Restless Legs Syndrome
Sitting perfectly still for long periods of time isn’t easy for anyone and it isn’t necessarily good for us, but people suffering from Restless Legs Syndrome feel an irresistible urge to move or shake their legs, especially at night in bed. The whole limb just begs to be moved – shaken or suffer incredible discomfort.
Restless Legs Syndrome (RLS), or Willis-Ekbom disease, was once considered a mild health condition with no clear cause. While it’s not usually much of a health threat, the constant stress, discomfort, and disrupted sleep can become a serious problem over time.
Restless Legs Syndrome usually presents as an irresistible urge to move one’s legs. There is seemingly no pain involved, but many people report feeling significant discomfort including symptoms such as throbbing, aching, and a creeping sensation in the legs that are just begging to be moved.
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RLS can affect one or both legs—the whole leg, or just the calves, feet, or thighs. The feeling cannot always be put into words, but it’s there.
RLS is not just a quirk or a fidgety habit, nor is it a muscle spasm. The urge to move is involuntary, but it’s not completely outside the sufferer’s control. The syndrome can become more serious with time because controlling the urge causes strong discomfort and feels almost impossible. RLS is now considered to be neurological in nature.
RLS can be especially bothersome at night when other ambient stimuli quiet down and the body is left with its own sensations. It is also quite common during pregnancy.
What causes Restless Legs Syndrome?
The mechanics of RLS are highly elusive, so it is difficult to pinpoint the exact cause of this syndrome. We have been aware of this condition for a long time—it was first described in the late 17th century. Unfortunately, this doesn’t mean it’s always easy to get a diagnosis, because both the symptoms and the underlying causes can be very vague.
Modern scientific studies agree that most people who experience RLS probably have a genetic predisposition to the condition. Neurological processes in the brain are what lie behind that feeling of restlessness. To regulate and move our muscles we depend on the brain’s communication network where neurotransmitters receive sensory information from the muscles and send signals to contract, relax, and move them. In individuals with RLS there is a glitch in the network that manifests as an urge to move the legs, especially during longer periods of sitting, lying, or rest in general.
One neurotransmitter thought to be responsible for RLS, is dopamine. It is well-known for its role in mood regulation and pleasure, but it also influences muscle control. Low levels of dopamine have been linked to RLS, and pregnancy, certain medications, and disorders such as Parkinson’s disease can disrupt dopamine levels, potentially triggering RLS.
Another important element in in the equation may be the micronutrient iron. Iron is essential for brain functioning and other physiological processes. Iron deficiency—and the closely related anaemia—can contribute to the symptoms of RLS.
Environmental factors and chemical triggers can also stir up that restless feeling, especially just before sleep and during the night. These factors include:
- stress
- alcohol
- caffeine
- lack of exercise
- poor sleep hygiene
It is important to note that RLS is not simply a direct response to stress, it has complex trigger mechanisms and is mostly related to genetic factors. Stress can aggravate or trigger the condition, but it is not the sole cause.
What helps restless legs go away?
Managing and alleviating restless legs often involves a combination of lifestyle changes, self-care strategies, and, in some cases, medical interventions. While there’s no one-size-fits-all solution, here are some of the techniques that can help with restless legs:
Lifestyle modifications. To calm the twitching in your muscles, prioritize an overall healthy lifestyle with regular exercise, a healthy diet, and good hydration. Gentle, regular exercise, such as walking, swimming, or yoga, is key to improving circulation throughout your body, to promoting healthy organs and muscles, and to supporting brain function.
Stress management is an important part of a healthy lifestyle because stress can negatively influence all spheres of life and health. The relentless pace of modern life often encourages us to neglect self-care. Life is not a smooth ride for anyone. If you are in a stressful situation at work, at school, or at home, create some space to talk it out with a friend or a therapist, or just to step away, so you can recharge. Stress-reduction techniques such as deep breathing, meditation, or mindfulness are a few of the methods people use to manage their RLS.
Given that RLS is especially problematic at night, a good sleep hygiene is key in achieving the rest that your body deserves, despite any unpleasant sensations in your legs you might be experiencing. Establish a consistent sleep schedule and create a comfortable sleep environment to fight the effects of RLS. Relaxation techniques such as meditation, deep breathing, warm baths, and massage or self-massage can be a beneficial addition to your nighttime routine.
Identify and avoid triggers that exacerbate restless leg symptoms for you, such as caffeine, alcohol, or certain medications.
