If not moved, the legs often jump involuntarily. The sensations come on with rest and are always relieved with walking. Rubbing the legs or moving them while sitting or lying will often relieve the sensations, at least temporarily. The sensations are always worse at night and may often only be felt at night, particularly around bedtime. In fact, the primary complaint that leads people to consult their physicians is the inability to fall asleep because of the sensations.
Sufferers often complain about spending nights pacing the room.
Leg movements severe enough to awaken patients from sleep lead to a complaint of frequent awakenings. Leg movements causing brief arousals during sleep without full awakenings lead to a complaint of tiredness on awakening and sustained tiredness throughout the day. Secondary causes are common and may represent as much as twenty percent of the RLS population. The most common secondary causes include iron deficiency, dialysis, pregnancy and underlying peripheral neuropathy. In patients with periodic leg movements of sleep only, or clinically ambiguous symptoms, the diagnostic investigation of choice is a polysomnogram.