According to The National Institute of Neurological Disorders and Stroke, restless legs syndrome (RLS), sometimes called Willis-Ekbom disease, often causes unpleasant or uncomfortable sensations in the legs and an irresistible urge to move them. Symptoms usually occur around late afternoon or evening, and they are often most severe at night when sitting or lying in bed. Perhaps these symptoms sound familiar to you? If so, you’ve likely been dealing with RLS.
Technically classified as a sleeping disorder, RLS affects around 7%-10% of the United States population and can begin at any age. For seniors in particular, RLS can have a large impact on their regular sleeping habits and become rather painful. Furthermore, many people fail to recognize the symptoms of RLS and end up frustrated and exhausted with the constant discomfort. As the experts at Snore Nation explain, “although sleep is one of our most basic human needs, almost all of us will experience some form of sleep disorder at some point in our lives. It’s important to understand the difference between the occasional bad night of sleep and chronic sleep disturbances that can be labeled as a disorder.” Luckily, RLS can often be treated with some diet and lifestyle changes, meaning you’ll be enjoying a great night of sleep sooner than you think.
- Restless Legs? Avoid These Pre-Bedtime Snacks
- Is Nocturnal Eating Intrinsic to Restless Legs Syndrome?
- A Healthy Diet for RLS
- 10 top tips to help you overcome restless leg syndrome
- What is Restless Leg Syndrome (RLS)?
- What causes Restless Leg Syndrome at night?
- Our top 10 tips to help you beat RLS
- 2 – Keep your mind active
- 3 – Heat things up a bit
- 4 – Or cool things down
- 5 – Avoid exercising too close to bedtime
- 6 – Cut down on caffeine
- 7 – Massage your legs
- 8 – Acupuncture
- 9 – Watch what you eat
- 10 – Try these herbal helpers
- Restless Legs Syndrome (RLS) Treatment
- Drugs Approved to Treat RLS
- Side Effects of RLS Drugs
- Home Treatment of RLS
- Restless Leg Syndrome (RLS)
- What is restless leg syndrome?
- What are the symptoms?
- What are the causes?
- Who is likely to develop restless leg syndrome?
- How is restless leg syndrome diagnosed?
- What is the conventional treatment for restless leg syndrome?
- What therapies does Dr. Weil recommend for restless leg syndrome?
Foods That Cause Restless Legs Syndrome
Our diet can affect several aspects of our health, including RLS. According to experts at Healthline, certain foods and beverages containing caffeine can stimulate your nerves and contribute to RLS. In addition to limiting tea, coffee, and chocolate, they recommend avoiding fattening items such as fried foods, processed foods, and foods high in sugar, as obesity can increase your risk of RLS.
Foods That Help with Restless Legs Syndrome
Including foods that will help combat the symptoms is just as important as reducing certain foods that cause RLS. Did you know that having an iron deficiency can be a leading cause in RLS? Iron helps transport oxygen throughout the body, which can help calm nerves during sleep. Coincidentally, anemia is an extremely common problem for seniors. As such, seniors battling with RLS should consider indulging more iron-rich foods. This includes: red meat, fish, poultry, green leafy vegetables, and pretty much all kinds of beans. Another mineral, magnesium, can help with RLS, so nuts, seeds, and unrefined grains would be a great addition to your diet.
Other Ways to Manage Restless Legs Syndrome
In addition to dietary changes, RLS can be managed by engaging in regular exercise and using some at-home tools. Investing in a foam roller or a weighted blanket can work in tandem with a healthy diet to reduce or diminish the symptoms of RLS. Foam rollers can be used right before bed to massage the affected areas and relax the muscles. For weighted blankets, as experts at Mattress Advisor explain, “the deep pressure touch a weighted blanket provides is called ‘grounding’.” This grounding helps fight stress, anxiety, and depression, which can cause RLS. It’s also recommended to stop smoking and talk to your doctor about other medication options if you feel that yours could be contributing to RLS.
Sleep is essential but not always a given. Restless legs syndrome can be exhausting to deal with, but there are ways to manage it. Diet is imperative, but it’s also worth investing in other resources to help you fight the battle towards a more fulfilling, restful sleep.
