Treatment Options for Restless Legs Syndrome

Lifestyle Modifications for Restless Legs Syndrome

Restless leg syndrome is a source of great frustration and distress for many of those who suffer from it. It can cause marked disruption in daily activities and impair quality of life. Some of the interference in daily routine is a result of:

  • Dyskinesia and paresthesia
  • Difficulty falling asleep and staying asleep
  • Constant urge to move when restlessness occurs
  • Symptoms activation with relaxation
  • Daytime fatigue and sleepiness
  • Random periodic limb movements that many experience during sleep or waking periods of rest or inaction.
  • Symptoms that the individual experiences during activities requiring prolonged sitting, such as theatre, movies, plane trips which can cause embarrassment

When questioned, many patients with restless legs syndrome report that activities that typically are affected by the various aspects of restless legs syndrome include:

  • Problems with concentration and memory
  • Depression and anxiety
  • Decreased motivation
  • Preference not to participate in activities that may trigger restless legs syndrome symptoms such as going to the movies or theatre, sitting on an airplane, going to concerts, or going out to dinner.

In addition to the interference and inconvenience caused by restless legs syndrome and PLMS to the patient during sleep, stress is added in that the sleeping partners of the patient are also affected by the restless legs syndrome. The interference is so pronounced that they may opt to modify the sleeping arrangement so that they too are not aroused from sleep by the restlessness of the patient. Upon questioning, bed partners often remember seeing leg movements while their partners slept long before the patient reported any sensory symptoms so that by the time the patient seeks help and is diagnosed, significant strain in various aspects of relationships may have already taken place.

An important aspect of lifestyle modifications is to avoid activities, food, routines, or anything that triggers or aggravates symptoms of restless legs syndrome and to increase the activities that alleviate the symptoms. Activities that appear to help prevent the onset of symptoms or alleviate the intensity of symptoms include:

  • Sleep Hygiene - Many patients with restless legs syndrome experience significant sleep disturbances causing them to feel tired and "sluggish" during the day. Educating patients about developing good sleep hygiene habits is important for improving their quality of life:

    • establish regular hours for sleep and stick to a regular sleep schedule.
    • sleep in a quiet bedroom without any distractions such as a TV or radio.
    • gradually reduce vigorous activity in the evening. Vigorous exercise should be completed at least 6 hours before going to bed. Some patients, however, find that some exercise before bedtime actually helps them fall asleep.
    • avoid eating heavy meals before bedtime
    • adjust sleep time to reach the optimum number of hours needed for good sleep when the medication is most effective or when the symptoms are mildest. Studies indicate that the best restorative sleep for patients with restless legs syndrome is later in the sleep cycle, from approximately 2 AM to 10 AM.
    • cognitive behavioral therapy, a therapy that combines behavior modification and sleep education, may be helpful in reducing sleep disturbances in patients with restless legs syndrome.

  • Use of Alcohol and Caffeine - Both alcohol and caffeine have been found to aggravate the symptoms of restless legs syndrome and should be avoided completely or reduced to the greatest extent possible.

  • Aggravating Medications - Certain medications may aggravate the symptoms of restless legs syndrome including neuroleptic (antipsychotic) drugs, lithium, and antihistamines, antinausea medication, and antidepressants. If you are currently taking any of these medications, talk with your doctor about the risks and benefits of switching to other medications that will not aggravate the symptoms of restless legs syndrome.

  • Exercise - regular moderate exercise may alleviate symptoms but excessive exercise may intensify symptoms.

  • Smoking - The effect of smoking on aggravating the symptoms of restless legs syndrome has not been established with any degree of certainty. Nevertheless, if you smoke, talk with your doctor about starting a smoking cessation program for improving your health in general.

  • Hot baths, muscle stretching, and moderate exercise may help to better control the symptoms of restless legs syndrome and when done before bedtime, may promote relaxation and sleep.

  • Eating balanced meals with attention to proper nutrition may be beneficial for patients with restless legs syndrome. Health care providers may also suggest vitamin supplementation if needed.

  • Maintaining a busy and active lifestyle, including participating in social activities, may also be useful by diverting your attention and concentration away from the symptoms of restless legs syndrome. Some patients with restless legs syndrome find that if they must be sedentary, they engage in mind games or activities such as crossword puzzles, videogames, or reading exciting novels reduces the severity of the symptoms or relieves them.