Benadryl restless legs. 11 Effective Treatments for Restless Legs Syndrome: Expert Guide

17.09.202330.06.2023 by alexxlab

What are the best treatments for Restless Legs Syndrome. How can you manage RLS symptoms effectively. What lifestyle changes can help alleviate RLS discomfort. Which medications are recommended for RLS relief. How does iron deficiency relate to Restless Legs Syndrome. Can exercise and stretching help with RLS symptoms. What role does proper sleep hygiene play in managing Restless Legs Syndrome.

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Understanding Restless Legs Syndrome: Causes and Symptoms

Restless Legs Syndrome (RLS), also known as Willis-Ekbom disease, is a neurological disorder characterized by uncomfortable sensations in the legs and an irresistible urge to move them. These sensations are often described as tingling, crawling, or creeping feelings that typically occur during periods of rest or inactivity, particularly at night.

RLS can be classified into two types:

Primary RLS: No known cause
Secondary RLS: Associated with conditions such as nerve problems, pregnancy, iron deficiency, or chronic kidney failure

The severity of RLS symptoms can vary from mild to severe, with moderate to severe cases significantly impacting an individual’s quality of life. Persistent sleep disruption due to RLS can lead to daytime fatigue, difficulty concentrating, and even anxiety and depression.

Common Symptoms of Restless Legs Syndrome

Uncomfortable sensations in the legs
Strong urge to move the affected limbs
Symptoms worsen during rest or inactivity
Relief obtained through movement
Symptoms typically occur in the evening or at night
Sleep disturbances

Identifying and Addressing RLS Triggers

The first step in managing Restless Legs Syndrome is to identify potential triggers that may be exacerbating your symptoms. By addressing these factors, you may be able to alleviate some of the discomfort associated with RLS.

Daily Habits and Lifestyle Factors

Certain lifestyle choices can significantly impact RLS symptoms. Are you consuming substances that might be aggravating your condition? Consider reducing or eliminating the following:

Caffeine
Alcohol
Tobacco

Many individuals with RLS have reported improvement in their symptoms after cutting back on these substances.

Medications That May Worsen RLS

Some medications can trigger or exacerbate RLS symptoms. It’s crucial to review your current medications with your healthcare provider. Medications that may potentially worsen RLS include:

Older antihistamines (e.g., diphenhydramine/Benadryl)
Antinausea drugs (e.g., metoclopramide/Reglan, prochlorperazine/Compro)
Antipsychotic drugs (e.g., haloperidol/Haldol, olanzapine/Zyprexa)
Lithium (Lithobid)
Selective serotonin reuptake inhibitors (SSRIs)
Tricyclic antidepressants
Tramadol (Ultram)
Levothyroxine (Levoxyl)

If you’re taking any of these medications and experiencing RLS symptoms, consult your doctor about potential alternatives or adjustments to your treatment plan.

Health Conditions Associated with RLS

Certain medical conditions have been linked to an increased risk of developing RLS. These include:

End-stage renal disease (ESRD)
Nerve damage from diabetes
Iron deficiency anemia

If you have any of these conditions, discuss with your healthcare provider how they might be impacting your RLS symptoms and explore potential treatment options.

Optimizing Sleep Hygiene for RLS Management

While improving sleep habits may not completely resolve RLS symptoms, it can help offset the sleep loss often associated with the condition. Implementing good sleep hygiene practices can contribute to more restful and restorative sleep.

Tips for Better Sleep with RLS

Maintain a consistent sleep schedule by going to bed and waking up at the same times each day
Create a sleep-conducive environment that is cool, quiet, and dark
Minimize distractions in the bedroom, such as TVs and phones
Avoid electronic screens for 2-3 hours before bedtime to prevent disruption of your circadian rhythm
Engage in relaxation techniques before bed, such as deep breathing or meditation
Consider using blackout curtains or a white noise machine to improve sleep quality

By implementing these sleep hygiene practices, you may be able to improve your overall sleep quality and better manage the impact of RLS on your daily life.

The Role of Exercise and Stretching in RLS Relief

Regular physical activity and targeted stretching exercises can play a significant role in managing Restless Legs Syndrome symptoms. How does exercise help with RLS? Physical activity can improve circulation, reduce stress, and promote better sleep quality, all of which may contribute to symptom relief.

Beneficial Exercises for RLS

Walking
Swimming
Cycling
Yoga
Pilates

Aim for at least 30 minutes of moderate exercise most days of the week. However, it’s important to note that intense exercise close to bedtime may exacerbate symptoms in some individuals, so find a time that works best for you.

Stretching Techniques for RLS Relief

Targeted stretching exercises can help alleviate muscle tension and reduce RLS discomfort. Consider incorporating the following stretches into your daily routine:

Calf stretches
Hamstring stretches
Hip flexor stretches
Quadriceps stretches
Gentle yoga poses, such as standing forward bend or legs-up-the-wall pose

Perform these stretches for 30 seconds to 1 minute each, repeating 2-3 times per session. Remember to stretch gently and avoid bouncing or forcing the stretch, as this can lead to injury.

