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Restless Legs Syndrome
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Sleeping Problems (Home) > Restless Legs Syndrome > Restless Legs Syndrome Treatment
Restless Legs Syndrome: Diagnosis, Treatment and Prevention
Diagnosis
A formal diagnosis for Restless Legs Syndrome (RLS) depends on existence of the symptoms for RLS.
Complications / Issues
In addition to a disturbed sleep for the Restless Legs Syndrome (RLS) sufferer and their family / partner, RLS can also be a cause of insomnia and Excessive Daytime Sleepiness (EDS).
Treatment
The treatment(s) for Restless Legs Syndrome (RLS) are based on how disruptive the symptoms are, and include:
Lifestyle Changes
Primarily, all Restless Legs Syndrome (RLS) sufferers should review their lifestyle and see what changes could be made to reduce or eliminate their RLS related symptoms.
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Random Sleeping Tip |
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| It is really important that we have a proper environment to sleep at night. There are a lot of people saying that they are unable to sleep and that can be because they lack the proper environment to sleep in and that can be related to the presence of light in the room or the light entering your room from a distant source of light. Therefore it is really important that you keep your room free from light and that will initiate sleep at a very fast pace. |
These lifestyle changes include:
- Exercise: includes finding the right level of exercise - too much worsens RLS while too little may trigger it. Walking, stretching, yoga, cycling, and other physical activity may also help relieve the symptoms of RLS. Eliminating caffeine, smoking, and alcohol.
- Dietary Changes: to eliminate foods that trigger RLS. These are different for each person, but may include eliminating sugar, triglycerides, gluten, sugar substitutes, and following a low-fat diet.
- Maintaining good sleep hygiene: However, most RLS can reduce their episodes by following good sleep hygiene practices:
- Exercise regularly (but not too close to bedtime)
- Ensure that they get enough sleep
- Keep a regular sleep diary
- Reducing stress levels in their lives
- Medical Conditions: Treating any medical conditions that are known to cause Secondary RLS, such as iron deficiency, folate deficiency, uremia, diabetes, thyroid problems, peripheral neuropathy, and certain auto-immune disorders, such as Sjogren's Disease, Celiac Disease, and Rheumatoid Arthritis. .
- Medications: avoiding or stopping over-the-counter or prescription drugs that trigger RLS, such as anti-nausea drugs, certain antihistamines (which are often contained in over-the-counter cold medications), drugs used to treat depression (both older tricyclics and newer SSRIs), antipsychotic drugs, and certain medications used to control seizures.
- Nutrient Supplements: adding various supplements to your diet can reduce the symptoms of RLS, such as magnesium, B-12, folate, vitamin E, and calcium.
- All people with RLS should have their ferritin levels tested. They should be at least 50 mcg for RLS sufferers. Oral iron supplements, taken under a doctor's care, can increase ferritin levels. For about 50-60% RLS sufferers, increasing their ferritin levels will eliminate or reduce the symptoms of RLS, however the remainder will not notice any improvement in their condition. Many people with RLS do not have low ferritin levels.
- Please Note: It is dangerous to take iron supplements without first having your ferritin levels tested, as an excess of iron in the body can cause hemochromatosis, a very dangerous condition.
- Heat or Cold: such as a hot or cold bath, a heating pad, or a fan can also relieve the symptoms of RLS.
- Active Mind: keeping your mind active by doing crosswords and puzzles, playing computer games, etc can help relieve the symptoms of RLS.
- Compression: wearing compression stockings, tight pantyhose, or wrapping the legs in ace bandages can help relieve the symptoms of RLS.
Medications
For those whose cannot be managed by lifestyle changes alone, or where the symptoms of RLS are more severe and the RLS sufferer is constantly having disrupted sleep or disrupted daily activities, medical treatments may be required.
Doctors currently use the Mayo Clinic Algorithm to treat RLS, which involves prescribing medications from four categories:
- Anticonvulsant agents: These medications reduce muscle contractions in some people, and often help people who experience the painful sensations during episodes. Gabapentin (Neurontin) is one of the most widely anticonvulsant drugs in the treatment of Periodic Limb Movement Disorder (PLMD) and Restless Leg Syndrome (RLS).
- Benzodiazepines: These drugs suppress muscle contractions and assist in staying asleep and reducing awakenings from the movements. They are also sedatives and help you sleep through the movements. Clonazepam (Klonopin) is one of the most widely used benzodiazepines to treat Periodic Limb Movement Disorder (PLMD) and Restless Leg Syndrome (RLS).
- Dopaminergic agents: These drugs are used to increase the levels of an important neurotransmitter (brain chemical) called dopamine, which is important in regulating muscle movements. These medications are effective in some people, but not in others. Levodopa / carbidopa combination (Sinemet), ropinirole, pramipexole (Sifrol in the US, Mirapexen in the EU), and pergolide (Permax) are commonly used medications for Periodic Limb Movement Disorder (PLMD) and Restless Leg Syndrome (RLS).
- Opioids: such as propoxyphene, oxycodone, or methadone.
Please Note: many of the medications used to treat RLS are the same as those used to treat Periodic Limb Movement Disorder (PLMD). There is also strong anecdotal evidence that medical marijuana use alleviates the symptoms of RLS, although studies are lacking because of governmental restrictions.
Another dopamine agonist, rotigitine which is delivered via a transdermal patch, is currently in approval process for treating RLS by the US FDA and EU Scientific Committee.
Dopamine agonists may cause augmentation. This is a medical condition where the drug itself causes symptoms to increase in severity and/or occur earlier in the day. Dopamine agonists may also may cause rebound, when symptoms increase as the drug wears off.
Prevention
- Primarily, all Restless Legs Syndrome (RLS) sufferers should review their lifestyle and see what changes could be made to reduce or eliminate their RLS related symptoms.
- If the Restless Legs Syndrome (RLS) is caused, triggered, or aggravated by existing medical condition(s), then treatment of these conditions can reduce or eliminate the symptoms of RLS.
- If the Restless Legs Syndrome (RLS) are caused, triggered, or aggravated by some form of nutritional deficiency, then tending to this deficiency can reduce or eliminate the symptoms of RLS
For other causes or triggers for Restless Legs Syndrome (RLS), various treatments are available to prevent or reduce the onset of the symptoms, especially in severe cases.
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