What is Restless Leg Syndrome?
Restless leg syndrome (RLS) can also be known as Willis Ekbom disease and is linked to involuntary movements and the urge to move. This is very common and affects 1 in 10 of adults. RLS can occur any time of life. Women are more prone to RLS and there is a link to pregnancy, where RLS can affect 1 in 5 pregnant women.
The cause is unknown but there is a potential link to issues with dopamine pathways. Dopamine reduces during the day and this may explain why people feel more effects at night. RLS is also hereditary. Most cases of RSL are not linked to health issues, but some people with health issues including anaemia, fibromyalgia, kidney disease, ADHD, underactive thyroid, and diabetes can also experience secondary restless leg syndrome.
What are symptoms of restless leg syndrome?
Symptoms can feel like any of the following:
- Urge to move legs, often worse in evenings and whilst in bed
- Involuntary movements of legs and sometimes arms
- Crawling sensation on the legs and feet.
- Tingling, burning, itching
- Cramping sensation
What causes restless leg syndrome?
RLS can flare up due to a variety of triggers, often related to lifestyle, diet, and underlying health conditions. Common factors that can cause flare-ups include:
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Lack of Sleep or Fatigue: Poor sleep or sleep deprivation can worsen RLS symptoms, as fatigue tends to exacerbate the sensation of restlessness in the legs.
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Caffeine, Alcohol, and Nicotine: These stimulants can disrupt nerve function and increase the frequency or intensity of RLS symptoms. Reducing or avoiding these substances may help decrease flare-ups.
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Iron Deficiency: Low levels of iron in the body, or iron deficiency anemia, can contribute to RLS symptoms. Ensuring proper iron intake, either through diet or supplements (under medical guidance), may help reduce flare-ups.
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Medications: Certain medications, such as antihistamines, some antidepressants, and antipsychotic drugs, may worsen RLS symptoms. If you suspect your medication is causing flare-ups, consult your doctor for alternatives.
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Stress and Anxiety: Emotional stress and anxiety can make RLS symptoms worse, especially during times of heightened stress. Practicing relaxation techniques like yoga, meditation, or deep breathing may help manage stress and reduce flare-ups.
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Sedentary Lifestyle: Long periods of inactivity, such as sitting or lying down for extended periods, can trigger or worsen RLS symptoms. Regular physical activity and stretching can help alleviate symptoms.
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Pregnancy: RLS is common in pregnant women, particularly in the third trimester, likely due to changes in hormones and iron levels. Symptoms often improve after delivery.
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Certain Medical Conditions: Conditions like diabetes, kidney disease, and peripheral neuropathy are associated with RLS. Managing these conditions may help reduce the frequency and severity of RLS flare-ups.
Addressing these triggers through lifestyle modifications, dietary changes, and consulting a healthcare provider can help manage RLS symptoms and reduce the frequency of flare-ups.
What is a naturopathic approach to RLS?
Those who experience restless leg syndrome with unrelated health issues may find simple lifestyle changes can help enormously. Disruption in sleep can cause other health issues, so it is important to address this by changing sleeping habits and finding ways to reprioritise your sleep.
Sleep hygiene, referring to simple techniques can help with good sleep, start from the moment we wake up. Opening curtains ensures good vitamin D and sunlight reaches us in our room. Bedtime routines aid melatonin production.
To get a good night’s sleep, the body must convert serotonin into melatonin. This process is triggered by darkness which helps induce and maintain sleep. This can be disrupted by computer and TV screen glare, which is why it is recommended not to use electrical devices in the bedroom for at least 1 hour before retiring. Research has also shown that exposure to noise and light during sleep can suppress the immune system as well as disrupt natural sleep patterns. Body temperature should drop prior to sleep and rise again as we wake, so maintaining a cooler room will help to keep a cooler body temperature, which is vital for a good night’s sleep. Creating a light breeze in the bedroom by opening a window or door to allow the air to flow, and wearing loose clothing in bed will also help.
Stress, anxiety, and depression happens to all of us at some time in our adult life and are the most common mental disorders in the UK. Long-term stress and anxiety can cause the adrenal glands to become exhausted, leading to adrenal fatigue, which increases symptoms of fatigue, lack of concentration, mood swings, weight issues, fear, depression, muscle aches, cravings, memory loss, anxiety, and insomnia. It can also affect our dopamine and serotonin pathways and therefore the production of melatonin.
Hydration and good electrolyte balance is also key. Staying hydrated can help prevent restless leg syndrome and leg cramp. When the body is dehydrated it won’t work at its optimum level and this can lead to worsened RLS symptoms. It is also particularly important when in warmer climates as you will be more susceptible to dehydration. You should try to avoid or reduce intake of diuretics such as caffeine and alcohol. Anaemia can also be a contributory factor, so it is important to get your iron levels tested.
Keeping active during the day also exhausts you, preparing for a better night’s sleep. This does not have to be frantic exercise as even a simple walk has shown to help, especially if you walk for a few hours before sleeping. Stretching exercises can also help, and some people have found relief with Yoga or Pilates to help stretch the muscles but also to help relax and calm the mind.
Some medications can make the symptoms of RLS worse for some patients, such as antidepressants, SSRI’s, Tricyclic medications, Antacids. Some medications, such as antihistamines and cold & flu remedies, can even contribute to RLS. If you are concerned, speak to your doctor. Do not stop any medication without your GP’s approval.