Restless Legs? Avoid These Pre-Bedtime Snacks
We all like to eat, but eating right before bed may in fact cause significant trouble with sleep. There are some foods and beverages that may be fine to eat before sleeping, but some of the worst also happen to be some of the most popular late-night foods and drinks. Here is a list of food to avoid before bedtime.
Alcohol consumption prior to bedtime can significantly disrupt your sleep. Many people misinterpret the drowsy effects of alcohol to mean that it is a good sleep aid. While it is true that a glass of wine may make you sleepy, it turns out that it will disrupt your sleep later in the night. So yes, it will help you to fall asleep, but it will not help you stay asleep. Some studies also suggest that there is a link between late night alcohol and triggering RLS symptoms.
Not ice cream! There is hardly a more popular late night comfort food than a large bowl of ice cream. How can that be a bad thing? Well, ice cream has fats and sugars that are the enemy of quality sleep.
Fats require your body to work hard to break them down and digest them, keeping you from relaxing sufficiently to enter into deep, restful sleep. Sugars, of course, give your body that burst of energy right when you need to relax. So if you must have a bowl of ice cream, do so at least a couple of hours before bedtime.
Caffeine is in an added ingredient in many popular drinks and even foods. In addition to coffee, soda, dark chocolate, tea and candy bars may contain caffeine.
The problem with caffeine is that it stays in your system as much as 10 hours after you consume it. While it may not stop you from falling asleep, when your body shifts into the shallow sleep phase, the caffeine in your system will cause you to awaken more easily, disrupting your sleep patterns.
Pizza, Pasta and Spicy Foods
Heavy foods like pizza can keep your stomach working when you should be sleeping, and spicy foods can lead to heartburn, which disrupts sleep. As much as you might like that late night pizza or bowl of pasta, it is best to avoid them if you want to get a full, restful night’s sleep.
Essentially, you need to avoid food or drink with alcohol, sugars, fats and caffeine. That may seem to basically rule out all foods, but remember that eating right before bed is not the best practice anyway. Getting a good, restful night sleep is the goal. Again, those suffering from RLS need to use every tool at their disposal like natural supplements for RLS to fight the symptoms. Since some of the foods listed here can trigger symptoms, it is best to avoid them.
Is Nocturnal Eating Intrinsic to Restless Legs Syndrome?
BOSTON—Patients with restless legs syndrome (RLS) are more likely to engage in nocturnal eating or have sleep-related eating disorder (SRED) than patients with psychophysiologic insomnia, according to research presented at the 26th Annual Meeting of the Associated Professional Sleep Societies. Dopaminergic agents reduced nocturnal eating and SRED by approximately half among patients with RLS. These findings help confirm that the unusual eating behaviors seen in RLS patients are not caused by dopaminergic agents.
Nocturnal eating, defined as breaking the overnight fast more than twice a month, can be dysfunctional or normal. “I would speculate that, in many cases, nocturnal eating is actually an intrinsic feature of RLS,” said Michael J. Howell, MD, Assistant Professor of Neurology at the University of Minnesota in Minneapolis. “It’s not merely an association, but it’s actually part of the condition.” Nocturnal eating has been associated with RLS since its original description. In 1960, Karl Ekbom wrote: “They often have to get up and walk ‘like a caged bear,’ to quote one of my patients, or they go into the kitchen and get something to eat.”
A Restless Basis for Nocturnal Eating?
Dr. Howell and colleagues followed consecutive adult patients with difficulty falling asleep because of RLS or psychophysiologic insomnia to determine whether nocturnal eating in RLS is a product of the patient’s awakenings or whether its roots are intrinsic to RLS. The researchers also sought to examine whether patients with RLS were more likely to manifest SRED when they were exposed to sedatives and to determine whether dopaminergic drugs affected nocturnal eating behavior.
Using a structured questionnaire and evaluation, the investigators identified more than 300 patients who had difficulty initiating sleep. The majority of patients had conditions such as circadian rhythm delay or chronic pain and were excluded from the analysis. A total of 130 patients had RLS or psychophysiologic insomnia. A total of 88 patients had RLS, and 42 had psychophysiologic insomnia.