If lifestyle changes aren’t doing enough, make an appointment with your healthcare provider. They may recommend medications that target dopamine levels or address specific underlying causes. RLS can sometimes be treated or managed with muscle relaxants or even opioids, or with prescription medications used to treat neurological conditions or sleep disorders. However, many RLS sufferers report that although their medications seem to work initially, they can lose their effectiveness over time.
If restless legs are a symptom of a known underlying condition, such as pregnancy, kidney disease, or neuropathy, treating the primary condition often helps alleviate the RLS.
If your RLS is persistent, severe, or significantly affects your daily life—seek guidance. A healthcare provider can help identify the potential causes and recommend appropriate treatment options.
What causes restless legs when pregnant?
Even if you don’t experience RLS in your everyday life, it is a common symptom of pregnancy that usually goes away, either after the first trimester or after giving birth. The exact cause of restless legs during pregnancy is not fully understood, but several big changes take place in the expectant mother’s body that could potentially trigger this condition.
Hormonal changes
Pregnancy is synonymous with hormonal fluctuations and a significant increase in oestrogen and progesterone levels. These changes affect many different systems in your body, including the central nervous system, which plays a role in triggering restless legs.
Iron deficiency
Some studies suggest that iron deficiency, or low iron stores in the body, can contribute to RLS. Iron deficiency is a common problem during pregnancy, as the overall volume of blood in the body increases and more iron is needed for mother and baby.
It is important for pregnant people to monitor their iron levels, especially if they have any of the following risk factors:
- having two or more pregnancies in close succession
- being pregnant with multiples (twins, triplets…)
- experiencing anaemia outside of pregnancy
- having a strong menstrual flow outside of pregnancy
- not eating a nutritious diet that includes iron-rich food
Pay attention to signs of anaemia, such as excessive tiredness and fatigue, dizziness, shortness of breath, pale skin, and—notoriously—strange cravings for non-foods such as sand, ice, or dirt.
Pressure on the nerves
It is no secret that pregnancy can be physically uncomfortable. As the uterus grows, it puts pressure on the adjacent nerves, often causing discomfort in the pelvis and legs. This can exacerbate or trigger restless legs, as well as sciatica and other conditions.
Sleep disturbances
Similarly, high-quality sleep is not always easy to achieve during pregnancy. There are many reasons for this: the growing baby bump, body aches, heartburn, and frequent visits to the toilet to name a few. If restless legs also come into play, a vicious cycle can arise where restless legs disrupt sleep, and lack of sleep aggravates RLS.
Stress, anxiety, and pregnancy-related conditions such as gestational diabetes or preeclampsia may also contribute to RLS.
What helps restless legs during pregnancy?
Experiencing restless legs during pregnancy can be particularly challenging, as getting a good night’s sleep is crucial for both the expectant mother and the growing baby. Managing RLS during pregnancy can be tricky, but there are some strategies that can help alleviate the discomfort. The suggestions below are generally safe and simple, but if you have any doubts consult you healthcare provider to ensure they are suitable for your situation.
Some ways to alleviate restless legs during pregnancy (and in general) include:
Gentle exercise. Engaging in light, low-impact exercises, such as walking or prenatal yoga, can promote better blood circulation and potentially reduce the symptoms of RLS. Getting yourself up and moving for some portion of the day will help your body naturally feel tired when it’s time to sleep. Similarly, gentle stretching before bedtime can relieve tension and help with relaxation. Focus on the muscles in your legs, calves, and feet, but gently. No need to overdo it.
Relaxation techniques. A warm bath, a massage, or a short meditation can all relieve stress and prepare your body for better sleep. Engaging with the body quiets the restless thoughts in your head and progressive muscle relaxation—systematically tensing and releasing the different muscle groups in the body—can release stress and help you feel more peaceful.
Applying a warm or cold compress to the affected leg/legs may provide temporary relief and help soothe the discomfort. It will not solve the underlying issue, but even short-term relief can be invaluable when precious sleep is concerned.
Elevating your legs can also assist with blood flow and reduce leg discomfort. This is a great tip, even for people who aren’t pregnant. When sleeping, use supportive pillows and maintain good sleep hygiene.
Make sure you are getting enough iron. If your healthcare provider confirms iron deficiency as a cause for restless legs during pregnancy, add recommend iron supplements to your nutrition regimen. In severe cases of RLS, certain medications can help alleviate symptoms, but these should only be used under strict instructions from your doctor.
