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What do we know about restless legs syndrome in the post-reproductive years? What might cause it, and how can we treat it? I’ve been having bouts of “jimmy legs,” as my grandma used to call it, at night, and I’m wondering if this is just my genetic fate or if there are lifestyle changes I can make to reduce them. I’m already taking a magnesium supplement. Thanks!
—Ana
Grandmas have the best names for things. But restless legs syndrome (RLS) is not so fun. Just as you are drifting off to sleep, the overwhelming urge to move your legs becomes too strong to ignore. So you move them, which helps temporarily, but by the time you have settled back down, you feel you need to move again.
RLS is very common. It affects between 5% and 15% of adults. We don’t understand what causes it, but genetics does seem to play a role. Upward of 60% of patients with the syndrome have a family history of it too. Despite the fact that it is common in pregnancy, there is no clear hormonal link.
However, iron deficiency is associated with symptoms of restless legs. And it is possible to have increased symptoms due to low iron even if you don’t have anemia. The thinking is that when iron stores in the brain are low, symptoms are more likely to occur. As a result, one thing you should do is talk to your doctor about checking your ferritin levels. Ferritin is a protein that stores iron, and as a result it reflects how much iron your body is storing, not just how much iron is circulating in your blood right now. If your ferritin is below 50 nanograms per milliliter, you should talk to your doctor about how best to bring these levels up.
Some patients are able to pinpoint triggers, like caffeine and alcohol, and then avoid those triggers. Doctors often recommend other lifestyle changes, like exercise that uses the legs, or distracting yourself with mentally challenging work like crossword puzzles (though I am not sure how you are supposed to do puzzles and fall asleep at the same time). The data for those interventions often comes from extremely small studies like this one regarding the efficacy of exercise, which included just 28 patients. There is no data suggesting that supplements such as magnesium are helpful.
If your iron levels are normal and you can’t pinpoint any triggers and restless legs are keeping you up at night, you should talk to your doctor. There are medications that can be taken on an as-needed or daily basis depending on how often you have symptoms, so that you can get to sleep.
The takeaway: Despite the fact that restless legs syndrome is more common in pregnancy, it does not seem to be a hormonal phenomenon. It is often hereditary, but making sure your iron levels are normal and looking for possible triggers, like caffeine or alcohol, may be helpful.
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I have had bad restless legs for most of my adult life, so I’m so sorry you’re experiencing this! In case it helps, in the middle of the night when it happens, if I stand up and move/pace the room for around 3 to 5 minutes, it usually makes it go away. For prevention, I have found that moderate exercise really helps. Too much can make it worse though! And finally, this is strange, but eating a few dried apricots every day has reduced my RLS dramatically. Good luck!