Nocturnal Eating Is Common in RLS
Of patients with RLS, 61% engaged in nocturnal eating, and most of them did it at least three times per week. In contrast, only 12% of patients with psychophysiologic insomnia engaged in this behavior. Results were also striking for SRED in RLS, noted Dr. Howell. Approximately 36% of RLS patients described the dysfunctional binge eating of SRED, but no psychophysiologic insomnia patients described dysfunctional nocturnal feeding behavior. About 80% of patients with RLS who had previously been exposed to a benzodiazepine receptor agonist described a history of sleepwalking or SRED, compared with 12% among patients with psychophysiologic insomnia. Compared with patients with RLS, patients with psychophysiologic insomnia were more likely to be awake at night for a prolonged period of time, but less likely to eat. “These findings mean that nocturnal eating is not merely ‘killing time’ in RLS patients, but instead employed in an attempt to fall back asleep,” Dr. Howell said. “These patients are, in fact, restlessly eating.”
Before beginning dopaminergic treatment, 68% of patients with RLS had engaged in nocturnal eating, and dopaminergic agents reduced this rate by half. Dopaminergic agents also halved the incidence of SRED among patients with RLS, but the number of cases was insufficient to achieve statistical significance.
The investigators observed no cases of de novo nocturnal eating or SRED once patients with RLS started taking dopaminergic agents. The coincident decrease in RLS and nocturnal eating “suggests that nocturnal eating in RLS is fundamentally different from the other impulse discontrol issues, such as gambling, that occur in RLS treatment,” said Dr. Howell. Evidence from previous studies supports this hypothesis, he added.
“This investigation helps confirm that amnestic SRED is rare in the absence of sedative–hypnotic medications,” Dr. Howell commented. “Amnestic SRED was common in the setting of sedative–hypnotic use among RLS, but not in psychophysiologic insomnia patients. Our study is also consistent with previous reports that SRED and sleepwalking are rare in patients who have been given zolpidem when RLS has been rigorously excluded,” he concluded.
A Healthy Diet for RLS
Add restless legs syndrome (RLS) to the long list of health woes that can be eased with theright healthy diet. Overall good nutrition, coupled with a few specific dietary changes, may help bring relief and improve your quality of life with RLS. For some people, dietary changes may eliminate the need for other types of treatment, including medications. That’s because symptoms of RLS, also known as Willis-Ekbom disease, can be triggered by underlying nutritional deficiencies. And research suggests a link between RLS and obesity, making a healthy diet and weight management even more important to your well-being.
The Link Between RLS and Obesity
People who are overweight or obese are at greater risk for a number of health conditions, including heart disease and stroke, type 2 diabetes, and cancer. A study published in Neurology found that being obese is also associated with an increased risk for RLS.
The study involved 65,554 women and 23,119 men. None of the participants had diabetes or arthritis, and none of the women were pregnant. Researchers found 6 percent of the women and 4 percent of the men to have RLS. It was noted those who were obese were roughly one and a half times more likely to have RLS than people with a normal body weight were. The study pointed out, however, that more research is needed to determine if obesity is actually a cause of RLS.
Although the link between obesity and RLS hasn’t been definitively established, Ihtsham Haq, MD, a neurologist at Wake Forest Baptist Medical Center in Winston-Salem, N.C., points out that maintaining a healthy weight is always a good idea. “Obesity is associated with many conditions, and encouraging people who are obese to lose weight is certainly in their best interest,” he says.
A Healthy Diet for RLS
Eating a healthy diet helps you maintain a healthy weight, and it may also help you avoid certain nutritional deficiencies that may be an underlying cause of RLS.
“Folic acid, vitamin B12, and iron deficiencies are all associated with RLS. In fact, iron deficiency can lead to anemia, which is a major risk factor for the condition,” says Georgia Giannopoulos, RD, a certified dietary manager and clinical nutrition support dietitian at New York Presbyterian Weill-Cornell Medical Center in New York City who treats people with RLS. “Once you pinpoint what type of deficiency a person has, you can treat the cause of their symptoms.”
Talk to your doctor about the possibility of one of the following nutritional deficiencies:
- Iron. Research published in the journal Alternative Medicine Review shows that anemia, or a low iron level, is a common underlying cause of RLS. Iron concentrations in the blood are also 50 percent to 60 percent lower at night, which may explain why RLS symptoms tend to flare later in the day. A study published in Sleep Medicine found that iron for RLS treatment produced significant or complete improvement of RLS symptoms in 17 of 25 women without causing major side effects. Dr. Haq notes that supplementing with iron for RLS is a simple way to help people with an iron deficiency get relief from their symptoms.
