Do you find that your legs uncontrollably twitch, throb, or jerk just as you crawl into bed? The feeling is so unpleasant that you have to move your legs to get relief. If this sounds familiar, you could be suffering from restless legs syndrome (RLS). This disorder can cause you to toss and turn all night — leading to significant disruptions in sleep. You may soon come to dread bedtime because of it. RLS often worsens if you don’t do anything about it.
What Is Restless Legs Syndrome?
Restless legs syndrome (RLS) or Willis-Ekbom disease is a neurological condition that causes strange sensations mainly in the legs. However, it can affect the arms and other parts of the body, as well. These sensations may resemble a “creepy crawly” feeling and result in an overwhelming urge to move. Approximately 10 percent of the population suffers from RLS in the U.S. The symptoms can range from mild to severe. RLS can increase the risk of depression if it's not treated.
What Causes Restless Legs Syndrome?
Researchers aren’t quite clear on what causes RLS. But, there are a number of things linked with the disorder:
- Iron deficiency: There is substantial research linking RLS with an iron deficiency in the brain.
- Pregnancy: RLS affects approximately 20 percent of pregnant women. The condition usually occurs in the last trimester of pregnancy.
- Genetic: According to the Mayo Clinic, RLS tends to run in families, especially when it occurs before age 40.
Women are two times as likely to experience RLS compared to men. It’s also more common in middle age.
RLS and Sleep
RLS is usually worse at night, which can result in serious sleep disruptions. Symptoms often start just as a person lies down to go to sleep. This explains why many sufferers experience sleep deprivation and daytime fatigue.
Approximately 80 to 90 percent of people with restless legs syndrome also have a disorder called periodic limb movement of sleep (PLMS). PLMS triggers repetitive leg movements (jerking or twitching) that occur during sleep. The symptoms can last the entire night. PMLS can add to the sleeping problems that people with RLS experience.
How to Sleep Better With RLS
Restless legs syndrome can be triggered by your diet, lifestyle, and other factors.
Lifestyle Changes
If your RLS symptoms are mild, the following lifestyle changes may help you reduce symptoms and get better sleep. Here are some things you can do to help RLS symptoms.
- Keep a diary: Keep a diary to look for possible RLS triggers. What things during the day tend to trigger RLS episodes at night? Perhaps you drank coffee late in the afternoon or skipped exercise. If you can pinpoint triggers, you may be able to avoid them.
- Stay active: People who exercise are 3.3 times less likely to be diagnosed with RLS than people who don’t exercise, according to the Restless Legs Syndrome Foundation. Given this research, exercise seems like a good practice for relieving RLS. Try walking, riding a bike, or aerobics. Just don’t engage in intense exercise close to bedtime.
- Try self-massage: Massaging your legs can help reduce RLS symptoms. A study published in 2022 found that massage relieves RLS symptoms.
- Practice healthy sleep habits: While this may not resolve RLS symptoms, it can help counteract the negative impact that RLS has on your sleep. You can adopt healthier sleeping habits by following the same sleep schedule every night, keeping your bedroom comfortable and cool, and doing a relaxing activity like meditation before bed.
- Sleep with a small pillow between your legs: This can possibly reduce symptoms as it keeps your nerves from compressing.
- Avoid alcohol, caffeine, and nicotine: All three of these have been linked with RLS symptoms.
- Cut back on sugar: Reducing your sugar intake may help RLS. Anecdotal evidence suggests that eating foods or drinking beverages high in sugar may contribute to symptoms. Try eliminating sweetened sodas, ice teas, juices, as well as candies, cookies, and cakes.
- Manage stress: Stress can be a trigger for RLS symptoms. Meditation, deep breathing, and other relaxation techniques can be helpful for reducing stress.
- Practice gentle stretching: Some simple, light stretches before bed might help RLS symptoms. You might try a calf stretch or front thigh stretch, as outlined by Healthline.
Use heat: Heat may help RLS symptoms. Therefore, apply a heating pad to your legs or soak them in a warm tub right before bed.
When To See A Doctor
Visit your doctor if symptoms have not improved with at-home remedies. There’s no medical test for RLS. Your doctor may do a neurological exam or order lab tests. They may do a sleep study or polysomnography.
Medications for RLS
If lifestyle changes don’t work, your physician may order medications for restless legs syndrome.
- Dopaminergic agents: Several dopaminergic agents are FDA-approved to treat RLS, including rotigotine (Neupro) and pramipexole (Mirapex). These drugs increase dopamine in the brain, which helps to decrease leg movements.
- Anticonvulsant drugs: These drugs can reduce leg movements. Popular anticonvulsants used for RLS include gabapentin (Neurontin) carbamazepine (Tegretol), and pregabalin (Lyrica).
- Benzodiazepines: These drugs may help you relax and go to sleep. Diazepam (Valium) and clonazepam (Klonopin) are two benzodiazepines used for RLS.
If you are pregnant, your doctor may encourage you to try lifestyle changes rather than medications as many RLS meds are not safe for pregnancy.
Other Treatment Options
Another alternative therapy that has been found to be effective for RLS is acupuncture. Emerging research has found that this traditional Chinese treatment is a safe and effective intervention for restless legs syndrome. Acupuncture is a good option for anyone worried about the potential side effects of medication.
