title: What patients do to counteract the symptoms of Willis-Ekbom disease (RLS/WED): Effect of gender and severity of illness.
abstract: OBJECTIVE
  This study was carried out to assess different counteracting strategies used by patients with idiopathic Willis-Ekbom disease (RLS/WED). Whether these strategies were influenced by gender or disease severity was also assessed.
  
  
  METHODS
  A total of 173 patients of idiopathic RLS/WED were included in this study. Their demographic data was recorded. Details regarding the RLS/WED and strategies that they used to counteract the symptoms were asked. The severity of RLS/WED was measured with the help of the Hindi version of international restless legs syndrome severity rating scale. They were asked to provide the details regarding the relief obtained from all the strategies they used on three-point scale: no relief, some relief, and complete relief.
  
  
  RESULTS
  Of the patients, 72% were females. Mean age of the subjects in this study was 39.6 ± 12.6 years, and male subjects were older than females. Four common strategies were reported by the patients to counter the sensations of RLS/WED: moving legs while in bed (85.5%), asking somebody to massage their legs or massaging legs themselves (76.9%), walking (53.2%), and tying a cloth/rope tightly on the legs (39.3%). Of all the patients who moved their legs, 6.7% did not experience any relief, 64.2% reported some relief, and 28.4% reported complete relief. Similarly, of all the patients who used "walking" to counteract symptoms, 50% reported complete relief, 44.5% reported some relief, and the rest did not experience any relief. Many of these patients reported that massage and tying a cloth/rope on legs brought greater relief than any of these strategies. Tying cloth on the leg was more common among females as compared to males (45.9% females vs. 23.5% males; χ(2) = 7.54; P = 0.006), while patients with moderately severe to severe RLS/WED reported "moving legs in bed" (79.3% in mild to moderate RLS/WED; 91.8% in severe to very severe RLS; χ(2) = 5.36; P = 0.02).
  
  
  CONCLUSIONS
  Patients with RLS/WED use a variety of strategies to counteract symptoms. These strategies may be influenced by gender, disease severity, and cultural practices.
authors.affiliation: Department of Psychiatry, Sleep Clinic, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Doiwala, Dehradun, Uttarakhand, India.
authors.forename: Ravi
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Department of Neurology, Sleep Clinic, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Doiwala, Dehradun, Uttarakhand, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Goel
authors.affiliation: Department of Medicine, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Doiwala, Dehradun, Uttarakhand, India.
authors.forename: Sohaib
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Department of Medicine, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Doiwala, Dehradun, Uttarakhand, India.
authors.forename: Minakshi
authors.initials: M
authors.lastname: Dhar
authors.affiliation: Department of Medicine, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Doiwala, Uttarakhand, India.
authors.forename: Vivekananda
authors.initials: V
authors.lastname: Lahan
keywords: Counter-acting strategies; Willis-Ekbom disease (RLS/WED); gender; severity