Sleep is elusive for many women in menopause. You’re exhausted, desperate to get just a few hours of uninterrupted sleep; you start to drift off at last, when suddenly leg pain starts… Tingling, then pins-and-needles, then throbbing, then an overwhelming urge to move your leg, which brings relief, for maybe a minute against these painful symptoms, until the whole thing starts again.
According to the National Institutes of Health, Restless Leg Syndrome (RLS) affects up to 10 percent of adults in the US, and it’s more common in women than men. It’s also more common in older people, which unfortunately means a lot of sufferers are women in menopause.
RLS sufferers generally report unpleasant sensations in the leg – tingling, electric shock, itching, crawling, throbbing, muscle cramps – plus an irresistible urge to move. It may affect both legs or just one. It may move from one leg to the other, and for up to 80 percent of RLS sufferers, it’s accompanied by the jerking or twitching of legs and arms, known as PLMS or periodic limb movement of sleep.
Restless Legs Syndrome is classified as a “sleep disorder” because symptoms generally start in the evening and worsen through the night. Obviously, restless leg syndrome can have a huge impact on the quality and quantity of sleep.
Moving generally relieves the symptoms temporarily, meaning someone with RLS may feel compelled to shift positions constantly or even get up and walk around. Many find that symptoms disappear for a time in the very early morning, allowing for at least a little sleep – that is, if you don’t have other issues keeping you awake.
Like so many neurological disorders, the exact cause isn’t well understood. It can be genetic; in fact, in most cases in which symptoms show up before age 40, there’s a genetic component.
It’s possible that RLS is caused by the part of the brain that controls movement – the basal ganglia. If that area cannot utilize the brain chemical dopamine properly, the disruption could cause the sensations and involuntary movements of RLS.
Other factors that may contribute to the development of RLS include:
How could perimenopause or menopause be a factor?
Many women in perimenopause who suffer heavy bleeding may have an iron deficiency, so that could contribute. Also, it’s thought estrogen helps muscles relax, so as estrogen declines, we lose that natural relaxant. You may need to do hormone therapy. Some simple blood tests can quickly confirm if you are experiencing hormone imbalances.
If you are not sure if you are menopausal consider if you are experiencing any of the more well know menopausal symptoms like mood swings, hot flashes, or vaginal dryness. If you are clearly showing these common symptoms of menopause the chances are high this is also affecting your RLS.
Now that you know what it is, how can you treat your restless leg syndrome and stop your leg pain? The first things to look at may include the list of “other factors” above – are you taking any of the medications, nearing the end of a pregnancy, or getting enough iron? When those conditions change, you may find your RLS goes away.
Diabetes is also a related condition that can worsen RLS, so if you have other risk factors for diabetes, you might want to be tested. If you’ve been diagnosed, check with your doctor to be sure it’s being managed correctly.
If none of those are causing your RLS, there are things you can do. As ever, we suggest lifestyle changes first:
Increasing both of these supplemental vitamins can help. Magnesium supplements help muscles relax, and it’s possible some cases of RLS are triggered (or worsened) by a magnesium deficiency. Both supplements can cause digestive upset, so talk to a doctor, add them carefully, and try to increase your intake primarily through food.
A poor diet can negatively affect your body in many ways. If hormone changes may be affecting RLS (aka low estrogen levels), adding back some estrogen via food may help with muscle aches. Registered Dietitian Krista Haynes suggests legumes, flaxseed, and alfalfa sprouts for a more balanced diet. Calcium-rich foods, like green leafy vegetables, may help muscles relax as well. Ms. Haynes also suggests having lavender essential oils nearby at bedtime to provide further relaxation.
Exercise moderately and not too close to bedtime. Excessive exercise can worsen RLS, but gentle exercise such as walking at a normal pace can bring some muscle tension relief. Adding in any type of exercise will lead to a more healthy lifestyle overall which could help you with other issues as well.
Be good about sleep habits. Known as “sleep hygiene,” having healthy, regular habits around bedtime can help calm you and prepare your mind and body for sleep. This can be difficult if you are experiencing post-menopausal night sweats or have some sort of sleep disorder.
Stretching has been shown to help RLS sufferers. RN Mary Ann Wilson has some great RLS stretches, especially for those of us who spend most of our day stuck at a desk. Yoga may also provide relief.
Reduce or reject caffeine, alcohol, nicotine. Studies have shown that all three of these can worsen a whole lot of menopause symptoms, so as hard as it may be to lessen intake or give them up entirely, you might find a decent night’s sleep is worth it.
Take a warm bath. Get a massage. Sometimes the best care is self-care, so consider indulging yourself in some calming comfort.
A Restiffic foot wrap. This adjustable foot wrap may help reduce symptoms by targeting pressure points on foot muscles. According to Berkeley Wellness, researchers thought that pressure on the foot would signal the brain to relax leg muscles. They claim on their site that through gentle manipulation of the feet, restiffic relief may reduce anxiety, relieve stress, ease foot pain, and improve blood flow and sleep. The wrap has only undergone small studies, so more research is needed to determine if the Restiffic is truly effective.
Tracking. Some sufferers have reported that keeping a sleep diary to help track triggers and successful strategies really helps them to manage the condition.
If none of the suggestions above work, it may be time to consider medicine. Helpful medications are available, so if you do all of the above and find you’re still suffering, it’s a good idea to talk to your healthcare provider.
Mayo Clinic lists Requip, Neupro, and Mirapex (dopamine agonists) as possible options. Other medications known as “dopaminergic” drugs (Sinemet) affect the levels of dopamine in your brain. However, there are concerns about the phenomenon known as “augmentation,” or the worsening of RLS symptoms after long-term use of some dopaminergics. Be sure to ask your doctor about the risks versus the benefits.
Other medications that may work are sedatives to help you stay asleep, regardless of your RLS symptoms. Anticonvulsants such as gabapentin have been shown to provide some relief, as have opioids. Opioids, however, are very addictive, so they may only be prescribed for a short time and for those with extreme symptoms.
There is no “cure” for RLS, and symptoms may worsen with age. However, a combination of healthy lifestyle choices plus medications, if necessary, may lessen the symptoms enough to allow you to sleep.
This article was originally posted on genneve.com.