Restless Legs Syndrome and Related Disorders - Treatment

Highlights	Complications	Resources
Introduction	Diagnosis	References
Causes	Treatment
Risk Factors	Medications

Treatment

The initial approach to a patient who complains of sleeplessness and restless legs syndrome is a nondrug one that aims at improving sleep and eliminating possible causes of RLS. A nondrug approach is a particularly important first step in elderly patients:

The doctor should first try to treat any underlying medical conditions that may be causing restless legs.
If medications may be causing RLS, the doctor should try to prescribe alternatives, if possible.
If the cause cannot be determined, it is best to try sleep hygiene and relaxation methods, which are described below. Such approach provides added benefits, even if drug therapy is later required.

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Possible Helpful Tips

Some people report help or relief from RLS with the following behaviors or devices:

Hot baths or cold compresses.
Ergonomic measures. For example, patients might find it useful to work at a high stool, where they can dangle their legs. In meetings or during air travel, it is helpful to obtain an aisle seat.
Changing sleep patterns. Some patients report that symptoms don't occur if they sleep late in the morning, so, if feasible, changing sleep patterns may also be helpful.
Avoiding caffeine, alcohol, and nicotine.

Alternative treatments that are sometimes advocated for RLS include acupuncture and massage. These treatments, however, have not been rigorously studied.

Vitamins and Minerals

The following may have some benefit:

Some people report that vitamin E (800 to 1200 IU per day) may help.
Calcium, magnesium, or potassium supplements have helped some people.
People who have folate deficiencies should take supplements of folic acid. This is particularly important during pregnancy.

Folate (folic acid) is necessary for the production of red blood cells and for the synthesis of DNA (which controls heredity and is used to guide the cell in its daily activities). Folic acid also helps with tissue growth and cell function. In addition, it helps to increase appetite when needed and stimulates the formation of digestive acids.

Dietary Iron

Because RLS is associated with iron insufficiency, people with the condition should be sure they have a diet that provides iron. Iron found in foods is either in the form of heme or non-heme iron:

Heme Iron. Foods containing heme iron are the best for increasing or maintaining healthy iron levels. Such foods include (in decreasing order of iron-richness) clams, oysters, organ meats, beef, pork, poultry, and fish.
Non-Heme Iron. Non-heme iron is less well absorbed. About 60% of the iron in meat is non-heme (although meat itself helps absorb non-heme iron). Eggs, dairy products, and iron-containing vegetables have only the non-heme form. Such vegetable products include dried beans and peas, iron-fortified cereals, bread, and pasta products, dark green leafy vegetables (chard, spinach, mustard greens, kale), dried fruits, nuts, and seeds.