Restless Legs Syndrome

Sufferers of Restless Legs Syndrome experience a wide range of uncomfortable sensations during inactivity, usually in the legs, but sometimes in the arms and trunk, making it difficult for them to relax and to fall asleep. These sensations are variously described as, "pulling, drawing, crawling, wormy, boring, tingling, pins and needles, prickly..." (source: National Institute of Neurological Disorders and Stroke website at http://www.ninds.nih.gov/health_and_medical/disorders/restless_doc.htm), and are accompanied by an overwhelming urge to move the affected body part. There is no known cure, and symptoms often worsen over time. Pain killers occasionally offer some relief.

Restless Legs Syndrome is also known as 'Jimmy Legs', under which name it was once featured in an episode of Seinfeld — Kramer's girlfriend suffered from it, and it was later revealed that George Costanza's mother was also a sufferer, although in actual fact, as George's father explained, she had "the Jimmy Arms.... like you w'n't beleef!".

I had this condition for a while. As mofaha notes, the syndrome involves uncomfortable muscular sensations coupled with an overwhelming desire to move one's legs; I generally described it by saying that my legs wanted to get up and go running even though the rest of me really wanted to go to sleep. Obviously, there are far worse diseases out there, but the syndrome does make life uncomfortable for the sufferer (and for anyone with whom he is sharing a bed).

Although the causes of restless-legs syndrome are unclear, there are a few treatments. Painkillers do work, especially if they contain a mild sleeping drug (like Tylenol PM). Doctors will sometimes prescribe benzodiazepines such as Restoril for more serious cases. Before resorting to drugs, though (especially habit-forming drugs whose effects decline over time) it's good to try some non-pharmacological approaches. Stretches, relaxation exercises, and massage can provide some relief; these helped me a little, but not much. It's often easier and more effective to eliminate some factors that may worsen the condition. For example, my syndrome went away entirely after I drastically reduced my intake of caffeine. These days, I don't consume any caffeinated drink within 12 hours of bedtime; I only have a problem if I forget and have some chocolate or a Coke at dinner.

("Go without caffeine?" you say. "You must be crazy! Wasn't it hard to give it up?") Yeah, but I can actually sleep through the night now, which means that I don't need caffeine to stay awake during the day. A blessing for the doctor who suggested that to me (and a pox on the doctor who recommended that I take a Valium every night for the rest of my life).

He has trouble sleeping. He's always had these tingles in his legs, he tells me. They keep him awake until he passes out from exhaustion.

We are sitting on the couch one evening when they start. He is obviously uncomfortable, shifting around and bouncing his legs. "Is it your legs?" I ask quietly. He sighs. Yes, of course.

I thought it was all in his head, an excuse to stay up late. I told him to stop drinking so much caffeine, to watch his diet and not sleep so late in the day. I wasn't really helping.

Until the day I asked his mother about it. Turns out his grandmother also had RLS and that, like him, it caused her many sleepless nights. There is no cure; it grows worse with age. So I start the search. And here's what I learned:

Restless Leg(s) Syndrome, also known as nocturnal myoclonus, is a sleep-related syndrome. Discovered in the 1940s by a Swedish neurologist, the disorder affects about 10% of us and tends to run in families. Doctors aren't sure the cause of RLS; prevention and treatment of symptoms are the best they can do for now.

What they do know is that it flares up during periods of inactivity (like when you're watching TV or falling asleep), and it is associated with peripheral nerve diseases, anemia, and ADHD. Contrary to the name, RLS is not only a disorder of the legs. It can also occur in the feet, hands, and arms.

It feels like tingles, or a stirring discomfort that leaves you restless. It keeps you awake and that's the real pickle, because sleeplessness and stress make it worse. So here you are, trying to fall asleep but you start to worry that your legs will tingle and you won't get any sleep. Sure enough, the sensation of worms crawling in your legs starts. Now you really begin to worry. You stay awake for hours past bedtime, searching for relief and stressing over your condition. After hours of stress, discomfort and frustration, you pass out. The cycle continues. So what're we to do?

