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Restless Legs Syndrome Center

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Restless Legs Syndrome and Sleep

4 Changes to Try for Better Sleep if You Have RLS
WebMD Feature

Restless legs syndrome (RLS) steals sleep. It's usually worst in the evening and overnight, which can mean little rest, and fatigue the next day.

"Most people with RLS have fragmented sleep, with difficulty falling asleep and repetitive jerking motions that can wake them up," says neurologist Nancy Foldvary-Schaefer, DO, director of the Cleveland Clinic's Sleep Disorders Center.

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What Causes Restless Legs Syndrome (RLS)?

The specific causes of restless legs syndrome (RLS) are not known. Disease in the blood vessels of the legs or in the nerves in the legs that control leg movement and sensation was once thought to cause RLS, but both of these suggestions have been rejected. RLS may be related to abnormalities in brain chemicals (neurotransmitters) that help regulate muscle movements, or to abnormalities in the part of the central nervous system that controls automatic movements. Research is still being done in these...

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The good news, she says, is that many people with RLS respond to simple treatments -- and that can mean better sleep.

Here are four simple changes to try:

1. Move Before Bedtime

What you do in the hours before going to bed could help you sleep better.

"Mild exercise in the later afternoon or early evening -- but not too close to bedtime -- can make symptoms somewhat better, as can doing something that keeps you alert and engaged," says neurologist Alon Avidan, MD, MPH, director of the UCLA Sleep Disorders Center.

Gardening, for example, helps some of Avidan's patients. One of them, Eugene Jones of Westlake Village, CA, goes for a walk or calms his body by taking a hot shower or bath. "That often helped enough to get back to sleep," says Jones, who has had RLS for 35 years, nearly half his life.

2. Time Your Medications

Take them before your symptoms act up, Foldvary-Schaefer says. "If you know your symptoms begin around dinner time, take your medications a little earlier. Don't wait until bedtime. You absolutely have to tailor when you take them to what works for you."

It's also important to go over all your medications with your health care provider. Some drugs can cause or worsen RLS symptoms.

If you take a drug to help treat your RLS, it may take some trial and error to find the one that works best for you. People can respond quite differently to medications, Foldvary-Schaefer says. Many respond to the first dose, and a good number stay on the same medication for years. Others need to switch medications more often.

"After a year or two, they may no longer respond to what they are on, so I rotate them off it and try something else for a while," she says.

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