Restless legs syndrome simulator

Restless legs syndrome (RLS) remains a common, yet often undiagnosed, neurological sensorimotor disorder, despite many years of research and increased disease recognition.

To help drive understanding and disease awareness among physicians and people with RLS, Boehringer Ingelheim Pharmaceuticals, Inc. has launched an initiative to educate about the symptoms, diagnosis and treatment of RLS including a major direct-to-consumer advertising campaign. For patients and physicians there is a web-based resource available at www.rlsrest.com, providing valuable RLS educational information and tools. In addition the company has developed an RLS Simulator – a multi-sensory experience simulating a “day in the life” of an RLS patient to help physicians better understand this complicated condition.

“The RLS Simulator may help increase physician awareness of the disturbing symptoms of RLS which is an underdiagnosed neurological sensorimotor disorder,” said Professor John W. Winkelman, MD, PhD, Medical Director of the Sleep Health Center of Brigham and Women's Hospital, Boston, Massachusetts.

While RLS symptoms can vary from person to person, they are generally described as burning, crawling, tingling, or tugging sensations in the legs. The RLS Simulator was designed to mimic the symptoms that many RLS patients experience and helps physicians gain a greater appreciation for the troubling symptoms their patients experience. This is accomplished through an audio-visual first-person narrative synched with simulated RLS sensations delivered through a state-of-the-art custom-made affixed sensory boot. It is the first experiential simulator utilizing three out of the five senses to aid in the community's understanding of RLS.

“We are committed to RLS education to ensure that the physicians better understand RLS and the impact it can have on patients' lives,” said Paul Fonteyne, executive vice president, Boehringer Ingelheim Pharmaceuticals, Inc. “The RLS Simulator was created to help physicians experience first-hand the symptoms and other effects of RLS. We believe this will help improve communication between physicians and their patients.”

The virtual reality format of the RLS Simulator may help convey the impact RLS symptoms have on a patient's life, showing the exhaustion these symptoms can cause due to the uncontrollable urge to move the legs at night which may interfere with the ability to sleep. According to the 2007 National Sleep Foundation Sleep in America Poll, of the more than 1,000 American adult women surveyed, women who exhibited signs of RLS at least a few nights each week were significantly more likely to also experience symptoms of insomnia at least a few nights per week.

“Though more doctors today are aware of RLS, unless they suffer from the condition themselves, they don't necessarily know what it is like for their patients to live with RLS symptoms,” said Sheila Connolly, a founding member of the Restless Legs Syndrome Foundation and an RLS Foundation support group facilitator.

To further educate the medical community, Boehringer Ingelheim will provide thousands of physicians with the opportunity to experience the RLS Simulator at multiple medical meetings throughout the country this year.

Developed by Boehringer Ingelheim, in partnership with the RJO Group, the RLS Simulator is a virtual reality sensory encounter simulating the experiences of an RLS sufferer. Designed to help physicians better understand the symptoms and impact of RLS, the RLS Simulator allows them to experience – from a first-person point of view – a typical “day in the life” of an RLS sufferer, while feeling the uncomfortable leg sensations associated with RLS. The RLS Simulator utilizes an audio-video headset and state-of-the-art custom-made boot with an inflatable lining that tightens around the participants' leg. It is intended to mimic RLS symptoms by stimulating leg and calf muscles and providing various sensory elements, like vibrations and temperature changes. The RLS Simulator is a pure simulation; that is, it does not induce restless legs syndrome symptoms or assist in a diagnosis; it merely simulates symptoms associated with RLS for educational purposes.

RLS is a common, yet often undiagnosed, neurological sensorimotor disorder. Up to 10 percent of U.S. adults are affected by RLS. Approximately 12 million Americans suffer from moderate to severe primary RLS. In the primary care section of the RLS Epidemiology, Symptoms, and Treatment (“REST”) study, only 12.9 percent (46 out of 357) of patients consulting a physician about RLS symptoms reported being given an accurate diagnosis for RLS. Some of the more common misdiagnoses associated with RLS symptoms are impaired circulation, nocturnal leg cramps, and osteoarthritis. Patients with RLS often experience an urge to move their legs at night due to uncomfortable leg sensations that worsen during periods of rest or inactivity, often interfere with the ability to sleep, and are partially or totally relieved with movement, such as walking or stretching. Additionally, people with RLS will often have difficulty falling asleep. Approximately one-third of sufferers experience symptoms more than twice weekly causing moderate to severe distress.

Despite many years of research and increased disease recognition, RLS still remains underdiagnosed or misdiagnosed to this day. RLS may be diagnosed with positive answers to the following criteria, which were developed by participants in the RLS Diagnosis & Epidemiology workshop at the National Institutes of Health in collaboration with members of the International Restless Legs Syndrome Study Group (IRLSSG):

• Do you have an urge to move your legs, usually accompanied by uncomfortable leg sensations?
• Do your symptoms begin or worsen during rest or inactivity, such as lying down or sitting?
• Are your RLS symptoms partially or totally relieved by movement, such as walking or stretching?
• Are your RLS symptoms worse in the evening or at night, or do they only occur in the evening and at night?

While medication isn't right for everyone, RLS can be successfully managed in some people with moderate to severe symptoms through treatment with FDA-approved medications, called dopamine agonists.

Boehringer Ingelheim Pharmaceuticals, Inc.
Boehringer Ingelheim Pharmaceuticals, Inc., based in Ridgefield, CT, is the largest U.S. subsidiary of Boehringer Ingelheim Corporation (Ridgefield, CT) and a member of the Boehringer Ingelheim group of companies.

The Boehringer Ingelheim group is one of the world's 20 leading pharmaceutical companies. Headquartered in Ingelheim, Germany, it operates globally with 137 affiliates in 47 countries and approximately 38,400 employees. Since it was founded in 1885, the family-owned company has been committed to researching, developing, manufacturing and marketing novel products of high therapeutic value for human and veterinary medicine.

In 2006, Boehringer Ingelheim posted net sales of U.S. $13.3 billion (10.6 billion euro) while spending approximately one-fifth of net sales in its largest business segment, Prescription Medicines, on research and development.