Dietary Considerations and Nutritional Supplements for RLS

While there is no specific diet proven to cure Restless Legs Syndrome, certain dietary changes and nutritional supplements may help alleviate symptoms in some individuals. What role does nutrition play in managing RLS?

Iron Supplementation

Iron deficiency has been strongly linked to RLS, and many individuals with RLS have found relief through iron supplementation. However, it’s crucial to consult with your healthcare provider before starting any supplementation regimen. Your doctor may recommend iron supplements if your ferritin levels (a measure of iron stores) are low.

Other Potentially Beneficial Supplements

Magnesium
Vitamin D
Vitamin B12
Folate

While research on these supplements for RLS is limited, some individuals have reported improvement in their symptoms. Always consult with a healthcare professional before adding new supplements to your routine.

Dietary Considerations

Some dietary changes that may help manage RLS symptoms include:

Reducing or eliminating caffeine intake
Limiting alcohol consumption
Avoiding large meals close to bedtime
Increasing intake of iron-rich foods (if iron deficiency is a factor)
Staying hydrated throughout the day

Keep in mind that dietary triggers can vary from person to person, so it may be helpful to keep a food diary to identify any potential correlations between your diet and RLS symptoms.

Medications and Medical Treatments for Restless Legs Syndrome

When lifestyle modifications and non-pharmacological approaches are insufficient, medications may be prescribed to manage Restless Legs Syndrome symptoms. What are the most commonly prescribed medications for RLS?

Dopaminergic Agents

These medications increase dopamine levels in the brain and are often the first line of treatment for moderate to severe RLS. Examples include:

Ropinirole (Requip)
Pramipexole (Mirapex)
Rotigotine (Neupro patch)

While effective, long-term use of dopaminergic agents may lead to augmentation, where symptoms worsen or occur earlier in the day.

Gabapentin and Similar Medications

These drugs, originally developed to treat seizures and nerve pain, have shown effectiveness in managing RLS symptoms:

Gabapentin (Neurontin)
Gabapentin enacarbil (Horizant)
Pregabalin (Lyrica)

Benzodiazepines

These medications may be prescribed for severe cases of RLS, particularly when sleep disturbances are significant:

Clonazepam (Klonopin)
Temazepam (Restoril)

Benzodiazepines are typically used with caution due to their potential for dependence and side effects.

Opioids

In some cases, low doses of opioids may be prescribed for severe RLS that doesn’t respond to other treatments. Examples include:

Codeine
Oxycodone
Methadone

Due to the risk of dependence and side effects, opioids are generally reserved for cases where other treatments have failed.

Alternative and Complementary Therapies for RLS

In addition to conventional treatments, some individuals with Restless Legs Syndrome find relief through alternative and complementary therapies. While scientific evidence for these approaches may be limited, they may provide additional options for symptom management.

Acupuncture

Some studies suggest that acupuncture may help reduce RLS symptoms. How does acupuncture potentially benefit individuals with RLS? It’s believed to work by stimulating the release of endorphins and improving circulation.

Massage Therapy

Regular massage, particularly of the legs, may help alleviate muscle tension and improve circulation, potentially reducing RLS symptoms.

Relaxation Techniques

Meditation
Progressive muscle relaxation
Deep breathing exercises
Biofeedback

These techniques can help reduce stress and promote relaxation, which may indirectly improve RLS symptoms.

Hot and Cold Therapy

Alternating hot and cold treatments on the legs may provide temporary relief for some individuals with RLS. This can be done using heating pads, ice packs, or by taking alternating hot and cold showers.

Aromatherapy

Some people find that certain essential oils, such as lavender or chamomile, help promote relaxation and may ease RLS symptoms when used in a diffuser or added to a warm bath.

While these alternative therapies may provide relief for some individuals, it’s important to discuss any new treatment approaches with your healthcare provider, especially if you’re currently taking medications for RLS.

Coping Strategies and Lifestyle Adjustments for Living with RLS

Living with Restless Legs Syndrome can be challenging, but there are various coping strategies and lifestyle adjustments that can help manage symptoms and improve quality of life. How can individuals with RLS better navigate daily life and minimize the impact of their symptoms?

Develop a Consistent Routine

Maintaining a regular sleep-wake schedule can help regulate your body’s circadian rhythm and potentially reduce RLS symptoms. Try to go to bed and wake up at the same time every day, even on weekends.

Create a Relaxing Bedtime Ritual

Establish a calming pre-sleep routine to help your body and mind wind down before bed. This might include:

Taking a warm bath
Reading a book
Practicing gentle yoga or stretching
Listening to soothing music
Using relaxation apps or guided meditations

Optimize Your Sleep Environment

Create a sleep-conducive bedroom by:

Keeping the room cool and well-ventilated
Using comfortable, breathable bedding
Investing in a supportive mattress and pillows
Using blackout curtains or an eye mask to block out light
Considering a white noise machine to mask disruptive sounds

Stay Active During the Day

Regular physical activity can help manage RLS symptoms, but timing is important. Engage in moderate exercise earlier in the day, avoiding intense workouts close to bedtime.