“Iron-rich foods are generally animal sources, such as beef. Fish also tends to be high in iron, particularly oysters and sardines,” says Demera Hale, RD, of Wake Forest Baptist Medical Center in Winston-Salem, N. C. “Vegetarian sources of iron include fortified grains and leafy greens such as spinach, kale, and collards.” Giannopoulos adds that eating iron-rich foods along with a source of vitamin C, such as citrus fruit like an orange or a grapefruit, can improve iron absorption.
- Magnesium. Magnesium helps maintain normal muscle and nerve function. A deficiency in this mineral is also associated with RLS. According to a study published in the journal Sleep, magnesium supplementation may be a good alternative therapy for people with mild or moderate RLS. The participants involved in the study were treated with oral magnesium for four to six weeks. Over the course of the study, their RLS symptoms decreased significantly.
Older adults and people with chronic malabsorptive conditions, such as Crohn’s disease, are at increased risk for magnesium deficiency. People with alcohol addiction and poorly controlled diabetes are also at greater risk.
Green vegetables, such as spinach, are high in magnesium. Other magnesium-rich foods include legumes, nuts, and whole grains.
- Folate and vitamin B12. Low levels of vitamin B12 and folate are associated with diabetic neuropathy — a condition that could trigger symptoms of RLS. Research from the same study that looked at iron for RLS in the journal Alternative Medicine Review also found that supplementation with folate may be effective in reducing RLS symptoms and could play a role in treating RLS.
People with alcohol addiction and other causes of malabsorption are among those at greater risk for folate and B12 deficiencies. “A folate deficiency is rare,” Giannopoulos notes. “It usually comes with another nutritional deficiency, such as iron.”
Although folate is found in a variety of foods, those with the highest levels include spinach, asparagus, and Brussels sprouts, Giannopoulos says. Folic acid is also added to enriched breads, cereals, flours, pastas, rice, and other grains. Beef liver and clams are among the best sources of vitamin B12. Other sources of this vitamin include enriched cereals, fish, eggs, and dairy products.
More Ideas for a Healthy RLS Diet
Caffeine intake has been linked to an increase in RLS symptoms. Avoiding this stimulant, which is found not only in coffee and tea but also chocolate and many sodas, may help ease your symptoms. Drinking alcohol can also increase the intensity of symptoms in many people with RLS.
By eating a healthy RLS diet and avoiding caffeine and alcohol, you may be able to help reduce the severity of your condition. Talk to your doctor or dietitian about your specific diet needs for managing RLS.
10 top tips to help you overcome restless leg syndrome
What is Restless Leg Syndrome (RLS)?
Restless Leg Syndrome is often considered to be a condition of the nervous system associated with an overwhelming urge to move the legs. Sufferers often describe the urge as a creeping sensation that begins in the feet, calves and thighs, sometimes accompanied by involuntary jerks, numbness and pins and needles.
It’s thought to sometimes worsen at night and, as a result, can lead to poor sleep patterns. Unfortunately, primary Restless Leg Syndrome is known as an idiopathic condition, which means it can often have no direct cause. Although genetics are thought to play a role as around 40% of primary Restless Leg sufferers have a family history of the condition.1
It’s also twice as likely to affect women as men as it is a frequent symptom experienced during pregnancy.
What causes Restless Leg Syndrome at night?
Primary RLS might be thought to be idiopathic but there are some triggers associated with the condition, as I identify in my blog, ‘7 reasons for restless legs at night.’ Factors such as poor circulation, lack of exercise, certain nutritional deficiencies and pregnancy can play a role but here are a few additional triggers and issues that may worsen your symptoms.
Dopamine: Research is starting to indicate that some forms of RLS could be related to a dysfunction with your Basal ganglia, the structure in the brain that is responsible for involuntary movements. When this part of the brain is affected, it can impact your production of dopamine, a neurotransmitter that can help to control muscle movement and coordination. Usually our levels of dopamine are lower in the evening, which may explain why symptoms occur before you go to bed.2
Fibromyalgia: Many sufferers of fibromyalgia are also afflicted by RLS, with one study finding that 64% of participants who had fibromyalgia also suffered from RLS.3 Although the underlying connection between the conditions is still unknown, it’s believed that they may both share similar mechanisms in the nervous system and brain.
