Identifying Restless Legs Triggers

Medications may be most effective for severe RLS, but identifying and avoiding things that aggravate your symptoms can also help, especially in mild or moderate cases. Here are some common restless legs triggers, plus tips to help you overcome them and get some sleep:

• Stress and anxiety.Rachel Salas, MD, an assistant professor of neurology at the Johns Hopkins University School of Medicine in Baltimore, says that stress and anxiety are big restless legs triggers. Stress reduction techniques like deep breathing or yoga may help.
• Nicotine.If you need another reason to stop smoking,calming your restless legs is a good one. Talk with your doctor if you think you need help quitting.
• Alcohol.Many people with RLS report that drinking can lead to more restless legs symptoms. Although alcohol can help people fall asleep quickly, it interferes with the quality of sleep and can make sleep apnea worse , says Alon Avidan, MD, MPH, an associate professor of neurology and director of the Sleep Disorders Clinic at UCLA. Try omitting alcohol to see whether your restless legs improve and whether you feel more rested in the morning.
• Vigorous exercise.Getting moderate exercise during the day can help ease restlessness at night. Butvigorousexercise, especially close to bedtime, can have the opposite effect in some people.
• Medications.A number of medications can make RLS worse. In particular, anti-nausea drugs and sedating antihistamines (like Benadryl) block the brain’s dopamine receptors, causing restless legs symptoms. Antidepressants that increase serotonin and antipsychotic medications can also aggravate the condition. Let your doctor know if your restless legs symptoms worsen after you take a new medication. A change in dosage or to a different medication may do the trick.
• Caffeine.Because caffeine is a stimulant, it can interfere with sleep if it’s consumed too close to bedtime. It’s long been on the list of restless legs triggers, but Dr. Salas says recent research shows it may not be that big of a problem. In fact, she says, it may be beneficial in some people. Try cutting out coffee, tea, colas, sports drinks, and even chocolate to see if your symptoms improve or worsen.

Other health conditions can also cause restless legs. This is what’s called secondary restless legs syndrome :

• Pregnancy.According to Dr. Avidan, about 20 percent of pregnant women report restless legs symptoms. This is more likely in the last three months of pregnancy, and iron deficiency is usually the culprit. If symptoms crop up when you’re expecting, your doctor will probably test the level of iron in your blood and prescribe iron supplements if it’s too low. The good news is that your restless legs symptoms will probably go away soon after you have your baby.
• Medical conditions.Restless legs symptoms are also seen in some people with kidney failure and diabetes. Treating these conditions will often calm the restless legs.

The Restless Legs Syndrome Foundation suggests using a sleep diary to pinpoint your personal triggers and gauge the severity of your symptoms. Always tell your doctor if your symptoms get noticeably worse.