Manage Stress

Stress can exacerbate RLS symptoms, so finding effective stress management techniques is crucial. Consider:

Practicing mindfulness or meditation
Engaging in hobbies or activities you enjoy
Seeking support from friends, family, or a therapist
Trying stress-reduction techniques like deep breathing or progressive muscle relaxation

Plan for Long Periods of Inactivity

If you know you’ll be sitting for extended periods, such as during long flights or car rides, plan ahead:

Request an aisle seat for easier movement
Take regular breaks to stand up and stretch
Bring a small massager or acupressure tool for quick relief
Consider compression socks to improve circulation

Join a Support Group

Connecting with others who have RLS can provide emotional support, practical tips, and a sense of community. Look for local or online support groups dedicated to RLS or sleep disorders.

Educate Your Loved Ones

Help your family and friends understand RLS and its impact on your life. Their support and understanding can make a significant difference in managing the condition.

By implementing these coping strategies and making appropriate lifestyle adjustments, individuals with Restless Legs Syndrome can better manage their symptoms and improve their overall quality of life. Remember that what works best may vary from person to person, so be patient as you find the right combination of strategies for your unique situation.

The 11 Best Treatments for Restless Legs Syndrome

Treatments for restless leg syndrome can depend on the cause but may include iron supplements, medications, and certain habits, including adopting a healthy sleep routine.

Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a condition that causes uncomfortable sensations, most often in the legs. These sensations have been described as tingly, crawling, creeping feelings, and cause the overwhelming urge to move the affected limb.

RLS symptoms typically occur when the person is sitting, resting, or sleeping, and often happen at night. The movements caused by RLS are called periodic limb movements of sleep (PLMS). Because of these movements, RLS can cause serious sleep problems.

Some people have primary RLS, which has no known cause. Others have secondary RLS, which is typically associated with nerve problems, pregnancy, iron deficiency, or chronic kidney failure.

For most people with RLS, symptoms are mild. But if your symptoms are moderate to severe, RLS can have a big impact on your life. It can prevent you from sleeping enough, and thus cause problems with daytime focus and thinking, your job, and your social activities.

As a result of these problems, RLS can lead to anxiety and depression. And the longer you have the condition, the worse it can get. It can even spread to other parts of your body, such as your arms (1).

Because of the effects RLS can have on your life, treatment is important. Methods of treatment are varied, as the root cause of RLS isn’t truly known. For instance, some researchers suggest that RLS is caused by problems with the brain chemical dopamine, while others suggest that it’s related to poor circulation.

Here we list the best treatments for RLS. Some of these you can try on your own. Others you can discuss with your doctor, who can help you create a treatment plan to help relieve your RLS symptoms.

Your first step in addressing RLS should be to figure out if something is causing it. While RLS can be related to things that are largely out of your control, such as genetics or pregnancy, other possible factors can be addressed.

These factors could be daily habits, medications you’re taking, health conditions you have, or other triggers.

Habits

The use of caffeine, alcohol, and tobacco can aggravate RLs symptoms. Limiting these substances could help reduce your RLS symptoms (2).

Medications

Certain medications can cause or worsen RLS symptoms. Examples include: (1, 2, 3).

older antihistamines such as diphenhydramine (Benadryl)
antinausea drugs such as metoclopramide (Reglan) or prochlorperazine (Compro)
antipsychotic drugs such as haloperidol (Haldol) or olanzapine (Zyprexa)
lithium (Lithobid)
selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), sertraline (Zoloft), or escitalopram (Lexapro)
tricyclic antidepressants such as amitriptyline (Elavil) or amoxapine (Asendin)
tramadol (Ultram)
levothyroxine (Levoxyl)

Make sure your doctor knows about all drugs you’re taking, both prescription and over the counter. Talk to your doctor about whether they could be making your RLS worse, especially if you’re taking any of the medications listed above.

Health conditions

Certain health conditions have been found to be related to RLS. End-stage renal (kidney) disease, or ESRD, and nerve damage from diabetes have been linked with RLS. Iron deficiency anemia also has a strong connection with RLS (see iron below) (4, 5, 6).

You should discuss with your doctor how your health history might impact your RLS, especially if you have any of these conditions.

Other triggers

Some people claim that eating lots of sugar or wearing tight clothing aggravates their RLS symptoms. While there’s not a lot of research to back up these connections, you might want to use some trial and error to see what seems to affect your own symptoms.

BOTTOM LINE
The first step in treating RLS should be figuring out if something is causing it. You should consider habits such drinking alcohol or smoking, certain medications or health conditions, and other triggers for their impact on your RLS symptoms.

Having good sleep habits is advisable for anyone, but perhaps especially for people who have trouble sleeping, such as those with RLS.

While sleeping better may not resolve your RLS symptoms, it could help you offset the sleep loss you suffer from your condition. Try the following tips to make your sleep as restful and restorative as possible.

Go to sleep and wake up at the same times each day.
Keep your sleep area cool, quiet, and dark.
Keep distractions, such as the TV and phone, to a minimum in your bedroom.
Avoid electronic screens for the two to three hours before you go to sleep. Blue light from these screens can throw off your circadian rhythm, which helps you keep a natural sleep cycle (7).

