RLS were enumerated by the IRLSSG. These criteria are; • A compulsive need to move the legs which is normally but not in all cases, or is caused by unpleasant and painful feelings in the legs. • The compulsive need to move the legs and its associated unpleasant feelings exacerbate when the person is in a relaxed position i.e. sitting or lying on a bed which is typical for our subject.

• The compulsive need to move the legs and its associated unpleasant feelings are partly or completely reduced by motion, including walking and stretching and this relief lasts the length of the motio which is typical for our subject. • The compulsive need to move the legs and its associated unpleasant feelings while relaxing or idle take place solely at bedtime or is more pronounced in the night compared to the day.

• These above signs are not major characteristic symptoms of any other clinical disorder such as venous stasis, myalgia, leg oedema, positional discomfort, leg cramps, arthritis, habitual foot tapping which is typical for our subject. Apart from the above criteria, a further test was carried out in the following regard; • The physician examines the patient's clinical records and checks for any occurrence of RLS associated signs.

With the basis of the recognized symptoms of the International Restless Legs Syndrome Study Group, the physician then makes a final conclusion on his diagnosis of RLS/WED • Furthermore, body and nerve tests are also carried out. Blood tests were recommended to ascertain any forms of iron shortage, which could give similar symptoms to RLS. Sleep tests were equally carried out on the patient by a sleep expert.

For this to take place, the patient had to spend the night at a sleep hospital where their sleep is examined to detect other kinds of sleep problems such as sleep apnea. Plan Certain daily routine has been proved to increase the danger of RLS and thus should be stopped in the case of our subject. They include: high caffeine consumption, extreme alcohol intake especially at night, acute stress, lack of proper sleep and high intensity physical work just before sleep at night.

Better sleep patterns, improved sleeping area and bedding as well as other daily routine modifications should be the first point of call before drugs and medicines are prescribed. Serious pains arising from RLS can be treated by rubbing the legs with hot or cold water, physical movements like walking and stretching, mind occupation and rest workouts (Gangadharan, Perkins, Sauerbier, & Chaudhuri, 2016). Treatment Only severe forms of RLS and situations where the disorder is seriously affecting daily routines require treatment. It is advised that non -- ergot dopamine agonists should.