For an estimated six million people in the U.S., this is a familiar bedtime routine. After a long, busy day of work, fun, and family, they finally fall into bed at night and turn out the light. Hoping to fall quickly to sleep, instead, quick movements of the legs (along with other symptoms) keep them up for hours. When they do manage to fall asleep in short intervals, Restless Legs wake them up regularly. Every morning they rise out of bed, barely having slept. Restless Legs Syndrome is a chronic, disruptive problem. Here’s what to do for restless legs.

What is and what to do for restless legs syndrome?

Restless Legs Syndrome is a neurological condition that results in uncontrollable twitching, jerking, pulling, and movement of the legs. This urge is involuntary and results in an inability to lie still or relax.

Most sufferers of restless leg syndrome report worsening symptoms at night. The moment they lie down, symptoms begin. In addition to involuntary movement, also known as periodic limb movement of sleep (PLMS), restless legs syndrome symptoms can include:

• Paresthesia (tingling or “pins and needles” sensations)
• Burning
• Symmetrical symptoms (occurring on both sides of the body)
• Cramps
• Symptoms that occur in the trunk of the body or the arms
• Creeping or “crawling” sensations

People with severe cases of restless legs syndrome may have a daily occurrence of these symptoms. Those with mild to moderate restless legs syndrome may experience symptoms two times or less each week, with only mild disturbance of sleep or other restful activities. Symptoms may also go into remission for a period of time, but they generally return, sometimes at a more extreme level.

Causes of restless leg syndrome

Some people develop restless legs syndrome with no definitive cause. In these cases, there may be a tentative genetic link (i.e., a first degree relative also has restless legs syndrome). Other causes of restless leg syndrome include:

• Neurological damage: Research indicates that restless legs syndrome may be caused by damage or dysfunction in the basal ganglia circuits in the brain. These regulate smooth muscle movement by regulating production of the neurotransmitter dopamine. If this circuitry is damaged or disrupted, as in those with Parkinson’s disease, restless legs syndrome may result.
• Chronic disease: Kidney failure, diabetes, and peripheral neuropathy all contribute to the development of restless legs syndrome.
• Medication: Anti-nausea drugs, anti-psychotic drugs, antidepressants that increase serotonin, and some cold and allergy medications with anti-histamines have been linked to this syndrome.
• Pregnancy: Expectant moms may experience restless legs syndrome in the last trimester.

What to do for restless legs

There are a number of treatment options for restless leg syndrome. For some causes, such as peripheral neuropathy, successfully treating the underlying cause may result in disappearance of symptoms. Additionally, many pregnant women find that their symptoms disappear once they give birth.

What to do for restless legs depends largely on what factors may be contributing to the condition. Treatments can be as varied as the people who suffer from this condition.

Remove triggers

Some people who experience restless legs syndrome find that certain substances are triggers, causing more severe symptoms. These triggers can include:

• Caffeine
• Alcohol
• Tobacco

Removing triggers is the easiest first step to take for restless legs syndrome. Those with mild to moderate cases may find relief just by making these simple changes.

Make lifestyle changes

It is ironic that a good night’s rest is a recommended treatment for restless legs syndrome when restless legs syndrome can cause poor sleep. Occasionally, though, an underlying sleep disorder like sleep apnea may be causing uncontrollable jerking or involuntary movement. Treating sleep apnea may help.

Practicing proper sleep hygiene can also help address sleep deficiencies due to restless legs syndrome. If you have an underlying pain condition, good sleep hygiene may also help to address your pain as well.

Other lifestyle changes to treat restless legs syndrome include exercising regularly and practicing stress-reduction techniques (e.g., meditation). Eating a healthy diet that addresses any underlying health conditions can also go a long way to reduce symptoms of restless legs syndrome.

Investigate medications

In rare cases, a single medication will relieve most if not all symptoms of restless legs syndrome. More often than not, sufferers need to experiment with multiple medications in different combinations to find what works best. Some medications for restless legs syndrome include:

• Dopaminergenic drugs: These dopamine-increasing medications help the brain regulate smooth muscle movement.
• Benzodiazepines: These are utilized at bedtime to promote restful sleep but cannot be used during the day.
• Opioids: Opioids should be used with caution and restriction. They may relieve pain and allow sufferers to sleep.
• Anticonvulsants: Anticonvulsants can help with the crawling sensation and may allow sufferers to relax.

Even when a combination of medications is found to be effective, over time their effectiveness may diminish. Additionally, patients may experience unwelcome side effects that cause them to re-evaluate their prescriptions.

Natural remedies

Some patients experiencing low iron may do well on a trial of iron supplementation. Others may find that magnesium deficiency is a culprit in worsening symptoms.

Muscle relaxing plants consumed as a tea or tincture may help. These include:

• Milky oats (Avena sativa)
• Gotu kola (Centella asiatica)
• Ashwaganda (Withania somnifera)

Passionflower (Passiflora incarnata), valerian (Valeriana officinalis), and kava (Piper methysticum) are also all relaxing herbs that can be consumed as tea before bedtime.

It is crucial to check with your doctor before utilizing natural remedies, as these are not regulated by the U.S. Food and Drug Administration and may interact with prescription medications.

The Restless Legs Syndrome Foundation (RLSF) offers helpful resources for those who suffer, including up-to-date research about what to do for restless legs. Check out the RLSF website today!

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