BOTTOM LINE
While they may not resolve your RLS symptoms, healthy sleep habits can improve your sleep and may help offset some of the effects of RLS.

Iron deficiency is thought to be one of the main causes of RLS. Several studies have shown that iron supplements can help ease RLS symptoms (1, 3).

A simple blood test can check for iron deficiency, so if you think this could be a problem for you, talk to your doctor.

If you test positive for iron deficiency, your doctor may recommend oral iron supplements, which you can find at your local pharmacy. In some cases, intravenous (IV) iron might be needed (1, 8).

In addition, vitamin D deficiency could be linked with RLS. A 2014 study found that vitamin D supplements reduced RLS symptoms in people with RLS and vitamin D deficiency (9).

And for people on hemodialysis, vitamins C and E supplements may help relieve RLS symptoms (4, 10).

BOTTOM LINE
Supplementation with iron or vitamins D, C, or E can help certain people with RLS. Your doctor can tell you if trying supplements would be a good idea for you.

Exercise can help you feel better if you have RLS.

The National Institutes of Health states that moderate exercise may help ease mild RLS symptoms (3).

And a 2006 study of 23 people with RLS found that aerobic exercise and lower body resistance training, done three times per week for 12 weeks, significantly decreased RLS symptoms (11).

Other studies have also found exercise very effective for RLS, especially in people with ESRD (4, 12).

Given these studies, plus others showing that activity can help improve sleep, exercise seems a natural fit for people with RLS (13).

One recommendation from the Restless Legs Foundation — exercise in moderation. Don’t work out to the point of aches and pains, as this could make your RLS symptoms worse (14).

BOTTOM LINE
Given its benefits for reducing RLS symptoms and improving sleep, regular exercise is a good habit to develop for people with RLS.

Like other types of exercise, yoga and stretching exercises have been shown to have benefits for people with RLS (12).

A 2013 eight-week study of 10 women found that yoga helped reduce their RLS symptoms. It also helped improve their mood and reduce their stress levels, which could in turn improve their sleep. And a 2012 study showed that yoga improved sleep in 20 women with RLS (15, 16).

Another study showed that stretching exercises made significant improvements in the RLS symptoms of people on hemodialysis (17).

It’s not entirely clear to researchers why yoga and stretching works, and more research would be beneficial. But given these results, you might want to add some calf and upper leg stretches to your daily exercise routine.

BOTTOM LINE
Although it’s not clear why, yoga and other stretching exercises could help relieve RLS symptoms.

Massaging your leg muscles could help ease your RLS symptoms. Many health organizations, such as the National Institutes of Health suggest it as an at-home treatment (3, 18,).

Although there’s not a lot of other research that backs up massage as an RLS treatment, a 2007 case study illustrated its benefits.

A 35-year-old woman who had 45-minute leg massages twice a week for three weeks had improved RLS symptoms throughout that time period. Her massages included a range of techniques, including Swedish massage and direct pressure to leg muscles (20).

Her RLS symptoms eased after two massage treatments, and didn’t start to return until two weeks after the massage regimen ended (20).

The author of that study suggested that the increased release of dopamine caused by massage could be a reason for the benefits. Also, massage has been shown to improve circulation, so that might be a reason for its effects on RLS (20, 21, 22).

As an added bonus, massage can aid in relaxation, which could help improve your sleep.

BOTTOM LINE
Whatever the reason, leg massage is an easy and relaxing treatment that could help ease your RLS symptoms.

Medication is a key treatment for moderate to severe RLS. Dopaminergic drugs are typically the first medications prescribed. They’re effective in relieving RLS symptoms, but they can cause side effects and other problems (1).

Other types of drugs can also help relieve RLS symptoms without causing these same types of problems.

Dopaminergic drugs

Dopaminergic drugs increase the release of dopamine in your brain. Dopamine is a chemical that helps enable normal body movements (1).

Dopaminergic drugs likely help relieve RLS symptoms because the condition is associated with problems in the body’s production of dopamine.

Three dopaminergic medications have been approved by the U.S. Food and Drug Administration (FDA) to treat moderate to severe primary RLS:

pramipexole (Mirapex) (23)
ropinirole (Requip) (24)
rotigotine (Neupro) (25)

While dopaminergic drugs have been shown to help improve RLS symptoms, long-term use can actually worsen symptoms. This phenomenon is called augmentation. To help delay this problem, doctors typically prescribe the lowest possible dose of these drugs (1, 26).

In addition, these drugs can become less effective over time. To help delay or prevent both of these problems, your doctor may prescribe a combination of dopaminergic drugs with other types of drugs to treat RLS (1).

Gabapentin

A fourth drug that’s been approved by the FDA to treat RLS is called gabapentin (Horizant). This is an antiseizure medication (27).

It’s not entirely understood how gabapentin works to relieve RLS symptoms, but studies show it to be effective (28).

In one study, 24 people with RLS were treated with gabapentin or a placebo for six weeks. Those treated with gabapentin had improved sleep and reduced leg movements from RLS, while those treated with a placebo did not (28).