Stress: Stress might not directly cause RLS, but it can certainly make the symptoms appear worse by heightening your awareness of them and instigating a stress reaction that may further prevent you from getting to sleep.
Substances: Alcohol, caffeine and nicotine can similarly affect your RLS symptoms, disrupting your sleep and worsening your deprivation.
Medications: Certain medications like antidepressants, lithium and antihistamines have sometimes been known to make RLS symptoms worse.4
Our top 10 tips to help you beat RLS
Experts aren’t exactly sure how stretching helps RLS, but the evidence certainly seems to be positive, with one eight week study finding that mindful stretching helped to reduce RLS symptoms as well as improve your mood and lower stress levels.5
Some speculate that mindful stretching is able to help RLS so efficiently because it encourages relaxation, helping to soothe the nervous system, which may then positively influence RLS symptoms.
2 – Keep your mind active
When restless legs strike it can be very easy to become fixated on your symptoms. The more you want your legs to keep still, the more it seems they will continue to jerk and twitch. That’s why, instead of lying and becoming more and more stressed, it might be an idea to try and keep your mind occupied.
Now this doesn’t mean you should reach for your smartphone and start scrolling through social media – it might divert your attention for a few minutes but, in the long run, it won’t do any favours for your sleep patterns. If you need to, get up and walk around, read a book or do a puzzle – anything that keeps your attention away from the sensations in your legs is bound to help, providing that it is a relatively relaxed activity that isn’t too stimulating!
3 – Heat things up a bit
When it comes to soothing your muscles, a nice hot bath usually works a treat. Not only will this help to relax your muscles, but it’s also a good way of helping you to unwind before bedtime.
For the best results, try adding some Epsom salts to your bath – these contain magnesium, which can naturally help to soothe your muscles, hopefully reducing the symptoms of RLS.
4 – Or cool things down
If you don’t fancy heating things up, you could try cooling them down. Cold treatment helps to numb any aches and pains and can even slow down nerve impulses, which may help to prevent any spasms or twitching.
However, just be careful when using this method. Make sure you’re not applying the cold compress for too long, around 20 minutes should suffice, and never apply a compress directly to an open wound!
5 – Avoid exercising too close to bedtime
If you have restless legs, exercising regularly during the day can be a great help, especially if you suffer from circulatory problems such as varicose veins. A little brisk movement can help to get the blood pumping around your body and can even release endorphins, the happy hormones, helping to improve your mood.
One study in 2006, even found that aerobic exercise, done 3 times a week, might be able to significantly reduce RLS symptoms.6 However, while exercising during the day is all well and good, if you decide that hitting the gym just before bed might be a good way to tire you and your legs out, you’re wrong.
If you over-exercise, it can exacerbate RLS symptoms and working out too close to bedtime may potentially make it harder for you to fall asleep, meaning that you’re more conscious and aware of any discomfort or spasms.
6 – Cut down on caffeine
Caffeine acts a stimulant in the body and is well known for interacting with sleep, however, when it comes to restless legs, caffeine can also increase other neurotransmitters in the brain, like norepinephrine, which can promote restlessness and hyperactivity – not what you want if you suffer from restless legs!
However, while most people are aware of caffeine’s influence, they don’t always understand how long the effects of caffeine can linger. It can sometimes take as long as 6 hours for caffeine to leave your system and this can sometimes take longer depending on whether or not you are on certain medications, like the contraceptive pill.
That’s why, if you must have a cup of tea or coffee, I’d recommend keeping it to the morning. As tempting as it might be, try to resist having a brew in the afternoon and instead opt for caffeine-free herbal teas or coffee substitutes like our own Bambu, which contains a rich blend of Turkish figs and chicory, helping to refresh and revitalise without upsetting your nervous system.
7 – Massage your legs
Giving your legs a little massage might just help to relieve some of the symptoms of RLS, according to research. One case study, conducted in 2007, found that a 45 minutes massage, twice a week improved one woman’s RLS symptoms dramatically.7
This is possibly due to the stimulating effect that massages can have on our circulation or perhaps because massaging can increase our levels of dopamine. Either way, it gives you an excuse for a little extra pampering so I’d definitely recommend making an appointment in the near future!
