Why does Restless Leg Syndrome (RLS) get worse at night?

Dopamine activity and brain iron availability naturally decline after 9 pm, while fatigue and stillness intensify uncomfortable leg sensations. Evening caffeine, nicotine, alcohol, and certain medications can intensify symptoms further. Before we dive into the details, let's see what Restless Leg Syndrome (RLS)? is.

What is RLS?

RLS, also known as Willis-Ekbom disease, is a common condition that causes intense urges to move the legs. A person may feel a tingling or unpleasant crawling sensation on the skin, which temporarily gets better after moving the limbs. Although it is not painful, it can lead to sleep disturbances.

What causes nighttime RLS?

The exact cause of RLS getting worse at night is not known. The possible theories are:

Fatigue: When they are tired, people with RLS sometimes notice their symptoms get worse. This may be why symptoms get worse when they are sleepy or at the end of the day.

Neurotransmitters: Dopamine dysregulation is connected to RLS. As part of a person’s circadian rhythm, neurotransmitter levels naturally change over the course of the day and night, and this may influence symptoms.

Rest: A 2023 review of medical literature notes that in some studies, researchers have found that RLS gets worse when people are sitting or lying down, no matter what time of day it is. This suggests rest may play a role in RLS symptoms as well as the time of day.

Managing nighttime RLS

There is no need for any treatment if it is mild RLS. You can reduce or manage the symptoms by avoiding triggers like evening caffeine or nicotine, or stopping consumption completely. It is best not to work out close to bedtime so that the body is relaxed. Taking a bath or reading can calm you before sleep.

Some people find that massaging the legs eases symptoms. If RLS is owing to nutritional deficiencies, you can get a blood test to determine the cause. A healthcare provider will be able to give supplements to address the cause or suggest making dietary changes. For those with iron deficiency, it may help to take vitamin C with iron to increase the body's absorption of iron.

In some cases, people with diabetes are shown to have RLS symptoms. Treating the condition may not cure RLS, but it can help prevent it from getting worse. For a treatment plan, it is better to speak with a certified medical practitioner.

—manuvipin@newindianexpress.com

@ManuVipin

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