Another study compared the use of gabapentin with the use of ropinirole (one of the drugs approved by the FDA to treat RLS). Eight people with RLS took each of the drugs for four weeks, and both groups achieved similar levels of relief from RLS symptoms (29).

Benzodiazepines

Benzodiazepines are drugs used to treat anxiety and sleep problems. Clonazepam (Klonopin) and other types of these drugs are often prescribed for people with RLS in combination with other drugs (30).

While these drugs may not relieve RLS symptoms themselves, their benefit of improved sleep can be very helpful for people with RLS (30).

Opioids

Opioids are typically used to treat pain. In some cases, usually when other medications aren’t helpful or cause augmentation, opioids can be used carefully in low doses to help treat RLS (26, 8).

Prolonged-release oxycodone/naloxone (Targinact) is one opioid that could help relieve RLS symptoms and improve sleep (4). However, because of the newer guidelines being developed for the use of opioids, this should be a last resort.

As with all opioids, use of these drugs should be carefully overseen by a doctor, due to their risk of misuse and dependence.

BOTTOM LINE
If you have moderate to severe RLS, your doctor will likely suggest one or more medications. Dopaminergic drugs are typically a primary RLS treatment, but they can cause side effects and augmentation, so their use must be managed carefully.

A foot wrap has been shown to help relieve RLS symptoms.

Called restiffic, the foot wrap puts pressure on certain points on the bottom of your foot. The pressure sends messages to your brain, which responds by telling the muscles affected by RLS to relax. This helps relieve your RLS symptoms (31).

A 2013 study of 30 people using the foot wrap for eight weeks found significant improvements in RLS symptoms and sleep quality (32).

The restiffic foot wrap is available by prescription only, and per the company’s website, it costs about $200. It may or may not be covered by your insurance (31).

BOTTOM LINE
The restiffic foot wrap requires a prescription and an initial monetary investment, but could provide RLS relief by applying pressure on certain points on the bottom of the foot.

If you’ve ever stayed overnight in the hospital, you may have had pneumatic compression. This treatment uses a “sleeve” that goes over your leg and inflates and deflates, gently squeezing and releasing your limb.

In the hospital, a pneumatic compression device (PCD) is typically used to improve circulation and prevent blood clots. Improved circulation might also be the reason pneumatic compression has been shown to help relieve RLS symptoms (33).

Some researchers believe that a cause of RLS is low oxygen levels in the limbs. They think that the body responds to this problem by increasing circulation via the muscle contractions that occur when the person moves their limb (33).

Whatever the reason, some research has shown that pneumatic compression can help relieve RLS symptoms.

A 2009 study of 35 people who used a PCD for at least an hour every day for a month had markedly improved RLS symptoms, sleep quality, and daytime function. However, other research has not shown the same effects (33, 34).

Some PCDs are rented, and others can be purchased over the counter or with a prescription. Insurance coverage for a PCD might be easier to acquire for people who can’t tolerate RLS medication (33, 35).

BOTTOM LINE
A PCD is a non-drug treatment that can be bought over the counter or with a prescription. It could help relieve RLS symptoms by improving circulation in your legs. Results from research on this device have been conflicted.

A vibrating pad called the Relaxis pad may not relieve your RLS symptoms, but it could help you sleep better (4).

You use the vibrating pad while you’re at rest or sleeping. You place the pad on the affected area, such as your leg, and set it to the desired vibration intensity. The pad vibrates for 30 minutes and then shuts itself off (33).

The idea behind the pad is that the vibrations provide “counterstimulation.” That is, they override the uncomfortable sensations caused by RLS so you feel the vibrations instead of your symptoms (33).

There’s not a lot of research available on the Relaxis pad, and it hasn’t been shown to actually relieve RLS symptoms. However, it has been shown to improve sleep (33).

In fact, one study found it to be as effective in improving sleep as the four FDA-approved RLS drugs: ropinirole, pramipexole, gabapentin, and rotigotine (36).

The Relaxis pad is available only by prescription from your doctor. Per the company website, the device is not covered by insurance, and it costs a little over $600 (37).

BOTTOM LINE
The vibrating Relaxis pad requires a prescription and costs over $600. It may not treat actual RLS symptoms, but its counterstimulation effects could help you sleep better.

A noninvasive treatment that’s not yet in wide use for this purpose could help relieve RLS symptoms.

This painless treatment is called near-infrared spectroscopy (NIRS). With NIRS, light beams with long wavelengths are used to penetrate the skin. The light causes blood vessels to dilate, increasing circulation (33).

One theory posits that RLS is caused by low oxygen levels in the affected area. It’s thought that the increased circulation caused by NIRS increases that oxygen level, helping to relieve the RLS symptoms (33).

Several studies have found this treatment effective. One study treated 21 people with RLS with NIRS three times per week for four weeks. Both circulation and RLS symptoms showed significant improvement (38).

Another showed that people treated with twelve 30-minute treatments of NIRS over four weeks also had significantly reduced symptoms of RLS. Symptoms were improved up to four weeks after treatment ended (39).

NIRS devices can be purchased online for several hundred dollars to over $1,000 (33).

BOTTOM LINE
A NIRS device could cost several hundred dollars, but the long-lasting effects of this noninvasive treatment could be worth the investment.

