Restless Legs Syndrome

Restless Legs Syndrome

Elizabeth Tunison struggles to sit still as she talks on the telephone in her Whittier, California, home. “I’m massaging my right leg with my right hand right now. It helps relax my leg muscles a bit and keeps me still for a few moments,” she says. “But I’m eventually going to have to get up and move. I can’t help it. My legs just don’t know how to stop.”

Tunison, a retired college professor in her seventies, is one of the estimated 3 percent of Americans—many of them over 60—who have restless legs syndrome (RLS), a condition that causes odd sensations of creeping, crawling, or tingling in the legs. For many, walking provides the only relief. They don’t have to walk far to rid themselves of the sensation. A stroll down the hallway or around the living room may be enough. But they often must do it over and over again. Because it usually worsens while lying down, people who have this syndrome seldom sleep well.

Restless legs syndrome typically starts at the onset of sleep, says Wayne Hening, M.D., Ph.D., research neurologist at the University of Medicine and Dentistry at Rutgers University in New Brunswick, New Jersey, and member of the Restless Legs Foundation’s medical advisory board. In severe cases, it may be impossible to sleep. Even more unusual are instances where the movements are noticeable enough to wake a person. Typically, the “wiggles” will subside within minutes.

Doctors aren’t certain what causes RLS, but it may have a genetic link since the condition tends to run in families, says Ralph Pascualy, M.D., medical director of the Sleep Disorders Center at Providence Medical Center in Seattle. Some researchers also suspect that RLS may be caused by low levels of dopamine, a neurotransmitter in the brain that helps regulate the body’s nervous system. In fact, doctors have discovered that drugs like levodopa (Larodopa) and dopamine substitutes like pergolide mesylate (Permax), which are used to treat Parkinson’s disease (also linked to low dopamine levels), can relieve RLS. Pain medications and sedatives, and certain drugs for high blood pressure also can dampen the symptoms. In addition, these natural remedies can help you handcuff this sleep thief.

Try This First

Maintain a regular bedtime. Fatigue aggravates RLS, says Dr. Hening. Getting all of the shut-eye you can is important, particularly if you have a mild case of RLS that only flares up once or twice a month. Hit the sack at the same time each evening, he suggests. Even if you have to get up several times during the night to stretch your legs, a consistent bedtime should help you get an adequate amount of sleep. After all, adds Dr. Hening, a regular bedtime is known to generally promote better sleep, and clinical experience has shown that waiting for fatigue to set in before going to bed may actually worsen the condition.

Other Wise Ways

Splish and splash. Sitting in a warm bath or hot tub for 10 to 15 minutes just before bedtime sometimes helps relieve RLS, Dr. Hening says. If you have difficulty getting into a tub, stand in a shower and let the warm water gently pour over your back and legs.

Sleep in. If necessary, sleep in late, suggests Virginia N. Wilson, co-founder of the Restless Legs Syndrome Foundation and author of Sleep Thief, Restless Legs Syndrome, a guide to coping with RLS. Because RLS is usually worse at night, many people who have it don’t get to sleep until 3:00 or 4:00 a.m. So avoid early-morning appointments because, odds are, you’ll be groggy and irritable, she says. Wilson, for instance, usually sleeps until at least 10:00 a.m. and rarely schedules any activities before noon.

Managing Your Meds

Any drug that reduces or blocks activity of the brain chemical dopamine, responsible for the transmission of nerve impulses, can worsen the symptoms of restless legs syndrome, says Wayne Hening, M.D., Ph.D., research neurologist at the University of Medicine and Dentistry at Rutgers University in New Brunswick, New Jersey, and member of the Restless Legs Foundation’s medical advisory board. In particular, be wary of prescription neuroleptic tranquilizers including haloperidol (Haldol) and chlorpromazine (Thorazine). In addition, avoid:

• Alcohol

• Caffeine

• Prescription antinausea drugs containing metoclopramide (Reglan)

• Prescription tricyclic antidepressants such as amitriptylene (Elavil)

Zone out. Some people report that engaging in mentally absorbing games and activities like building jigsaw puzzles or solving logic problems stifles their attacks of RLS, Dr. Hening says. If you find an engaging hobby that requires intense concentration, it may help you control this condition, he says.

Find an aisle land. Ask for an aisle seat in the back of the theater when you attend a play or concert, Wilson suggests. If your legs begin to bother you, you will be able to stand up and walk around without blocking the view of other patrons.

Likewise, ask for an aisle seat when making airplane reservations. Try booking a flight that has one or two stops before your destination, so you can get off the plane and stretch your legs for a few minutes during each layover, Wilson says.

Try to schedule a morning flight, when discomfort is less likely, advises Dr. Hening. He also suggests asking your doctor if medication will help.

Have you or a family member had an experience with this? Help others by sharing your story now.

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