How to improve sleep with restless leg syndrome
Improving sleep with Restless Leg Syndrome (RLS) can be challenging, but certain strategies can help manage symptoms and promote better rest. Here are some tips to improve sleep when dealing with RLS:
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Establish a Consistent Sleep Routine: Going to bed and waking up at the same time every day can help regulate your body’s internal clock and improve overall sleep quality. A consistent routine may also help minimize the frequency of RLS symptoms.
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Exercise Regularly: Regular physical activity, especially low-impact exercises like walking, swimming, or yoga, can help reduce the severity of RLS symptoms and improve sleep. However, avoid vigorous exercise late in the evening, as it can worsen symptoms for some individuals.
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Create a Relaxing Bedtime Routine: Engage in relaxing activities before bed, such as taking a warm bath, practicing gentle stretches, or meditating. These activities can help calm the body and mind, making it easier to fall asleep despite RLS symptoms.
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Limit Caffeine, Alcohol, and Nicotine: These substances can trigger or worsen RLS symptoms. Avoid consuming them, especially in the hours leading up to bedtime, to improve your chances of sleeping more soundly.
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Stretching and Massaging the Legs: Stretching your legs before bed or massaging them can reduce the urge to move, helping ease RLS symptoms and promote better sleep.
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Apply Heat or Cold: Some individuals find relief from RLS symptoms by using heating pads or cold compresses on their legs before bed. Experimenting with heat or cold therapy can help you find what works best to calm your symptoms.
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Ensure Proper Nutrition: Low levels of iron, magnesium, or vitamin D can contribute to RLS. Consult with your healthcare provider about testing for deficiencies, and consider adjusting your diet or taking supplements if needed.
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Consider Medication if Necessary: If lifestyle changes aren’t providing enough relief, talk to your doctor about potential medications to manage RLS. Several options, including dopaminergic agents, can help reduce symptoms and improve sleep.
By incorporating these strategies, you can reduce RLS symptoms and improve the quality of your sleep. It’s important to speak with a healthcare provider if symptoms persist or worsen, as they can recommend further treatments tailored to your specific needs.
What is the right diet for RLS?
Changing diet and lifestyle and dealing with associated health issues, such as weight, high cholesterol, high blood pressure, inflammation will all help with RLS. Diabetes and other health issues increase your risk of restless leg syndrome, so it is very important to address this.
Ensure you are consuming a balanced, nutrient-rich diet, full of B-vitamins, especially folic acid, as well as omega 3, Iron, vitamin C, potassium, and magnesium. B vitamins are essential to produce serotonin and melatonin, especially B1, B3 and B6 and Omega 3 fish oils. These are found in salmon and mackerel and are known to both relieve stress and anxiety and to regulate inflammation.
You should also look for foods that help the melatonin cycle and aid sleep, such as foods rich in Tryptophan, found in turkey, fish, nuts, seeds, and bananas.
Avoid a processed foods, sugars, and inflammatory foods. The main aim is to encourage a nutrient-dense diet, higher in fat and protein, to encourage repair and to support good blood sugar balance. It is also important to avoid triggers such as alcohol and caffeine.
What are key supplements and herbs to help with RLS?
Magnesium
Magnesium is responsible for over 300 metabolic processes within the body, including energy metabolism, DNA replication, protein synthesis and detoxification. Despite its long list of health benefits which supports its name as the ‘miracle mineral’, many individuals simply do not get enough magnesium from their diet due to several reasons such as overconsumption of processed foods, poor digestive health, poor soil quality, medication or simply not eating enough magnesium rich foods. Magnesium is found in many molecules and some of these cannot be absorbed or digested well, such as magnesium oxide, which tends to be found in cheaper supplement formulations. The 3 best and most popular forms of magnesium are magnesium glycinate, magnesium citrate and magnesium malate. The best magnesium for general support is magnesium glycinate which is known for great relaxation properties. Magnesium citrate is another bioavailable form which has the added benefit for those who have sluggish bowels as it can help hydrate the stools. Magnesium malate is another great form of magnesium for those with energy or mitochondrial issues.
B Vitamins
These can help with restless leg but are also often missed with a poor diet or a vegan diet. B12 and folate are also needed for good sleep and mental health. You can get good sources of B vitamins from red meat, especially organ meat, leafy greens, beans and pulses and some cereals.
Iron
Anaemia can be a contributing factor for some people with RLS, so it is worth getting your iron levels tested to ensure they are at optimum levels. It is also important to add vitamin C to help with the utilisation and absorption of iron. Vitamin E has also been shown to be beneficial for those with RLS, especially when combined with vitamin C.
Vitamin D
Patients with RLS have been shown to have lower levels of vitamin D. Vitamin D is a very underestimated vitamin which impacts our health in many ways. Vitamin D deficiency can affect our immune system, respiratory system (especially incidences of asthma) depression, heart disease, multiple sclerosis, diabetes and even cancer. Vitamin D helps lower our blood pressure and helps to keep us calm and less anxious. It has even been shown to help the body break down the stubborn fat cells.
All recommendations are intended for informational and educational purposes only. The information and recommendations provided are not intended to be a substitute for professional medical advice from your GP.