The above treatments have some research to support their use. Other treatments have less evidence, but may still work for some people with RLS.

Hot and cold treatments

While there’s not a lot of research backing up using heat and cold to relieve RLS symptoms, many healthcare organizations recommend it. They include the Restless Legs Syndrome Foundation (40).

These organizations suggest taking a hot or cold bath before going to bed, or applying hot or cold packs to your legs (18).

Some people’s RLS symptoms are aggravated by cold, while others have problems with heat. This could explain the benefits of these hot or cold treatments.

Repetitive transcranial magnetic stimulation (rTMS)

A noninvasive procedure that’s typically used to treat depression could be helpful in relieving RLS symptoms. So far, studies have been limited and more research is needed, but the results are promising (4, 41, 42).

Repetitive transcranial magnetic stimulation (rTMS) sends magnetic impulses to certain areas of the brain.

It’s not entirely clear why rTMS could help relieve RLS symptoms. One theory is that the impulses increase the release of dopamine in the brain. Another suggests that rTMS could help calm the hyperarousal in parts of the brain that are associated with RLS (43).

In one 2015 study, 14 people with RLS were given 14 sessions of rTMS over 18 days. The sessions significantly improved their RLS symptoms and improved their sleep. The results lasted for at least two months after the treatment ended (44).

Transcutaneous electrical nerve stimulation (TENS)

With transcutaneous electrical nerve stimulation (TENS), a device sends small electrical currents to parts of your body to help relieve pain.

There’s not a lot of research on the use of TENS to treat RLS, but it could work.

The idea is that like the Relaxis vibrating pad, it uses counterstimulation. One study showed that regular use of TENS along with a vibration treatment completely relieved one man’s RLS symptoms (33, 45).

Acupuncture

Acupuncture can be helpful in the treatment of many health conditions, and RLS might be one of them.

A 2015 study of 38 people with RLS who were treated with acupuncture for six weeks showed that their abnormal leg activity from RLS was greatly reduced (46).

However, more research is needed to confirm acupuncture as a reliable treatment for RLS.

Surgery for varicose veins

For people with certain circulatory issues, surgery could be the most effective treatment for their RLS (12).

Varicose veins are enlarged blood vessels, often in the legs, that overfill with blood. This increased amount of blood can lead to superficial venous insufficiency (SVI), which means your body can’t properly circulate blood. As a result, the blood pools in your legs.

In a 2008 study, 35 people with SVI and RLS had a procedure called endovenous laser ablation to treat their varicose veins. Of the 35 people, 84 percent of them had their RLS symptoms significantly improved or completely eliminated by the surgery (47).

Again, more research is needed on this surgery as a treatment for RLS.

BOTTOM LINE
If you’re interested in any of these less-researched treatments, ask your doctor about them. Of course, you can try hot and cold treatments on your own, but your doctor can tell you more about the other treatments and whether they might be able to help you.

RLS can cause significant discomfort, sleep issues, and problems with daily functioning, so treatment should be a priority. Your first step should be to try the at-home options on this list. But if they don’t help you, be sure to talk to your doctor.

Your doctor can provide more information about each of these treatments and which one — or ones — might be a good choice for you.

Keep in mind that what works for one person may not work for another, and you may need to try several different drugs or treatments. Keep trying until you find the treatment plan that works for you (48).

Restless legs syndrome – Causes

In many cases, the exact cause of restless legs syndrome is unknown.

When no cause can be found, it’s known as idiopathic or primary restless legs syndrome.

Research has identified specific genes related to restless legs syndrome, and it can run in families. In these cases, symptoms usually occur before the age of 40.

Dopamine

There’s evidence to suggest restless legs syndrome is related to a problem with part of the brain called the basal ganglia.

The basal ganglia uses a chemical (neurotransmitter) called dopamine to help control muscle activity and movement.

Dopamine acts as a messenger between the brain and nervous system to help the brain regulate and co-ordinate movement.

If nerve cells become damaged, the amount of dopamine in the brain is reduced, which causes muscle spasms and involuntary movements.

Dopamine levels naturally fall towards the end of the day, which may explain why the symptoms of restless legs syndrome are often worse in the evening and during the night.

Underlying health condition

Restless legs syndrome can sometimes occur as a complication of another health condition, or it can be the result of another health-related factor.

This is known as secondary restless legs syndrome.

You can develop secondary restless legs syndrome if you:

have iron deficiency anaemia (low levels of iron in the blood can lead to a fall in dopamine, triggering restless legs syndrome)
have a long-term health condition (such as chronic kidney disease, diabetes, Parkinson’s disease, rheumatoid arthritis, an underactive thyroid, or fibromyalgia)
are pregnant (particularly from week 27 until birth; in most cases the symptoms disappear within 4 weeks of giving birth)

Triggers

There are a number of triggers that don’t cause restless legs syndrome, but can make symptoms worse.

