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Medication, supplements or self-care strategies like massage can all help soothe your legs at night.

You’re ready to drift off to dreamland, but there’s one problem: it feels like there are creepy crawlies on your legs. You feel the need to stretch or walk around to make the sensation go away, but that means getting out of bed and delaying your much-needed rest.

If this sounds like your nightly routine, you might have restless legs syndrome (RLS), a neurological condition that can prevent you from falling or staying asleep. 

Looking for relief? These RLS treatments can help you get some shut eye.

What is restless legs syndrome?

RLS, also known as Willis-Ekbom disease, is a sleep-related movement disorder that causes an uncomfortable and often irresistible urge to move your legs.

“People might also notice burning, tingling or a creepy crawly sensation on their legs or arms, like bugs walking on them,” explains Anne Marie Morse, DO, FAASM, a pediatric neurologist and sleep specialist at Geisinger.

These sensations are usually worse when sitting or lying down and can be relieved temporarily by moving or walking around.

“Because most people typically have these symptoms at night, RLS can make it difficult to fall or stay asleep,” Dr. Morse says. “Poor sleep quality can affect your mood, ability to concentrate and think, alertness and overall health and well-being."

What causes restless legs syndrome?

The exact cause of RLS is unknown, but there are a few possibilities.

“Research suggests that some RLS cases could be related to signaling abnormalities in brain pathways involving movement,” Dr. Morse says. “For others, RLS could be linked to other pre-existing medical conditions.”

You might also be at risk of developing RLS if you:

  • Have a family history of RLS
  • Have an iron deficiency or anemia
  • Are pregnant
  • Frequently consume caffeine, alcohol or nicotine
  • Have kidney disease
  • Use medications like antipsychotics, antidepressants, anti-nausea drugs or cold and allergy medicines
  • Have a disease or injury of your spinal cord 

Lifestyle choices can make a difference as well. 

“Poor food choices, lack of exercise or not getting enough sleep can also make you more likely to have restless legs at night,” explains Dr. Morse. “It’s important to get plenty of high-quality rest, eat a well-balanced diet and prioritize physical activity throughout the day.”

RLS treatments

There’s no one-size-fits-all approach to restless legs syndrome treatments. The best treatment plan for each person depends on the severity of their symptoms and the underlying causes. But, in general, here’s what Dr. Morse suggests:

Build healthy sleep habits

RLS can be a vicious cycle: It can ruin your sleep, but it’s also made worse by poor sleep quality. Dr. Morse suggests improving your sleep hygiene, or the habits leading up to bedtime, with the following:

  • Try to go to bed around the same time every night and wake up around the same time every day.
  • Avoid using screens (like your phone, computer or TV) in the hour leading up to bedtime.
  • Keep your bed reserved for sleeping.

“If you still can’t sleep, it’s better to get up and do a relaxing activity like meditation or reading a book,” Dr. Morse says. “Then return to bed once you feel sleepy.” 

Although good sleep hygiene won’t prevent or fix RLS, these are great habits to maintain and will make additional treatments more likely to be effective. 

Add iron supplements, if needed

In diagnosing your RLS, your doctor might check your iron and ferritin levels to make sure you’re getting enough in your diet. If not, adding iron supplements along with vitamin C could help reduce your symptoms. Be sure to work with your primary care provider or sleep specialist before starting a supplement regimen.

Medications

Several medications are available to treat RLS, including Gabapentin, Gabapentin enacarbil, Pregabalin, or dopamine agonists like Ropinirole, Pramipexole or Rotigotine.

“More rarely, in severe cases that don’t respond to other treatments, opioid medications may be used to help reduce RLS symptoms,” explains Dr. Morse. Tailoring a treatment regimen to a person’s individual needs is always required.

Exercise regularly

Exercise can help alleviate symptoms of RLS and help you get better sleep overall. Aim for at least 30 minutes of moderate physical activity daily but watch your timing.

“Exercising too close to bedtime can wake you up, so it’s best to avoid it within the three hours leading up to going to sleep,” says Dr. Morse.

Gentle stretches like calf raises close to bedtime can also help with symptoms and not disturb your sleep. Hold the stretch for 20 to 30 seconds before releasing it slowly.

Reduce your stress levels

Stress can make you feel unsettled and may worsen RLS symptoms. Try incorporating relaxation techniques like meditation, deep breathing or yoga. Working with a mental health counselor can also help you develop healthy coping strategies.

Cut out alcohol, caffeine and nicotine

Alcohol, caffeine and nicotine can all worsen RLS symptoms and increase feelings of restlessness. Reducing how much you consume can help you manage your symptoms and get a better night’s sleep.

Massage your muscles

Massage therapy can improve circulation, promote relaxation and loosen tense muscles — all of which can help alleviate symptoms. Ask your doctor if medical or therapeutic massage might be an option for you.

Apply a warm or cool compress

If you need immediate relief from the discomfort in your legs, try taking a warm bath or applying a heated compress for 15 minutes. If heat doesn’t help, try an ice pack for 10 to 15 minutes.

Getting the rest you deserve

If you have RLS, a sleep specialist can help find the right treatment plan for you.

Keep in mind, if you have leg discomfort throughout the day, trouble walking or new weakness related to your pain, it’s best to discuss this with your doctor. These could be symptoms of a different condition that requires further testing and treatment.

“You don’t usually need a sleep study to diagnose RLS, but working with a sleep specialist can help pinpoint what’s causing or triggering your symptoms,” says Dr. Morse. “Then, they can help you build a treatment plan to help make sleepless nights a thing of the past.”

Next steps:

Find a sleep specialist near you
Considering a sleep aid? Talk to your doctor first
Here are the signs you have sleep apnea

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