Restless Leg Syndrome (RLS): When You Can’t Sleep Because You’re Not Able To Lay Still

Approximately 5% of American adults have a mild form of RLS, a seriously sleep-disrupting condition

Approximately one in 10 people in the United States are affected by restless legs syndrome (RLS). While not life threatening, the uncontrollable urge to move your legs throughout the night can cause serious disruption to sleep, which can affect overall health in the short and long term.

RLS affects twice as many women as men and can also be found in one million children of school age. Despite its prevalence – about 5% of adults will have a mild form and five million will have moderate to severe cases of RLS. It’s a condition that’s not well understood, but researchers are learning more about it every year and finding more effective strategies to addressing it.

Dr. Kristine Tatosyan-Jones, a family medicine physician and a faculty physician at Vanderbilt University has been treating RLS for more than 8 years. “Restless legs syndrome (RLS) is a condition that causes an uncontrollable urge to move your legs, usually because of an uncomfortable sensation,” she explains. “It typically happens in the evening or nighttime hours when you’re sitting or lying down. Moving helps to ease the unpleasant feeling, but just temporarily. RLS, now known as restless legs syndrome/Willis-Ekbom disease (RLS/WED), can begin at any age. It can disrupt sleep, which interferes with daily activities.”

The causes of RLS remain allusive, but there are some clues. “Researchers suspect that the condition may be caused by an imbalance of brain chemical dopamine, which sends messages to control muscle movement, Dr. Tatosyan-Jones explains. “Genetics plays a strong role since patients often have strong family history of RLS.”

Studies have shown that pregnancy, alcohol use and smoking may worsen signs and symptoms of RLS. Third trimester is usually is most affected and symptoms resolve after delivery. Other conditions strongly associated with RLS are peripheral neuropathy, iron deficiency, kidney failure and certain spinal cord conditions. There are several medications that may worsen symptoms of RLS, including certain antidepressants and antihistamines.

RLS treatment options

Current treatment options for RLS is targeted at easing symptoms. In people with mild to moderate restless legs syndrome, Dr. Tatosyan-Jones says that lifestyle changes, such as beginning a regular exercise program, establishing regular sleep patterns and eliminating or decreasing the use of caffeine and alcohol, are useful measures.

There are several medications that are FDA approved for moderate to severe RLS. These include dopaminergic drugs, benzodiazepines, narcotic pain relievers and anticonvulsants. Dopaminergic drugs act on the neurotransmitter dopamine in the brain. These include Mirapex, Neupro and Requip. Benzodizepines are a class of sedative medications that may be used to help with sleep and improve RLS symptoms. Narcotic pain relievers may be used for patients with RLS who suffer with severe pain. Anticonvulsants are antiseizure medications that are also FDA approved. These include Tegretol, Lyrica and Neurontin.

As Ellen Wermter, nurse practitioner and a sleep profession certified in cognitive behavioral therapy for insomnia at the Charlottesville Neurology and Sleep Medicine in Virginia, notes symptoms tend to increase with age. Addressing the problem becomes more pressing later in life as symptoms worsen. It’s important to alleviate triggers, which may include irregular sleep schedules, travel, stress/anxiety, alcohol, smoking, caffeine, some medications (antihistamines, antidepressants, etc.), untreated sleep disorders, and being sleep deprived in general.

Low ferritin levels (a measure of iron stores) can also contribute to symptoms and a blood test can help determine treatment parameters, if that is the case. “Sometimes an iron infusion can be immensely helpful,” she says. “Patients may also want to try natural treatments include daily moderate exercise and treating the symptoms with warm baths or a weighted blanket.” And here’s the good news: Sometimes having sex can help as well since it provides a natural dopamine boost.

In 2013, the FDA approved the first non-medication called Relaxis to treat primary RLS symptoms. The vibrating pad goes under legs to provide counter-stimulation. During an RLS episode, the vibrations interrupt the unpleasant sensations that cause an overwhelming desire to move legs. It can be plugged in next to your bed or used with batteries.

The role of magnesium in RLS

Magnesium deficiency is associated with RLS, say Dr. Carolyn Dean, a member of the medical board for the Nutritional Magnesium Association. ADHD is also associated with the condition as they are linked to dopamine dysfunction. “Dopamine is a magnesium dependent neurotransmitter,” she says. “Magnesium is also an excellent treatment for ADHD.”

She recommends to her clients that they try to treat RLS with magnesium while they also balance their other mineral stores. “It is important to note that not all forms of magnesium are easily absorbed by the body,” she notes. “Magnesium citrate powder is highly absorbed and mixed with water is easy to take.”

Prepare a water bottle with a teaspoon or two of magnesium citrate powder and sip this throughout the day, while traveling and/or have it available at your bedside. In this form, it’s fast acting and highly absorbable. It will help you get restful, rejuvenating sleep and lower stress levels.

Rest well & wake up ready to go!

Better sleep gives rise to better mornings, bringing your goals into focus and dreams within reach. Hungry for more sleep info? Dig into these posts:

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