Primary care doctors need to ask patients about restless leg syndrome

LETTER — Posted March 8, 2004

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Regarding "Patients toss and turn with restless legs, but don't tell," (Article, Dec. 15, 2003): Your article points out why restless legs syndrome is the most undiagnosed, common, morbid condition in primary care: Patients do not ask their doctors about symptoms.

But that is only half the reason. The other half is that we physicians do not ask patients about RLS symptoms. Why not? Time constraints of a busy, overworked office, and competing, more serious common issues for screening: diabetes, hypertension, lipids, smoking, diet, exercise, depression, social anxiety, sexual dysfunction, headache, etc. Another screening questionnaire is just too much!

I did it for RLS for three months, but my office staff rebelled. But, just as physician organizations are recommending reducing screening to just a few questions, so RLS screening can be reduced to just one question. "When falling asleep, or during the night, is your sleep disturbed by restless legs (crawling or aching feelings, and inability to keep your legs still?)" If that is too long, ask: "Do you have trouble sleeping at night? If so, why?" This question at all new patient comprehensive assessments, and periodic screening will uncover the large number of primary care patients silently suffering, losing precious sleep at night, and experiencing dangerous daytime fatigue.

Robert Werra, MD, Ukiah, Calif.

Editor's note: Dr. Werra is a member of the Restless Leg Syndrome Foundation Advisory Board.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/03/08/edlt0308.htm.

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