While RLS is not particularly painful, many sufferers self-medicate with pain relievers, alcohol, and other drugs. I can't begin to tell you how many things are wrong with that plan. Try regular exercise, yoga, meditation, and other physical activity that promotes restful sleep and stress reduction. As leighton mentions above, limiting your caffeine intake may help as well. The RLS Foundation recommends experimenting with your sleep cycle to find a more suitable bedtime. Some people seem to respond better to rising and sleeping at later hours. Acupuncture, warm baths, aromatherapy and massage may also help relieve symptoms.

If you are experiencing the symptoms of RLS, please see a physician to rule out any other medical problems.

Information from The Restless Legs Syndrome Foundation (http://www.rls.org), WebMD and Yahoo! Health.

Restless Legs Syndrome runs in my family. It's in our genes. There are some other problems we have too (hearing loss is the big one) but those are separate stories for another time.

Let me tell you a few things about RLS that they don't always mention on the medical databases. I'll try to avoid overlapping previous writeups, though. First off, if you don't have it in your genes, RLS is often a symptom of something else, so if you've suddenly developed it out of nowhere- you should probably get a check up. Hey, can't hurt to be cautious.

It's a pain to get officially diagnosed with RLS. (no pun intended) It generally involves spending a night or two (at least one place required a week) in a sleep institute, and more often that not your insurance won't pay for it because this is a minor condition with no special treatment anyway. Most people in my family (me included) have not been officially diagnosed because it's just a bother without any real rewards- except the occassional "oh, that's interesting" that people who look at your records will say. Keep in mind, though, most people who have it don't know it, because they have it so mildly. (I, for one, have many physical oddities about me- had this not run in my family so much, I'd probably never realized it was RLS.)

RLS is most unfun for sleeping partners. Not just because you might have gotten into the habit of getting up and down from bed a lot, but because a lot of RLS sufferers kick or move a lot in their sleep. At least in my family they do. I have to pick up the sheets from the floor nearly every morning, because I kicked them off the bed.

RLS is generally worse when your hormones are very active. This kicked in for me around age 10 or so. I'd get major pains in my ankle and shin, to the point where I couldn't sit still or sleep for hours. My grandmother called these "growing pains" and remarked how everyone in the family had gotten them at some point, which eventually led to someone doing internet research, and- erm, I digress. As with most pain that you suffer from RLS, it's impossible to pin down the exact spot that hurts (as opposed to getting a cut on your foot, you can feel right where it is even if you can't see it.) Personally, this stopped around my 14th year of life. Women in the family say it got less severe when their periods stopped.

Painkillers can sorta work. You can get used to taking them, or just sick of them eventually. I don't suggest you bother, as there are better things, unless you've got the condition for a short-term period (meaning it's a symptom of something else). I still have used them on occassion when it was truly bad, though.

The best remedy for RLS, in my experience, is daily exercise. Walk briskly, and stretch those leg muscles! My family used to go out for a walk every evening.

This condition is real, but it's very much influenced by your state of mind. It is possible to ignore it when it is mild, for example. If you're in a restful state, it tends to get worse. If you're excited, you probably won't feel it much. Learning to meditate or concentrate well is a way to some relief, because you learn to focus your mind elsewhere.

Anyway, if you've got this condition, I hope you are able to learn to cope. It sounds like some other noders out there have learned more or less the same things I have, but completely separately, so there certainly is hope.