8 – Acupuncture
Acupuncture? As in that thing where they stick needles into your skin? You’re probably thinking ‘no thanks!’ but acupuncture has demonstrated its ability to help treat a range of conditions so I wouldn’t be so quick to dismiss it.
Research even appears to be on acupuncture’s side as one 2015 study found that participants who had RLS and were treated with acupuncture showed reduced abnormal leg activity!8 Admittedly, more research is needed but so far, the results do seem to be positive!
9 – Watch what you eat
What you eat might just be having an impact on your RLS symptoms. For a start, we know that nutritional deficiencies, such as low levels of iron and magnesium, can act as triggers for the condition so I would start by focusing on foods rich in these minerals – spinach, avocados, cashews, almonds, wholegrains, lentils and pulses are a good starting place.
Once you’ve addressed your intake of these pivotal nutrients, it might be time to also consider the foods that you should be avoiding. I’ve already mentioned the effects of caffeine on your nervous system, but other foods that are high in sugar or processed fats should also be restricted. Not only can these affect your circulation and nervous system, but they can also influence your waistline – remember, obesity is a leading cause of RLS!
It may not have a direct impact, but staying hydrated is extremely important too! Dehydration can affect your sleep patterns and will make you feel more fatigued during the day. Try to consume at least 1.5L of plain water a day – fizzy drinks and fresh fruit juices don’t count!
10 – Try these herbal helpers
If restless legs are preventing you from nodding off at night, it might be worth considering a gentle herbal remedy. I often recommend a combination of Valerian and Hops to help relax the nervous system and allow you to unwind.
Our Dormeasan remedy should be able to provide relief from sleep disturbances and, if you feel as though stress is fuelling your symptoms, it should be able to help you calm down, enabling you to fall into a deep, natural sleep, unhindered by grogginess the following morning.
Another common cause of restless legs is poor circulation in the legs, with conditions like varicose veins often being accompanied by RLS symptoms. Fortunately, we have two excellent remedies that can help to promote healthy circulation in the legs – Ginkgo biloba and Venaforce.
Ginkgo has a long history when it comes to herbal medicine and is traditionally used to help improve your blood flow and circulation, while Venaforce helps to strengthen the veins in the legs, easing the symptoms of varicose veins. We also offer a topical horse chestnut gel, Venagel, which can be applied directly to your legs to soothe any aches or heaviness.
There may be nothing worse than being physically exhausted, looking forward to bedtime after a long day, but as soon as you hit the pillow, that familiar feeling, unfortunately, starts to set in. That irresistible urge to move the legs continually due to uncomfortable sensations people often describe as creeping, crawling, cramping, tingling, pulling, aching, burning or even painful. Symptoms start or become worse when resting and improve when the legs move. Relief occurs during activity and persists as long as the activity continues. Finally, symptoms worsen in the evening, especially when lying down. What I am referring to here is what is diagnosed as Restless Leg Syndrome. Approximately 1 in 6 people suffer from what we call Restless Leg Syndrome (RLS). The exact cause of RLS remains unknown, but nutritional deficiencies may contribute to or worsen the symptoms. For those with specific vitamin or mineral deficiencies, eating certain foods can help to lessen the symptoms of RLS.
The human body needs iron to transport oxygen. An iron deficiency interferes with the delivery of oxygen to cells throughout the body, resulting in fatigue. Iron deficiency may contribute to the onset of restless leg syndrome or cause the symptoms to worsen. To relieve symptoms, patients should eat foods rich in iron. The best dietary sources of iron include animal products such as red meat, fish and poultry. These foods contain heme iron, derived from hemoglobin, from which the body can absorb 15 to 35 percent of the iron, according to the National Institutes of Health Office of Dietary Supplements. The richest sources of iron include chicken livers, beef, clams, oysters and dark meat turkey. Plant products, such as dried beans, lentils, spinach and raisins; contain non-heme iron, from which the body only absorbs 2 to 20 percent of the iron. The body absorbs iron more easily by coupling the intake of an iron source with a Vitamin C source, such as strawberries and red peppers. Make sure you are receiving your Epogen, Procrit and other medications, as prescribed. Always follow your dietary restrictions on protein, potassium and phosphorus.
