October 4, 2018

Know Your Triggers

A trigger is a stimulus that causes a worsening of your RLS. Certain foods, beverages, medicines, excessive stress or exercise can be the source of a trigger. Triggers can vary from one person to another and even among members of the same family. For example, caffeine may be a trigger for one person but not another. All individuals with RLS can benefit from learning what triggers their RLS in order to avoid these substances.

Some common RLS triggers reported by individuals with RLS include:

Caffeine
Smoking
Alcohol
Carbohydrates and refined sugars
Foods high in sodium
Extreme exercise
Emotional stress
Supplements
Over-the-counter medications
Prescribed medications

Sleep Habits

Sleep deprivation is known to worsen RLS symptoms. Good sleep habits such as maintaining a cool, dark sleeping environment, removing electronics from the bedroom to limit exposure to blue light and adhering to a schedule of bed and wake times are key to a restful night’s sleep.

Medications

It is important to be knowledgeable about medications that are acceptable for use and those best avoided by individuals with RLS. Many prescribed and over-the-counter medications are known to aggravate RLS symptoms. The RLS Foundation Medical Alert Card lists important information about these medications on a small card that fits into your wallet so you can easily share it with your doctor, hospital and family members. Diphenhydramine (Benadryl) is an antihistamine commonly found in cold remedies and sleep aids; any over-the-counter medication containing diphenhydramine should be avoided. Decongestants like pseudoephedrine (Sudafed) can severely disrupt sleep for those with RLS. Contrary to popular belief, melatonin may worsen symptoms because of the serotonergic properties (serotonin regulates sleep, mood and appetite) found in the medication. St. John’s Wort, an herbal supplement believed to help with depressive symptoms, can cause a flare up of RLS symptoms in some individuals.

Drugs in the antipsychotic (haldol and seroquel), anti-nausea (phenergan and compazine) and antidepressant (mirtazapine) medication classes are often the culprit for a worsening case of RLS. You should never discontinue use of a medication without consulting your healthcare provider, the RLS Foundation’s Medical Bulletin contains suggestions for safe alternatives to these medications to share with your physician. If you have an upcoming surgery, it is helpful to alert your surgical team to which medications they should avoid so they are prepared.

Although certain medications may be hard to avoid, it is crucial to be vigilant about the ingredients in any of the medications you take. No one knows your RLS triggers better than you; not even your healthcare provider. When you are knowledgeable about your own triggers, you can avoid those substances before they worsen your RLS!

An Introduction to Yoga: An RLS Coping Strategy with Many Health Benefits

This is an excerpt from the summer 2017 edition of NightWalkers, the Foundation's quarterly magazine. To get your subscription to NightWalkers and to enjoy other benefits, become a member of the Restless Legs Syndrome Foundation today!

In 2016, a study conducted by the Yoga Journal and Yoga Alliance found that 36.7 million Americans practice yoga – an 80 percent increase from 2012. Of these individuals, 74 percent have been practicing for five years or less (1). Yoga is an ancient discipline that focuses on meditation, concentrated breathing and body postures. The health benefits of yoga are many. A sustained practice can lead to lower blood pressure, improved lung capacity, relief from chronic neck and back pain, and decreased anxiety.

For those with RLS, stretching can be an important tool in alleviating symptoms. Many RLS patients find that 30 minutes of mild to moderate exercise per day can help keep their RLS at bay. (Note: Avoid intense exercising before bedtime, as that has been known to exacerbate RLS symptoms.) (2) Yoga incorporates both stretching and exercise, and can be a valuable coping strategy to add to one's RLS tool kit.

Yoga has increased in popularity in recent years, making it more accessible than ever. There are now YouTube channels (the above channel, Yoga with Adriene, is just one option of many to choose from) dedicated to providing free online classes – a cheaper and convenient alternative for those with busy lifestyles and a limited budget. However, for the beginner, it is a good idea to initially attend a few in-person classes. This will give you a feel for how you should approach your home practice, and ensure that you are doing the poses properly to avoid injury. Remember to always listen to your body. Everyone is unique and may react differently to various types of stretching. Be particularly careful if you have a chronic condition or injury. You should always consult with your physician before beginning a new fitness regimen, including yoga.

Each individual’s practice is as unique as the person, and can be altered to fit their needs and wants – therein lies the beauty of yoga. Thus, many yogis end their practices with a calming word: "Namaste" – “The light in me acknowledges the light in you.”

For more lifestyle considerations for your RLS, visit our website.

---

1. Yoga Journal and Yoga Alliance. January 2016. “2016 Yoga in America Study.”

2. Aukerman MM, et al., 2006. “Exercise and restless legs syndrome: a randomized controlled trial.” J Am Board Fam Med. 19(5): 487–93

Important Tips to Help with Your Sleep Cycle

For RLS sufferers, it is oftentimes nearly impossible to fall and stay asleep. Many have reported to the Foundation that they get as little as 2-4 hours of sleep per night. When the recommended amount of sleep is 7-9 hours each night, such little sleep can have debilitating effects on waking life.

However, it is recommended for those with RLS to get at least 30 minutes of exercise a day, as regular exercise can significantly improve and stabilize the sleep cycle. Studies from the National Sleep Foundation have continuously shown us that:

1. Exercise reduces stress and tires us out, allowing us to have a longer and better quality sleep
2. Sleep disorders like insomnia, sleep apnea, restless legs syndrome, and narcolepsy cost millions in medical costs and disrupt work and social lives
3. Those that exercise report getting a better quality of sleep than those who do not, and are less likely to have sleep issues

Exercise in the early hours of the morning or afternoon can have a positive effect on the natural circadian rhythm, or "sleep-wake cycle." Exercise raises the body's temperature for roughly four to five hours before gradually falling, thus helping one feel sleepy in the evening around bedtime. However, it is important to note that especially for RLS sufferers, rigorous exercise before bed should be avoided, since it can stimulate the brain and prevent one from falling asleep.

Meditation, yoga or light stretching are great options for easing RLS symptoms before bed, as they can help settle both the mind and body. Additionally, the Foundation's Sleep Diary is a great resources to help find sleep cycle patterns and potential RLS triggers.

Other suggestions for getting a good night's sleep include avoiding technology before bed, sticking to a consistent schedule and cultivating a relaxing evening ritual for yourself. Remember to refrain from any activity that your doctor has specifically told you to avoid. Read more about healthy lifestyle habits for RLS sufferers on our website.

Check out the original article about sleep and exercise and its great infographics at CapeCod.com.