Restless legs syndrome (RLS) is the common term for a disorder that produces strange nervous system-related sensations in the legs, as well as a powerful desire to move the legs abnormally. Scientists also know the same condition as Willis-Ekbom disease. Because of its ability to significantly alter a person’s waking mental state, the American Psychiatric Association (APA) views restless legs syndrome as a form of mental health problem called a sleep-wake disorder. According to the results of a study published in June 2013 in the journal Neurology, men who develop RLS apparently have a substantially increased chance of dying prematurely. Restless Legs Syndrome Basics Prior to 2013, restless legs syndrome did not appear as a separate listing in the Diagnostic and Statistical Manual of Mental Disorders, the reference text that American doctors typically use to diagnose their patients’ mental health concerns. Instead, it only received secondary mention in the manual as part of a group of unofficial sleep disturbances known as “dyssomnias not otherwise specified.” The American Psychiatric Association changed the status of RLS as part of a restructuring of the sleep-wake disorders category that took place in advance of the publication of the Diagnostic and Statistical Manual’s most recent edition. In part, the APA made this change to underline the syndrome’s direct effects on mental health; the change was also made to underscore the link between RLS and medically serious depression. Nerve-related symptoms that appear in people with restless legs syndrome include aching sensations, crawling or creeping sensations, throbbing sensations, itching sensations, and sensations that resemble electric shocks. In line with the condition’s name, these symptoms typically appear in the legs; however, they can also appear in the torso, head or arms. The leg movement associated with RLS usually occurs when affected individuals knowingly or spontaneously try to prevent or relieve the disorder’s nerve-related unpleasantness. As a rule, restless legs syndrome has its most prominent effect at night during the hours dedicated to sleep. For this reason, some people with serious cases of the disorder experience sleep disruptions that substantially reduce their ability to stay awake or otherwise function normally during the day. Links to Early Death In the study published in Neurology, a team of researchers affiliated with Harvard University examined the medical histories of over 18,000 men over a period of eight years. Initially, 690 of these men had diagnosable cases of restless legs syndrome. Over the course of the study, roughly 25 percent of the participants with an RLS diagnosis died an early death in comparison to their expected lifespan. In contrast, only roughly 15 percent of the men without an RLS diagnosis died prematurely. These figures equated to a nearly 40 percent increase in premature death risks for men affected by restless legs syndrome. Apart from the presence of RLS, a number of factors can potentially contribute to early death, including chronic sleep disturbances unrelated to restless legs syndrome, obesity and lifestyle choices such as cigarette smoking, eating a nutritionally poor diet, or physical inactivity. The study’s authors took steps to account for these factors before making a final assessment regarding RLS’s contribution to death risks. After reanalyzing their findings, they concluded that men with restless legs syndrome who don’t share these risk factors die prematurely almost as often as men with RLS who do share these factors. Next, the researchers took steps to account for the effects of more directly threatening health problems related to premature death, such as various forms of heart disease and various forms of cancer. After making the necessary adjustments in their findings, the study’s authors concluded that men with RLS who have these major health issues still die prematurely 92 percent more often than men without RLS who have these issues. Considerations The authors of the study published in Neurology made one curious finding. While the fatal effects of restless legs syndrome are not associated with aging or the common risk factors usually linked to premature death, they are associated with a number of other significant health problems, including autoimmune disease, hormone disorders, breathing disorders, and diseases that alter the normal processing of food inside the body. The authors could not explain the link between RLS and these problems. They also could not explain why restless legs syndrome leads to early death in general, or to early death in men in particular.