Avoid triggers that worsen your RLS. These may include caffeine, certain medications, and stressful activities. Identify the most common triggers in your life and avoid them as much as possible. Your health and that of your baby are the highest priority at this time.
Should I stretch my restless legs?
Stretching your legs can be a great way to alleviate discomfort and temporarily relieve the symptoms of RLS, but not always and not for everyone. As the condition is neurological in nature, focussing too much attention on the affected muscles and overworking them sometimes has the opposite effect. Approach stretching with caution and monitor your body’s responses.
Be sure to use gentle mobility stretches, starting with your calves or even your toes, and include hip openers in your stretching routine to relieve tension in the whole leg and pelvis.
Stretching can be more effective when combined with other methods to manage restless legs, such as warm baths, gentle massage, applying hot or cold packs, and doing some yoga, which helps reduce stress in general. Of course, walking and regularly engaging in moderate physical activity are important in promoting good circulation and optimizing your health.
How should you sleep with restless legs?
Sleeping can be one of the most challenging aspects of living with RLS, but there are some strategies that may improve your comfort and quality of sleep. Many of the steps overlap with maintaining a healthy sleep hygiene in general, as well as in the case of various sleep disorders. In fact, it might be beneficial to view RLS as something of a sleep disorder on its own and tackle it accordingly:
Create a comfortable, reliable sleep environment and practice good sleep hygiene. To promote relaxation, ensure your sleep environment is cool, dark, and quiet. Remove any distractions and make sure your bedding is fresh and clean. Use comfortable pillows and a supportive mattress to minimize pressure on your legs. The alignment of your spine and legs is important.
We are often told that back sleeping is best because your weight is more evenly distributed, but if you are already bothered by RLS, it can be difficult to force a sleeping position. Most people are side sleepers. If sleeping on your side feels more natural, try placing a pillow between your knees to help align your spine and legs.
Sleep is so important that the brain and body will adapt to whatever situation you create, but there are certain rules of thumb that help us sleep better. Wake up around the same time every morning, so your body knows what to expect, and go to sleep around the same time every night. Eat meals at regular times and be sure that you have some protein with your last meal, so you don’t sugar crash in the middle of the night and wake up hungry. Turn off your screens about two hours before bedtime because the blue light that emanates from our devices keeps us awake. Engage in regular, gentle exercise during the day so you feel a little tired when night comes. Even if you are sleeping the required number of hours, you may not be getting enough deep sleep. There are now many different sleep tracking devices that can help you understand your sleep cycles better. There may even be one on your phone right now.
Practice relaxation techniques for a few minutes before bedtime. Techniques such as deep breathing, meditation, or progressive muscle relaxation to help calm your body and mind. Taking a warm bath before bedtime can help relax your muscles and get you in the mood for sleep. Applying warm or cold packs to your legs may provide temporary relief and soothe discomfort.
Consider using a sleep aid. In some cases, short-term use of natural remedies or over-the-counter sleep aids may help improve sleep quality. Always consult your healthcare provider before using sleep aids, especially during pregnancy or if you have a medical condition. The first-generation antihistamine diphenhydramine is known for it’s soporific effects and is commonly added to over-the-counter medications to encourage sleep, however recent studies have shown that long-term use can be very detrimental to brain health. Creating a bedtime ritual that includes a cup of warm chamomile tea, can serve as a sleep trigger. There are many different herbal tea mixtures available that promote relaxation.
Is Magnesium good for restless legs?
Yes, magnesium is another mineral that can potentially help manage RLS in some individuals. Magnesium plays a crucial role in many bodily functions, including muscle and nerve function. Some research suggests that magnesium deficiency might be linked to the development of restless legs or the exacerbation of its symptoms.
Magnesium is known for its muscle relaxant properties. Adequate magnesium levels can help reduce muscle tension and discomfort, which can alleviate some of the sensations associated with RLS. Magnesium is also associated with improved sleep quality, better brain function, and a reduced risk of heart disease, all of which can also help with RLS.
Consider incorporating magnesium-rich foods such as leafy green vegetables, nuts, seeds, whole grains, and legumes, into your diet. Before starting a new supplement regimen—especially during pregnancy or if you have underlying health conditions—talk to your healthcare provider for advice on which supplements are most appropriate for your specific situation.
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