These include medications such as:

antidepressants
some antipsychotics
lithium (used in the treatment of bipolar disorder)
antihistamines

Other possible triggers include:

excessive caffeine or alcohol
smoking
being overweight or obese
stress

Page last reviewed: 23 March 2022
Next review due: 23 March 2025

23 ways to sleep better tonight – Wellness

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Grab a Pillow – March 13 is World Sleep Day, an annual international health event to raise awareness of the vital importance of a good night’s sleep.

Research shows that more than a third of all adults sleep less than the recommended seven hours per night. American Sleep Association (ASA). Lack of sleep contributes to all sorts of accidents, including those caused by sleepy driving. What keeps everyone awake?

“Sleep is often sacrificed due to lifestyle demands, including professional and social responsibilities,” he says. Brandon R. Peters, MD, FAASM, GP at Virginia Mason Medical Center and author of Sleep Through Insomnia . The emergence of limitless entertainment can also undermine sleep. In addition, there are often sleep disorders that are often forgotten. In fact, according to the ASA, between 50 million and 70 million adults in the US suffer from a sleep disorder.

If you’re wondering how to sleep better, the first step is to determine the cause of your restless nights.

Why can’t I sleep at night?

More than 80 sleep disorders are reported. MedlinePlus, an online health resource operated by the National Library of Medicine. Some of the major sleep conditions include:

Insomnia: Insomnia, defined as difficulty falling or staying asleep, is the most common specific sleep disorder. According to the ASA, 30% of Americans report short-term insomnia and 10% report chronic illness. This leads to fatigue, loss of concentration, mood disturbance and low productivity. National Sleep Foundation.
Sleep Apnea: More than 22 million Americans suffer from sleep apnea, according to a study. American Sleep Apnea Association. This is a potentially serious condition in which you briefly stop breathing while you sleep, sometimes due to an upper airway blockage. Common signs include loud snoring and difficulty breathing during sleep, which usually results in daytime fatigue.
Restless legs syndrome: This nervous system disorder causes an uncontrollable urge to move the legs during sleep. Symptoms usually occur in the evening before bedtime and possibly during long periods of inactivity (eg, long car rides).
Long-haul jet lag: Travelers are familiar with this temporary sleep disturbance that occurs when your internal clock (or circadian rhythm) is disrupted after arriving in a new time zone.
Hypersomnia: Narcolepsy is the most common form of hypersomnia, a class of sleep disorders that includes excessive daytime sleepiness. This disorder can make you fall asleep at inappropriate times, such as at work or while driving.

Other common problems include sleepwalking, drowsiness, nightmares and more.

How to get better sleep in 23 steps

The good news is you can get quality sleep by developing healthy bedtime habits by following these simple tips.

1. Stick to your sleep routine.

Of all the sleep tips you’ll ever read or hear about, the most important is to stick to one sleep schedule every day, says Michael J. Breus, Ph.D. Doctor of Sleep, clinical psychologist and diplomat of the American Council of Sleep Medicine and member of the American Academy of Sleep Medicine.

In other words, go to bed and wake up at about the same time every day, including weekends. “When sleep has a regular rhythm, your biological clock will be synchronized and all other functions of your body, including your sleep, will become smoother,” Breus says.

two. Create a ritual before bed.

Adopting a bedtime routine signals your body that it’s time for bed. Breus recommends consistent healthy sleep habits or good sleep hygiene. Schedule an hour of quiet, relaxing activities, such as dimming the lights, drinking a cup of chamomile tea, or applying night creams.

3. Do something boring.

Dr. Peters recommends including at least one relaxing activity in your evening ritual. He suggests choosing something “boring”, like reading a book. Breus says journaling or taking a warm bath before bed can relieve stress and set the stage for a good night’s sleep.

Four. Turn off all devices.

Turn off your TV, computer and smartphone (and yes, this includes turning off social media). Breus explains that the blue light emitted by screens can suppress the production of melatonin, the hormone that keeps your body’s circadian rhythm going.

5. Choose the right pillow.

The best pillow depends on your preferred sleeping position, says the National Sleep Foundation. For example, side sleepers should use a pillow that supports their head, neck, and shoulders. Stomach sleepers should choose a thin pillow to keep their spine straight.

6. Lower the temperature.

Set thermostat between 60 and 67 degrees. Sleep experts say this is the perfect bedroom temperature for catching z. “While it may feel a little cold, your body naturally cools down in preparation for sleep,” Breus explains. Thus, a decrease in body temperature helps to fall asleep faster.

7. Avoid oversleeping.

Don’t spend too much time in bed, Dr. Peters warns. The average adult needs 7 to 9hours of sleep to feel rested, but if you exceed your need for sleep, you will spend the difference on sleep. Excessive sleep can be a sign of a problem, so talk to your doctor if you can’t get up.

8. Let the sunshine in.

After the alarm goes off in the morning, try to stay in direct sunlight for at least 15 minutes. “By increasing the circadian rhythm, it will be easier to wake up and also easier to fall asleep at the same time every day,” explains Dr. Peters.

9. Spend it.

According to Breus, regular exercise is good for your overall health and helps you sleep at night. Although researchers don’t fully understand why, Johns Hopkins Medicine reports that moderate aerobic exercise increases the duration of non-REM sleep (also known as deep sleep) and promotes mood stabilization and relaxation, which may encourage the body to naturally transition to sleep. Just don’t exercise before bed, it can energize you and make it harder to fall asleep.

