Restless Legs Syndrome

20 Calming Techniques

No party, no music, no Gene Kelly. But as you lie in bed, anxious to fall asleep, your legs—just feel like dancing.

What's going on?

Well, maybe you've been repressing your true calling—to be a Rockette. But probably you are one of the estimated 5 percent of the population with restless legs syndrome.

The condition, also known as Ekbom syndrome, is usually a chronic annoyance rather than a symptom of a serious neurological disorder. It is characterized by an irresistible urge to move the legs, "jumping" of the legs, and deep creeping or crawling sensations in the legs.

"Typically both lower legs are affected, although the thighs and even the arms can be involved," says Lawrence Z. Stern, M.D., a professor of neurology and director of the Mu«cio F. Delgado Clinic for neuromuscular Disorders at the University of Arizona Health Sciences Center. "Both sides are not always symmetrical."

The origin of the sensations is unknown. Some researchers suspect an imbalance in the brain's chemistry may be the root cause of the problem.

Whatever the physiology of it, the condition certainly isn't as much fun as dancing. So here are a few steps you can take to cut in on restless legs syndrome.

Get up and walk. Restless legs syndrome tends to strike at night, when you're at rest. So the quickest way to satisfy the legs' urge to move is to comply with a stroll around the bedroom, says Ronald F. Pfeiffer, M.D., an associate professor of neurology and pharmacology and chief of the Section of Neurology at the University of Nebraska Medical Center in Omaha.

Of course, some people have trouble sleeping even without restless legs syndrome. Thus, while walking is a good way to halt a sudden, severe attack, it might also be a good idea to try the following.

MEDICAL ALERT

Be Conscientious: See a Doctor

If you have restless legs syndrome, you probably don't have anything to worry about—except the sleep it sometimes causes you to miss.

But if you're experiencing symptoms for the first time—pronounced sensations in the legs, usually at night—see your doctor. The symptoms of restless legs syndrome can be warning signs for serious medical problems such as lung disease, kidney disease, diabetes, Parkinson's disease, and many neurological disorders.

So for safety—not to mention peace of mind—let your doctor diagnose.

Walk before going to bed. In some cases this noticeably reduces bedtime bouts of restless legs syndrome, says Dr. Stern. "Exercise changes chemical balances in the brain—endorphins are released—and may promote more restful sleep," he adds.

Wriggle. Or is that wiggle? Either way, the idea is to move your feet back and forth when symptoms arise.

Change positions. "Some people seem to develop symptoms a lot more sleeping in one position than another," says Dr. Stern. "Experiment with different sleeping positions. It's harmless and may prove to be worthwhile."

Soak your feet in cool water. "It works for some," Dr. Pfeiffer says. One caution: Do not follow a "more is better" theory and immerse your feet in a bucket of ice; you could cause nerve damage.

Warm up. While cold helps some people, others find using a heating pad more soothing and effective, Dr. Pfeiffer says.

Take one multivitamin daily. "Iron deficiency may be a cause of restless legs syndrome," Dr. Pfeiffer says, noting that several studies have found an association between iron deficiency and restless legs syndrome. Folate deficiency also has been implicated in restless legs syndrome. If you suspect a deficiency, check with your doctor.

Dr. Stern says a daily multivitamin can protect you against deficiencies of both nutrients.

Take two aspirins before bedtime. Doctors can't say why aspirin helps, but apparently it does reduce symptoms in some people.

Don't eat a big meal late. Eating a lot late at night may get the legs really jumping. "It may be the activity of digesting a big meal that triggers something that causes symptoms," offers Dr. Stern.

Lower your stress level. Easier said than done but certainly worth trying. "Stress just worsens the problem," says Dr. Stern. Being organized, giving yourself quiet time, taking deep breaths, and practicing various relaxation techniques are good ways to reduce stress.

Get plenty of rest. Symptoms may be more severe if you allow yourself to become overtired.

The Alternate Route

Different Nighttime Routines

Restless legs syndrome can be chronic—it pesters some people off and on for years and years. "So a lot of people will try different rituals," says Richard K. Olney, M.D. And some of those rituals, odd as they may be, work—at least some of the time.

Why do they work? Doctors don't even want to hazard a guess. But at the same time, if these unusual methods pose no danger and could help, you may want to give them a try.

Wear cotton stockings to bed. Maybe try this one in winter—at least they're warm.

Wear silk pajamas to bed. They'll feel good on you, and if you still have to get up and walk around, you'll be classily clothed.

Rub your legs with an electric vibrator. Some people say this reduces symptoms; in a few people, however, it could make symptoms worse.

Massage your legs. "Right before bedtime, rubbing your legs might be beneficial," suggests Richard K. Olney, M.D., an assistant professor of neurology at the University of California, San Francisco. Mild stretching also might help.

Avoid sleep-inducing medications. They may provide short-term benefits, but many people build up a tolerance to them and then they have two problems—restless legs syndrome and dependence on the drugs, says Dr. Stern.

Don't use alcohol as a sedative. Again, you set yourself up for double trouble, Dr. Stern says.

Stop or dramatically reduce caffeine. "Some studies have shown an association between relief of restless legs syndrome and stopping caffeine," Dr. Pfeiffer says.

Quit smoking. A 70-year-old woman who was a smoker and long-time sufferer of restless legs syndrome found relief a month after she stopped smoking, according to one Canadian doctor. Another four months later, according to the doctor's report, the woman was still free of symptoms.

Come in from the cold. Several studies have implicated prolonged exposure to cold as a possible cause of restless legs syndrome.

PANEL OF ADVISERS

Richard K. Olney, M.D., is an assistant professor of neurology at the University of California, San Francisco.

Ronald F. Pfeiffer, M.D., is an associate professor of neurology and pharmacology and chief of the Section of Neurology at the University of Nebraska Medical Center in Omaha.

Lawrence Z. Stern, M.D., is a professor of neurology and director of the Mu«cio F. Delgado Clinic for Neuromuscular Disorders at the University of Arizona Health Sciences Center in Tucson.

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