9 Ways to Get a Good Night's Sleep with Restless Legs Syndrome
If you have Restless Legs Syndrome (RLS), which is also called Willis-Ekbom Disease, you’re all too familiar with the unpleasant creepy-crawly sensation in your legs that characterizes this neurological condition.
RLS tends to get worse at night, when you want to let go of your cares and drift off to sleep. You find yourself unable to settle down and get comfortable because you just really, really need to move your legs. In the morning, you’re irritable or unable to concentrate—or both—because you’re so exhausted. Some people with RLS even develop symptoms of depression.
Unfortunately, there isn’t a cure for RLS yet. However, you don’t have to completely resign yourself to an endless stretch of sleepless nights and giant bags under your eyes. There are some steps you can take that may reduce or minimize the discomfort and maximize your chances of catching some shut-eye.
1. Embrace good sleep hygiene.
Set yourself up for success by practicing healthy sleep habits, which include setting a regular schedule for going to bed and getting up each day, maintaining a cool and dark sleeping environment, and giving electronics the boot from your bedroom.
2. Avoid OTC sleep aids.
Resist the urge to reach for an over-the-counter medication to help you sleep. These meds, along with many antihistamines and anti-nausea drugs, can make your symptoms even worse. Certain antidepressants, especially some selective serotonin reuptake inhibitors, or SSRIs, also seem to make the symptoms worse. Talk to your doctor for guidance on selecting a different medication.
3. Cut back on alcohol.
A glass of wine or two before bedtime might seem like it would make you sleepy, but evidence suggests that alcohol can be a trigger for RLS symptoms in some people. The WED Foundation suggests cutting yourself off from alcoholic beverages after 6 p.m.
4. Reduce your caffeine intake.
While you’re reducing the amount of alcohol you drink, you might also want to consider cutting back on the amount of caffeinated beverages you consume. The caffeine may contribute to keeping you awake.
5. Try a vibrating pad under your legs.
If you’ve ever sat in a vibrating chair, this method of treatment will be familiar to you. You lie down and put a specially designed vibrating pad under your legs. The pad provides counterstimulation to your RLS symptoms by vibrating at one level of intensity for 30 minutes, then switching to a different level of intensity. It’s currently available on a prescription basis to people in the United States.
If sitting still and concentrating sounds far-fetched to you, consider this: incorporating some mild stretching and meditation techniques in your evening routine can lower your stress levels, which can alleviate some of the symptoms of RLS. For example, you could try some simple exercises to stretch your calves and your hips while listening to relaxing music. Or you could try some basic yoga poses.
7. Add an iron supplement.
An iron deficiency may be exacerbating the problem for you. Research indicates that a low level of iron in your brain may be partially responsible for RLS, according to the National Institute of Neurological Disorders and Stroke. However, don’t up your iron intake on your own—consult your doctor first. You may need to get a spinal fluid analysis or an MRI to get more precise information about the iron levels in your brain. Your doctor may also want to investigate other nutritional deficiencies, such as vitamin B12, magnesium or folic acid, to see if you might benefit from a supplement.
8. Try a dopamine-related medication.
Research suggests that a dopamine imbalance in your brain could also be the culprit. Dopamine is the chemical that transmits “messages” between the nerve cells in your brain, and certain drugs that increase dopamine levels can help alleviate some of the effects of RLS, even the periodic limb movements of sleep known as PLMS. The U.S. Food and Drug Administration has approved rotigotine (Neupro), pramipexole (Mirapex) and ropinirole (Requip), which are medications also used to treat the symptoms of Parkinson’s disease. However, some experts caution that chronic use may eventually exacerbate RLS—a progressive worsening called augmentation.
9. Consider other prescription medications.
Some doctors will prescribe benzodiazepines, narcotics, or anticonvulsants off-label to help their patients suffering from RLS, but these drugs can have side effects that might not make them appropriate for everyone. Another prescription medication that’s a possible option is the anticonvulsant gabapentin enacarbil (Horizant), which has also been prescribed to treat nerve pain and was approved by the FDA in 2011 to treat RLS.
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- Restless Legs Syndrome (RLS) and Sleep. National Sleep Foundation. http://sleepfoundation.org/sleep-disorders-problems/restless-legs-syndrome
- Causes of Restless Legs Syndrome. Johns Hopkins Medicine. http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/restless-legs-syndrome/what-is...
- Treatment for Restless Legs Syndrome (RLS). Johns Hopkins Medicine. http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/restless-legs-syndrome/what-is...
- Agarwal P, et al. Gabapentin enacarbil – clinical efficacy in restless legs syndrome. Neuropsychiatric Disease and Treatment. 2010; 6: 151–158. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874339/
- Restless Legs Syndrome Fact Sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm
- Restless Legs Syndrome: Causes, Diagnosis, and Treatment. Restless Syndrome Foundation. http://www.rls.org/document.doc?id=2323