I didn't know what Restless Legs were when I was a child, but I sure did suffer from it plenty. I called it "jumpy legs" when it happened, because the sensation in my legs would drive me nuts until I couldn't stand it anymore and jerked them to a new position in a vain hopeful attempt to relieve the feeling. I would get some relief by tensing my legs up as much as possible, but the "jumpy" feeling would return worse when I relaxed again. I still get restless legs now that I am older. Sometimes I won't have them for ages, and then suddenly I'll have them for a week. Sometimes I have no idea why I have them, but other times I can trace it to a cause

Here is a list of triggers that sometimes cause me to have restless legs, in the hopes that it may help others identify their own triggers:

• Dehydration
• Indigestion/reflux, especially from greasy food or excessive amounts of meat (this will 100% of the time cause restless legs for me, but I do it anyway often)
• Alcohol
• Sugar overload in a short time period, or high amounts of sugar over a longer period
• A high amount of exercise after being sedentary for a week or two
• Stress for several days or more in a row
• Not enough sleep for several days in a row
• Holding on and not relieving a full bladder for a while (computer games & internet are distracting)
• Sitting still on the computer for ages
• *Caffeine has been noted by others, but I don't remember with regards to my own legs because I haven't had caffeine for over a decade now for other unrelated reasons.

Sometimes my restless legs are so irritating that I don't even try to attempt sleeping until I just can't keep my eyes open anymore. Sometimes my restless legs will be so mild that I don't even notice them when going to bed, but I will wake up in the morning after a decent amount of sleep feeling like I've barely slept at all, usually with my head still full of dreams. This is because my restless legs send nerve signals to my brain which keeps it more active and prevents it transitioning from the REM stage of sleep into the necessary restorative deep sleep stage. Without the deep sleep, I don't feel rested when I wake up, plus having a higher percentage of the REM stage gives me the head full of dreams.

I don't believe the common assertation that restless legs get worse when one tries to sleep or relax. I believe that what happens is the foreground mind noise goes away and stops distracting you from the sensation that's been there all along. This is similar to when you have a mild headache that can be ignored if you are busy at work or absorbed in a movie, and you almost forget about it until you stop doing the something else and notice that you still have the headache. Or like the ticking of a clock that you don't hear until you turn the TV off and everything else is quiet.  The headache/ticking/legs were there the whole time and didn't go away, you just had your attention successfully distracted elsewhere for a while. This is why restless legs can be such a problem when trying to go to sleep; the more your mind relaxes and clears of distractions, the more difficult it is to ignore the more obvious leg sensations. I'll often be right on the point of sleep and suddenly need to jerk my legs because the leg sensations spreads over my otherwise blank mind and wakes me up from the half-doze.

Things that will sometimes (not always) fix my legs enough for me to get to sleep, in the hopes it may help others find something that works for them:

• Cautious rehydration - too much water at once when dehydrated will make my stomach complain and then indigestion causes the legs instead.
• Working on my calf muscles. Massage, calf stretches, heel drops with my toes on a step.
• Doing quad stretches for my thighs, which affects the sensations in my calves.
• Stretching or cracking my hip joints, which affects the sensations in my calves.
• A short walk. Too long and my muscles will get too excited and will cause the legs instead.
• A small amount of apple cider vinegar sometimes relieves my indigestion enough, but sometimes just adds to my indigestion instead with an acidic feeling.
• An apple can help my indigestion occasionally, but sometimes will make me overfull instead without helping.
• Dozing on the couch. Giving myself permission to not sleep properly means that I can catch just enough rest to help out.
• Very soft baroque music. Loud enough to hear, not loud enough that I start listening to it. It gives my brain another background focal point to help offset the demanding legs, while being a slower beat that encourages sleep.
• Ibuprofen. In years past I just about lived on this type of painkiller at times. They are not good for your internal organs though, so I cut back and now only use them when my legs are extra bad.
• Eating a banana can work in minutes. (suggested by moeyz)
• Stand & roll your bare feet (one at a time) on a tennis ball, which releases some lymphatic juices. (suggested by moeyz)
• Take magnesium (with your doctor's knowledge) about 2 hrs before sleep. (suggested by moeyz)
• Tonic water, because of the quinine in it. Using tonic water too often can cause a prolonged high sugar trigger though.

 

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If you have further triggers or fixes that sometimes work for you, let me know and I'll add it/quote you. I will also add more of my own if I think of more.