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Restless Legs Syndrome

From tossing and turning to constant kicking, why some people can't stop moving all night long.

As soon as you lie down in your bed, you get a creepy crawly feeling in your legs making it impossible for you to find a comfortable position. Moving your legs is your only relief so you end up tossing and turning all night. If this sounds like you, you could have restless legs syndrome.

The main symptom of restless legs syndrome (RLS) is an unpleasant burning, prickling, tickling or aching feeling in your leg muscles, mainly in the calf, when you're inactive or relaxing - which is why it's worse at night. You'll have an irresistible urge to move your legs which is only relieved by actually moving them. In the day, it just makes you fidget - at night you'll probably have to keep changing position or you might even have to get out of bed and walk around. Some people also suffer involuntary jerking movements in their legs - so don't be surprised if your bed partner wakes up black and blue, complaining of being kicked in the stomach all night. Chances are, you - and possibly your partner - are sleep deprived. You're probably taking more than half an hour to get to sleep and could be waking up three or more times in the night.

WHO GETS IT?

Up to 15% of people suffer - some only mildly, others finding it almost impossible to get an uninterrupted night's sleep. It tends to run in families, it's more common in women and the risk goes up as you get older. Pregnant women are also more prone.

WHAT CAUSES IT?

No one really knows this - no detectable abnormality of the nervous system, circulation or muscles has been found. However, RLS has been associated with other conditions, which if treated, can help. For instance, restless legs can be a symptom of a deficiency in iron, vitamin B12 or folic acid, and taking supplements will normally sort it out. Nerve damage associated with rheumatoid arthritis, kidney failure or diabetes may also cause RLS - but once the underlying condition is treated, RLS will probably get better. Certain medications including lithium, anticonvulsants, antidepressants and beta-blockers are also thought to be triggers - so changing to other drugs can help. Smoking, drinking alcohol and having too much caffeine seems to make RLS symptoms worse - so cut down or cut them out.

ACTION PLAN

Stick to a regular sleep routine - irregular sleep habits may make you more tired and make RLS symptoms worse. So go to bed and wake up at the same time every day if possible. Work out how many hours you need to feel refreshed, and adjust your sleep schedule. If possible go to sleep later and wake up later. If you've got RLS, you're more likely to sleep better later in the night - from about 2a.m. to 10a.m.
Test out different pre-bed rituals to see what works for you. Good ones to try are pacing up and down, performing a stretching routine that includes leg work, taking a hot or cold bath, massaging your legs with oil or applying hot or cold packs. Some people swear by TENs machines, which are often used during labour as a drug-free way of easing the pain of contractions: you put pads on your legs which are attached via wires to a stimulator. These emit vibrating electrical impulses which block the aching and tickling sensations in your leg. To distract you, read a novel or try a relaxation technique such as meditation or yoga.
If lifestyle changes don't work, there are a huge amount of drugs, such as levodopa, bromocriptine, oxycodone and clonazepam, that are used to control RLS: they work in different ways by stopping the restlessness, abnormal sensations, involuntary movements, anxiety and by relaxing muscles. However, it's a complicated process - so your doctor will have to tailor-make a treatment programme for you.


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