What is Restless Leg Syndrome and How Does it Impact Sleep?

What is restless leg syndrome?

Also known as Willis-Ekbom disease, restless leg syndrome is an irresistible urge to move your legs, usually because of an uncomfortable sensation.² It typically occurs in the evening, or during the night, when you’re sitting or lying down.

Moving eases the uncontrollable urge, therefore it can obviously negatively impact sleep. It can begin at any age, and generally worsens as you get older. Occasionally, the arms are affected too.

Symptoms

Along with the overwhelming urge to move your legs, symptoms can also include:

1. An unpleasant crawling sensation in the feet, calves and thighs
2. Involuntary jerking/twitching of the legs and arms; periodic limb movements in sleep (PLMS)
3. A feeling of itching, pulling, throbbing or aching

Sensations usually begin after you’ve been sitting or standing for a period of time, often occurring at night. These symptoms usually ease with movement, e.g. jiggling, standing or walking.

Of course, everyone is different so symptoms vary widely. But, muscle cramps and numbness aren’t usually associated with the condition. Other sensations like ‘creeping’ or ‘electric’ have been described by sufferers though.

What causes restless leg syndrome?

There’s no one cause that can be identified, but genes are thought to play a role: if you have a family history of the condition, you’re more likely to get it.

Dopamine

Also, it could be related to a problem with a part of the brain called the basal ganglia, which uses dopamine to help control muscle activity and movement. If nerve cells become damaged, the amount of dopamine in the brain is reduced, causing muscle spasms and involuntary movements.³

Health condition

If you have an underlying health condition and develop restless leg syndrome, this is known as secondary restless leg syndrome.

Conditions include:

• Anaemia (low iron levels can cause a fall in dopamine)
• Diabetes
• Chronic kidney disease
• Parkinson’s
• Fibromyalgia
• Spinal cord conditions

What triggers it?

While these factors don’t necessarily cause restless leg syndrome, they can trigger it:

• Medications (e.g. some antidepressants, antipsychotics antihistamines)
• Stress
• Lack of exercise
• Excessive smoking, caffeine or alcohol
• Pregnancy

The problem with restless leg syndrome in sleep

Unsurprisingly, the condition can interrupt sleep, causing daytime drowsiness and affecting quality of life. Sleep is an essential function that allows your body and mind to recharge.⁴

Lack of it can:

• Negatively impact work performance
• Impair your ability to concentrate, think clearly, and process memories
• Leave you at a higher risk of certain diseases e.g.
  • High blood pressure
  • Type 2 diabetes
  • Obesity
  • Poor mental health
  • Stroke
• Leave you vulnerable to attention lapses, reduced cognition, delayed reactions, and mood shifts
• Negatively impact mood

Restless leg syndrome treatment

If restless leg syndrome is not linked to a health condition, there are a number of lifestyle changes that can ease the symptoms. Otherwise, medication might be necessary – you should speak to a doctor if so.

You can ease symptoms by:

1. Quitting smoking
2. Avoiding stimulants, especially in the evening (e.g. caffeine and alcohol)
3. Setting a sleep schedule; going to bed at the regular time every night
4. Exercising more regularly
5. Identifying medicines that trigger symptoms and avoiding them⁵
6. Massaging/stretching leg muscles in the evening
7. Practicing yoga or meditation before bed
8. Using a heated pad or ice pack whenever you experience symptoms⁶

What’s the best sleeping position for restless leg syndrome?

Your sleep posture can aggravate your RLS symptoms and the discomfort you feel at night. If you like sleeping on your side, try using a pillow between your legs. If you prefer to sleep on your back, try a leg rest pillow under your legs. This can help to promote blood flow, looking after both joints and muscles in the legs.⁷

Other tips for better sleep with RLS

Here are some other tips from both doctors and patients to help you sleep better:

• Low blood sugar is a trigger for RLS, and protein stabilises blood sugar, so eat a protein snack before bed, such as a hard-boiled egg
• Check your over-the-counter and prescription medications (e.g. antihistamines can make symptoms worse)
• Take a hot bath with two cups of Epsom salts (these contain magnesium). Soaking magnesium into your muscles before bed can relax them
• Drink plenty of water
• Elevate your legs
• Do calf stretches
• Do deep breathing exercises to help you relax before bed
• Keep the temperature cool in the room
• Get tested for sleep apnea if you’re over-40 and overweight
• Use a leg-raising pillow
• Mild pain relievers can sometimes help⁸

Sleep is as important for our bodies as good nutrition, so it’s vital you make it a priority. Improve sleep quality by increasing your exposure to natural light, creating a clean, comfortable sleep environment and avoiding long naps during the day. It can be difficult and take time to improve your sleep, but it can be done.

Any positive changes you can make to your lifestyle and sleep habits can help alleviate RLS symptoms. They can also help you sleep better in general. Try to ensure you’re getting the recommended 6-9 hours of quality sleep a night.