Another deficiency, Folate, may contribute to exacerbating symptoms of RLS. Folate, also known as vitamin B9 or the synthetic version of folic acid, is essential in producing and maintaining new cells. The body needs folate to produce red blood cells and prevent anemia. Patients with low levels of folate may experience the symptoms of restless leg syndrome. To possible relieve these symptoms; patients can eat foods rich in folate or fortified with folic acid. Many types of foods naturally contain folate, including green leafy vegetables such as spinach, citrus fruits and fruit juices and dried beans such as cowpeas and great northern beans. Foods fortified with folic acid including breakfast cereals and enriched breads, rice and pastas, may also be helpful.
Magnesium, a mineral, helps regulate blood pressure and blood sugar, keep the heart rhythm steady, keep bones strong, support a healthy immune system and maintains muscle and nerve function. Magnesium deficiency can cause nausea, vomiting, loss of appetite and fatigue that can lead to numbness and tingling, along with muscle contractions and cramps. Since a magnesium deficiency can contribute to the symptoms of restless leg syndrome, eating foods high in magnesium can help relieve symptoms. Foods such as spinach, potatoes, beans and peas all contain magnesium. As kidneys fail they may not be able to remove adequate levels of magnesium from the blood. Therefore, blood levels of magnesium can build up. Also, large doses of antacids and laxatives containing magnesium have been associated with magnesium toxicity. Magnesium toxicity resulting from kidney failure has signs similar to those of magnesium deficiency. Thus, neurological impairment changes in mental status, appetite loss, muscle weakness and irregular heartbeat may occur. Since people with kidney disease may lack the ability to efficiency excrete excess magnesium, they should generally refrain from taking magnesium supplements. Make sure you receive your physician’s “okay” before you start increasing magnesium in your daily diet.
Foods that may worsen RLS
According to the Mayo Clinic, people with restless legs syndrome should limit caffeine and caffeine-containing products, including chocolate and beverages like tea and soda. If symptoms improve after several weeks of no caffeine, then the patient knows to avoid these foods permanently.
Alcohol may initially alleviate restlessness and cause sedation, but after approximately one hour, this effect wanes and a rebound sympathetic drive may worsen leg restlessness and sleep disturbance. Decrease alcohol, which may also trigger or increase the span or intensity of symptoms of restless legs syndrome for most individuals.
All flavors of ice cream may trigger or cause worsening of restless legs syndrome symptoms. For example, chocolate ice cream contains caffeine. In addition, some brands of ice cream may contain gluten. Ben & Jerry’s ice cream is one of the few brands that are gluten-free. Patients with restless legs syndrome may want to decrease consumption of ice cream.
Information or materials posted on this blog are intended for general informational purposes only, and should not be construed as medical advice, medical opinion, diagnosis or treatment. Any information posted on this blog is not a substitute for patient specific medical information or dietary advice. Please consult with your healthcare team or dietitian for a more complete dietary plan and recommendations.
Restless Legs Syndrome (RLS) Treatment
Drugs Approved to Treat RLS
- Horizant® (gabapentin enacarbil) was approved by the FDA in 2011 for the treatment of moderate-to-severe primary RLS.
- Mirapex® was approved by the FDA in 2006 for the treatment of moderate-to-severe primary RLS.
- Requip® (ropinirole hydrochloride), a drug commonly used to treat Parkinson disease, was given FDA approval at lower doses for the treatment of moderate-to-severe primary RLS in 2005.
All three drugs may cause side effects, such as sedation, nausea and dizziness and may cause patients to fall asleep without any warning, even while doing normal daily activities such as driving.
In addition to Horizant®, Requip®, and Mirapex®, there are several drugs approved for other conditions that have been shown to alleviate RLS symptoms. They are:
- Dopaminergic agonists — reduce RLS symptoms
- Dopaminergic agents — reduce RLS symptoms
- Benzodiazepines — allow for a more restful sleep
- Opiates — induce relaxation and diminish pain
Side Effects of RLS Drugs
Side effects of RLS drug therapy may include daytime sleepiness (dopaminergic agonists and benzodiazepines), hallucinations and nausea (dopaminergic agents) or constipation and dependency (opiates). Before taking any medication, discuss the possibility of side effects with your doctor.
