How to Sleep with Restless Legs Syndrome

November 23, 2020 - 500 views

Learn how Restless Legs Syndrome can affect your sleep and what you can do about it

By Andrea Pisani Babich

Restless Legs Syndrome (RLS), also called Willis-Ekbom disease, is a neurological condition that causes an urge to move your legs. It typically comes on at night just as you are relaxing and beginning to fall asleep. Everyone gets restless sometimes, but if you have RLS, you likely deal with this pain and discomfort most nights, and it can have a significant impact on your sleep quality. 

Thankfully, there are ways to deal with RLS. Lifestyle changes, medications, and the treatment of associated conditions can all help lessen the effect of RLS and get you a better, more comfortable night’s sleep. With the right solutions, you can fall asleep and stay asleep without feeling like your legs are ready to run a marathon without you.

Getting a Better Sleep with Restless Leg Syndrome

There are three basic ways doctors can help you treat your RLS. First, they look for an underlying condition and try to treat that. If your RLS isn’t associated with another condition or if you are treating that condition and still struggling with RLS, then doctors will try the second course of action: lifestyle changes. There are several small changes you can make to your lifestyle, which we’ll discuss more in the sections below. Finally, if these options are not effective, the doctor will prescribe medications specifically meant to relieve RLS symptoms.

Treating Conditions Related to RLS

How your doctor will go about treating conditions related to RLS depends on your doctor and your condition. If your RLS is related to your anxiety, for example, some doctors may recommend therapy and lifestyle changes, while others may prescribe an anti-anxiety medication. If you have both Parkinson’s and RLS, your doctor may be able to treat both conditions with one medicine. Both Parkinson’s and RLS are affected by dopamine levels, so a dopamine medication could help reduce both symptoms.

Treating RLS Through Lifestyle Changes 

RLS that is caused by a temporary medical condition or lifestyle choices may be resolved by altering certain daily activities and treating the underlying condition.

Home remedies for RLS include regular moderate exercise during the day or quitting smoking and decreasing your consumption of alcoholDr. Takeesha Roland-Jenkins

Here are some lifestyle changes to consider when treating RLS:

  • Regular moderate exercise during the day: Strenuous exercise, especially within those last few hours before bed, is generally not a good idea for people with sleep disorders. But a small study found that moderate exercise in the middle of the day can significantly reduce RLS symptoms.
  • Stress reduction or relaxation techniques: Even though RLS is a neurological disorder, some promising research suggests that psychological intervention could provide significant relief. A small study found that a 6-week mindfulness-based stress relief program resulted in a significant decrease in symptom relief and daytime sleepiness, and a significant increase in sleep quality.
  • Use a comfortable mattress: Thus far, researchers haven’t found one specific type of mattress that is better for RLS symptoms, but according to the University of Michigan, sleeping on a mattress that’s comfortable for you is important for getting better sleep with RLS.
  • Quit smoking and reduce or eliminate caffeine and alcohol: Smoking, caffeine, and alcohol all have the potential to make your RLS symptoms worse. According to one study, people who smoke are more likely to develop RLS in the first place, but other studies aren’t sure if quitting will actually help relieve symptoms. A case study found that nicotine’s effect on the brain’s dopamine production might help alleviate some people’s symptoms.
  • Massage your legs: In addition to simply feeling nice, massage has been clinically proven to help reduce RLS symptoms. According to one study, the combination of massage and lavender essential oil helps significantly reduce RLS symptoms.

Treating RLS Through Supplements 

Some over-the-counter supplements may also help treat your RLS when it appears to be caused by certain deficiencies. 

Some of these supplements include: 

  • Iron supplements when the patient has iron-deficiency anemia.
  • Vitamin D when the patient demonstrates a Vitamin D deficiency.
  • Vitamins C and E for patients on dialysis.
  • Magnesium – especially when a magnesium deficiency is believed to contribute to the condition. Magnesium is believed to help regulate nerves and muscles. When magnesium levels are low, calcium can activate nerves and trigger muscle contractions.


Always consult with your doctor before starting any treatment regimen to determine if your RLS is caused by a deficiency and to target that deficiency properly.  

