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Restless Legs Syndrome and Sleep: 5 changes to try for better sleep if you have RLS

Restless legs syndrome (RLS) steals sleep. It's usually worst in the evening and overnight, which can mean little rest and fatigue the next day.

"Most people with RLS have fragmented sleep, with difficulty falling asleep and repetitive jerking motions that can wake them up," says neurologist Nancy Foldvary-Schaefer, DO, director of the Cleveland Clinic's Sleep Disorders Center.

The good news, she says, is that many people with RLS respond to simple treatments -- and that can mean better sleep.

Here are five simple changes to try:

1. Rethink your bed.

Eugene Jones of Westlake Village, Calif., has had RLS for 35 years -- nearly half his life. Though it can disrupt his sleep, he and his wife, Joyce, still wanted to share a bed.

So they found a way to make it through most nights together, despite Jones' leg movements: They bought a king-sized bed consisting of two mattresses, one for each of them.

Now, "If he moves a lot or kicks, or gets up, it does not move my side of the bed," Joyce Jones says. "It really does help."

2. Move before bedtime.

What you do in the hours before going to bed could help you sleep better.

"Mild exercise in the later afternoon or early evening -- but not too close to bedtime -- can make symptoms somewhat better, as can doing something that keeps you alert and engaged," says neurologist Alon Avidan, MD, MPH, director of the UCLA Sleep Disorders Center, who is treating Jones.

Gardening, for example, helps some of Avidan's patients. Jones' solution on sleepless nights includes going for a walk, or calming his body by taking a hot shower or bath. "That often helped enough to get back to sleep," Jones says.

3. Time your medications.

"You need to treat before the onset of symptoms,” Foldvary-Schaefer says. "If you know your symptoms begin around dinner time, take your medications a little earlier. Don't wait until bedtime. You absolutely have to tailor when you take them to what works for you."

It's also important to go over all your medications with your health care provider. Some drugs -- such as anti-nausea medications, some antidepressants, and antipsychotic drugs -- can cause or worsen RLS symptoms.

If you take a drug to help treat your RLS, it may take some trial and error to find the one that works best for you. Foldvary-Schaefer says that patients can respond quite differently to medications. Many respond to the first dose, and a good number stay on the same medication for years. Others need to switch medications more often.

"After a year or two, they may no longer respond to what they are on, so I rotate them off it and try something else for a while," she says.

4. Cut out alcohol, caffeine, and nicotine.

They're known to worsen RLS symptoms, Avidan says.

He also advises his patients not to eat aged cheese because it contains high amounts of tyramine, an amino acid that can trigger symptoms.

5. Engage your mind.

Jones finds that his RLS symptoms often improve when he concentrates on doing something like building a model ship or flying a remote control toy helicopter. 

And when he can't sleep, he often gets out of bed and heads to his computer in another room, or goes for a drive.

Now, with medication and lifestyle adjustments, RLS takes much less of a toll on Jones' sleep.

"I can get through the night most nights," Jones says. "The symptoms come on about two nights a week now, and they are much milder than they used to be."