In 1996, Drs. Allen and Earley from Johns Hopkins University described a phenomenon called augmentation, in which RLS symptoms are more severe, spread to parts of the body other than the legs, and begin earlier in the evening as a result of taking dopaminergic agents to treat RLS symptoms. If augmentation occurs it can be managed with dose and medication adjustments.
Home Treatment of RLS
There are also a number of self-directed activities for managing the symptoms of RLS including walking, massaging the legs, stretching, hot or cold packs, vibration, and acupressure. Practicing relaxation techniques such as meditation or yoga have been known to alleviate symptoms. For many people, treating an underlying cause or effective pharmacological treatment of primary RLS and implementation of coping strategies provides relief from most symptoms. However, sometimes medications need to be changed over time or doses adjusted and regular consultation with a physician is recommended.
Restless Leg Syndrome (RLS)
0 shares 2 min
What is restless leg syndrome?
Restless leg syndrome (RLS) is a condition in which a person feels an irresistible compulsion to move, and involves uncomfortable sensations in the arms and legs while he or she is sitting still or lying down. This discomfort often occurs when the person is trying to sleep and is usually relieved by moving the legs. Often, the discomfort is characterized as an “urge” to move the legs.
What are the symptoms?
The main symptom of RLS is unpleasant sensations in the legs, which have been described as creeping, crawling, burning, or tingling feelings. These sensations typically get worse when the person is sitting or lying down, particularly at bedtime. They can prevent or interrupt sleep, leading to insomnia. Symptoms usually improve when the person stands up or moves his or her legs. Most people with RLS also have a condition called periodic limb disorder, which causes their arms and legs to involuntarily twitch or kick during sleep.
What are the causes?
There is no known cause for RLS, although some researchers believe it may involve an imbalance in brain chemicals.
Who is likely to develop restless leg syndrome?
Certain factors appear to increase the risk of developing RLS, such as:
- Heredity (RLS appears to run in families)
- Age (RLS occurs more often in middle-aged and older adults)
- Discontinuing sedatives (particularly benzodiazepines such as Valium)
- Using stimulants (including caffeine)
- Other conditions, including peripheral neuropathy, iron deficiency, liver disorders, and kidney failure
How is restless leg syndrome diagnosed?
There is no specific test for RLS. Physicians generally diagnose the condition based on the person’s symptoms and medical history.
What is the conventional treatment for restless leg syndrome?
Treating underlying conditions, such as iron deficiency, may help clear up RLS in some people. Otherwise, conventional physicians may first recommend lifestyle approaches for RLS. These include:
- Warm baths and massages
- Hot and cold packs
- Stress management
- Avoiding caffeine
- Moderate, regular exercise
In some cases, conventional physicians may prescribe medication to help ease RLS, such as:
- Muscle relaxants and sleep medications (Klonopin, Lunesta, Ambien)
- Drugs used to treat Parkinson’s disease (Mirapex, Requip)
- Opioids (Percocet, Vicodin)
- Drugs used to treat epilepsy (Neurotin)
All of these medications can have side effects. Opioids, muscle relaxants and sleep medications can be addicting.
What therapies does Dr. Weil recommend for restless leg syndrome?
As with many conditions that have nonspecific, non-measurable, and variable symptoms, some clinicians have expressed doubt that RLS is a true, clinical syndrome. They point out that restlessness of the legs can have a variety of simple physical and psychological contributors, and pharmaceutical manufacturers have irresponsibly promoted the idea that any sensations of restlessness in the legs usually indicate a disease state.
Dr. Weil sees some merit in this skepticism, and emphasizes that the drugs listed above – many of which have serious side effects – should be employed only as a last resort. In the meantime, these measures may bring relief:
- If you smoke, stop. Smoking may impair blood flow to leg muscles.
- Avoid caffeine and alcohol, both of which can make symptoms worse.
- Take a calcium/magnesium supplement at bedtime. Try 500 mg of calcium citrate and 250 to 500 mg of magnesium to calm nerves and muscles.
- Exercise, stretch or massage your legs (this can help when symptoms are mild).
- Take a hot bath to relax your legs.
- Consider mind body therapies, such as clinical hypnosis and guided imagery, which can help address underlying anxiety.