10. Limit your caffeine intake.

Avoid all caffeinated drinks (including coffee, tea, and sodas) by 2:00 pm. every day,” suggests Breus. He explains that caffeine has a so-called “half-life” of about eight hours, which means that its levels decrease – but still remain somewhat effective – in your body after that time.

eleven. Also limit your alcohol intake.

Set aside wine, beer or cocktails at least three hours before touching the sheets. Alcohol slows down your REM (rapid eye movement) sleep, the stage of sleep that occurs within the first 90 minutes after you fall asleep. “We don’t fully understand the underlying cause of REM sleep, but decades of research strongly suggests that it provides important brain development and repair functions,” says Breus. This phase of sleep is believed to aid memory consolidation and emotional processing.

12. Don’t take a nap.

People who have trouble sleeping should resist daytime naps. Daytime naps can affect the amount of sleep you can get at night. Dr. Peters explains that the perception of lack of sleep perpetuates sleep problems by affecting the next night.

13. Snack on certain foods.

Snacking before bed at night is generally not recommended. However, if someone needs to snack, the National Sleep Foundation recommends snacking on complex carbohydrates and whole grains like popcorn or oatmeal instead of refined sugar. Healthy fats like almonds or walnuts contain melatonin, which can help you feel sleepy. Lean proteins, such as cottage cheese, act on the serotonin transmitter in the brain, which helps regulate the wake-wake sleep cycle and the internal body clock.

14. Just don’t eat too much before bed.

If you have a late dinner, consider reducing your portion size. “When your body is busy digesting a large meal, it may take longer to fall asleep and you are more likely to fall asleep restlessly,” Breus says.

fifteen. Try aromatherapy.

Three highly concentrated essential oils – lavender, valerian and bergamot – have properties that can induce sleep. National Sleep Foundation. The organization suggests adding a few drops of any of these oils to a diffuser or directly onto your pillow.

16. Stay in bed.

If you wake up at night, keep lying down. Breus explains that when you sleep – and even when you first open your eyes – your pulse is slow and relaxed, but when you sit in bed and get out of bed, you increase your heart rate, and invigorate your nervous system. This can make it difficult to fall asleep.

17. Turn on night lights.

However, if getting out of bed (to use the toilet or for any other reason) is necessary, place a night light on the way from the bedroom to the bathroom. Breus explains that turning on bright lights will stop melatonin production. People who are osteoporotic or prone to fractures should have night lighting to avoid falling if they have to use the toilet at night.

18. Exercise is breathing exercises.

If you’re feeling stressed and awake in the middle of the night, you need to quiet your racing mind. and your heart palpitations before you can fall asleep again. Breus recommends practicing the 4-7-8 breathing method: inhale for four seconds, hold your breath for seven seconds, and exhale slowly for eight seconds. Repeat this relaxation technique as many times as needed until your heart rate drops to an optimal sleep rate of 60 beats per minute or less.

19. Turn away from the alarm clock.

Don’t watch the minutes tick by, even if you have trouble falling asleep or fall asleep again at midnight. If you have already seen the time and are staring at the ceiling, try to make the situation look positive. Panic about not getting enough sleep won’t help you fall asleep, so tell yourself, “Great, I’ve got X hours more to sleep well,” Breus advises. Focus on relaxation and stay positive.

twenty. Make happiness a habit.

A February 2018 study published in Journal of Behavioral Medicine of more than 3,500 adults aged 32 to 51 concluded that optimistic people generally report good sleep quality on a regular basis. In fact, over the five-year study period, volunteers with higher levels of optimism had a 74% chance of not suffering from insomnia.

21. Go to the pharmacy.

If you still can’t get a good night’s sleep, Dr. Peters suggests trying an over-the-counter melatonin supplement. Melatonin is a natural sleep-promoting hormone, but the body produces very little of it, so avoid higher doses, he adds. The generally safe recommended dose is 0.5 mg to 3 mg. Other over-the-counter sleep aids include: valerian root, as well as the sedative antihistamines diphenhydramine (such as Benadryl and Aleve PM) and doxylamine (Unisom SleepTabs). Pair them with earplugs or a white noise canceling device to help you sleep better.

22. Seek therapy.

Dr. Peters also advises treating the sleep condition with Cognitive Behavioral Therapy for Insomnia (CBTI). “This program can teach you skills to improve sleep with long-term effects,” he explains. This can be done with the help of a behavioral psychologist, with an online course, or with a book that guides you through treatment.

2. 3. Think prescription sleeping pills.

For chronic sleep problems, talk to your healthcare provider about the various medications available that treat a variety of symptoms associated with sleep disturbances, including Z sedative-hypnotics (such as Lunesta and Ambien), dual orexin receptor antagonists (Belsomra) , melatonin receptor agonists (Roserem) and antidepressants (Silenor). Keep in mind that sleeping pills should have a limited role and should not be needed for more than a few weeks, advises Dr. Peters.

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When to see a doctor about sleep disorders doing your best to follow the proven sleep advice.

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