Alternative RLS Treatments 

It is important to note that there are other ways to provide relief for RLS aside from taking a pill or supplementing. Some of these tactics include: 

  • A foot wrap called restiffic applies pressure to certain points on the bottom of your feet. The pressure points send signals to the brain to relax the muscles. According to a study done on the effects of restiffic, patients who used it saw a significant decrease in symptom severity in just 24 hours, and their symptoms continued to decline the longer they used it.
  • Pneumatic compression sleeves fit over your legs, inflating and deflating to provide and release gentle pressure; this increases blood flow, and several studies have shown that pneumatic compression sleeves improve quality of life, decrease sleepiness and fatigue, and continue to reduce symptoms long-term.
  • Near-infrared spectroscopy (NIRS) uses long-wavelength light beams to penetrate the skin and increase circulation to help relieve RLS symptoms. Multiple studies show that 30-minute treatments three times a week significantly reduce symptoms when compared to symptom severity before treatment.
  • Acupuncture has been shown to reduce the symptoms of RLS significantly. Acupuncture is part of Traditional Chinese Medicine (TCM), and many studies have demonstrated its effectiveness in several areas of medicine. When it comes to RLS specifically, there are several limited studies that demonstrate acupuncture’s ability to reduce symptoms and improve sleep quality even better than Western medications typically prescribed for RLS.

Prescription Medication Treatment for RLS

When behavioral adaptations and other drug-free remedies fail to relieve RLS symptoms, you may need prescription medication. If you feel that non-prescription options aren’t helping, be sure to consult your doctor about your medication options.

Be wary of certain medications that worsen RLS symptoms such as anti-nausea drugs like prochlorperazine or tricylcic antidepressantsDr. Takeesha Roland-Jenkins
  • The first-line treatment for RLS is often the dopaminergic drugs pramipexole, ropinirole, and rotigotine, which promote the release of dopamine to your brain. Dopamine is involved in purposeful muscle movements, and some RLS patients experience symptoms as a result of a dopamine deficiency. Since long-term use of dopaminergic drugs has been shown to make symptoms worse or onset earlier in the day, doctors will often prescribe the lowest dose possible. However, even at low doses, sometimes these drugs lose their efficacy.
  • The antiseizure medicine gabapentin has been approved by the FDA to treat RLS. Studies show that it works by interacting with calcium channel proteins, resulting in fewer and less severe symptoms.
  • Opioids are used judiciously when other first-line treatments are ineffective or make symptoms worse. Because of the risk of addiction, doctors will prescribe low doses and monitor usage carefully.

Understanding Restless Legs Syndrome

As many of us who have RLS know, you could have this condition for years before realizing that you can take steps to lessen discomfort. This is due in part to the fact that we don’t know how to identify symptoms or may not even realize that there are two different types of this condition: Primary Restless Legs Syndrome and Secondary Restless Legs Syndrome.


Common symptoms of RLS 

  • An overwhelming urge to move your legs. This is the defining symptom of RLS. Many people who experience RLS find this urge difficult to describe, but according to the National Institute of Neurological Disorders and Stroke, it is often described as “aching, throbbing, pulling, itching, crawling, or creeping.”
  • The urge gets worse during inactivity. Most people with RLS find that movement can temporarily relieve their discomfort, and when they stop moving (for instance, to go to bed), the urge gets worse. If you experience discomfort in your legs that is not relieved with movement or does not get worse with inactivity, then you are probably not experiencing RLS.
  • Periodic limb movement disorder (PLMD). According to the Cleveland Clinic, 80% of people with RLS also experience PLMD. This is an additional disorder that causes involuntary twitching or jerking of the limbs while you are asleep.
  • Insomnia. Because the restlessness tends to get worse at night, many people with RLS also have a lot of trouble sleeping. According to a large survey, insomnia is one potential predictor for RLS because many people who reported having RLS also reported insomnia.

Causes of Restless Legs Syndrome 

Restless Leg Syndrome affects 5-10% of adults and 2-4% of children, with women having the condition slightly more often than men.

Researchers still can’t say for sure what causes RLS, but they have discovered evidence linking it to a few different factors, including genetics, pregnancy, iron abnormalities, and kidney abnormalities. They have also linked RLS with other conditions such as ADHD, Parkinson’s disease, spinal cord, and neurological abnormalities, Rheumatoid Arthritis, and Sleep Apnea. 


The Takeaway

Although restless legs syndrome is not a fun condition, it isn’t a hopeless one either. There are many treatment options out there to help reduce the uncomfortable, sometimes painful urge to move. There are several medications for RLS, but if you don’t love pills, there are lifestyle changes you can adopt and non-drug treatments you can try, like acupuncture. You don’t have to lie awake at night feeling miserable anymore, you have options; there are treatments. So talk to your doctor today to find the right solution for your restless leg syndrome.

Source:  Mattress Advisor


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Dr. Luis Javier Peña-Hernández

Lung and sleep health specialist at PCSI, the largest integrated pulmonary and sleep disorder specialty group in Palm Beach County


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