Restless Leg Syndrome Treatments for Seniors
Drug and Non-Drug Therapies for RLS in Older Adults
Aug 25, 2009
Restless Legs Syndrome (RLS) often begins in younger years and worsens with time. Symptoms of RLS and periodic leg movements resulting in insomnia may be controlled through lifestyle changes, drug treatments, or a combination of therapies. Some people may need to try several different approaches before finding one that works. Strategies that worked in the past may become less effective over time, but a change in therapy may improve results.
Non-Drug Treatments for RLS
Physicians may suggest lifestyle changes before trying any medications for RLS, especially if the symptoms are mild. These changes may take time and effort, but some people get relief from symptoms without unwanted side effects, which is particularly helpful for seniors who are at a higher risk for medication complications or who may not be candidates for certain drug therapies due to chronic health conditions.
People with RLS may find it helpful to look at the bedroom environment and to alter nighttime routines if they experience insomnia. Suggestions for lifestyle changes include:
- Create a predictable routine that includes a set time to go to bed and to awaken.
- Try going to bed later and getting up later, if possible.
- Provide a dark, cool, and calm bedroom environment.
- Remove distractions, such as a telephone, computer, or television, from the bedroom.
- Avoid known triggers for insomnia like caffeine, nicotine, and alcohol.
- Stay out of the bed when awake for any extended period of time, if possible.
- Take a warm or cool bath before going to bed.
- Try a mentally stimulating activity, such as a game of chess, checkers, card games, crossword puzzles, or sudoku, shortly before bedtime.
- Massaging the affected limbs may be helpful, but only if safe to do so. Massaging an area with a blood clot can cause life-threatening problems.
- Utilize warm or cold therapy, if appropriate and only under a physician’s supervision. Seniors are at risk for injuries related to warm and cold therapy.
- Incorporate relaxation techniques, such as progressive relaxation, guided imagery, and breathing exercises, when preparing to sleep.
Incorporating healthy daytime routines may help people with RLS, including:
- Eat a healthy diet.
- Underlying causes, like diabetes, ADD, and renal disease, should be treated first.
- Nutritional deficits, such as anemia due to low iron levels and electrolyte imbalances, such as low magnesium levels, may worsen symptoms. Treatment with supplements such as vitamin B, magnesium, or folate should be under physician supervision. Blood samples may be checked to see if these levels are within normal ranges.
- According to the RLS Foundation web site’s article “About RLS,” certain medications may make RLS symptoms worse, including antihistamines, anti-nausea drugs, medications for dizziness, and certain psychiatric drugs.
- Consider checking for food sensitivities and allergies. Conditions such as celiac disease may be associated with RLS.
- Stretch regularly, focusing on the muscles involved in RLS. Most people have leg involvement, as the name suggestions, but others may have involvement of the trunk or arms. Some people find yoga stretches to be helpful.
- Get moderate daily exercise, such as walking, gardening, golf, active range of motion exercises, or shuffleboard at least 3-4 hours before going to bed. According to the RLS Foundation web site, a study from 2006 showed positive results from moderate aerobic activity and lower body resistance exercises three days per week, but benefits might take six weeks to achieve.
Drug Treatments for RLS
People who have RLS may find certain medications to be helpful. The physician will typically start dosages low to determine the lowest effective dose to prevent unnecessary medications and side effects in seniors. The prescribing physician should carefully weigh pros and cons of treating RLS with medications.
According to the RLS Foundation web site, the Food and Drug Administration has approved two drugs specifically for treating RLS: Requip (ropinirole) in 2005 and Mirapex (pramipexole) in 2006. The WebMD web site’s article “Restless Legs Syndrome – Treatment Overview” mentions several other drugs for treating RLS:
- Dopaminergic medications, typically used to treat Parkinson's Disease, may help some people’s symptoms because RLS may involve inappropriate dopamine activity within the brain.
- Neurontin, an anticonvulsant commonly used in the treatment of postherpetic neuralgia related to shingles, may also be beneficial.
- Opiod pain medications like Percocet, Ultram, and Lortab may help a person with RLS but may have added side effects and risks in seniors.
- Sleep aids, such as Ambien and Lunesta, may also be prescribed with caution.
Complications Related to Treating RLS with Medications
RLS medications may help symptoms for a period of time but can become ineffective after a while with the return of symptoms, which is called augmentation. Ironically, increasing the dosage of certain medications may worsen the symptoms. The healthcare provider may look at dose adjustments, adding a second drug, incorporating additional lifestyle changes, or recommend different treatments if symptoms are increasing.
According to the National Institutes of Health online article “How is Restless Legs Syndrome Treated?” medications used to treat RLS may “worsen problems controlling excessive gambling, shopping, or sexual activity.”
Effective RLS Treatments Are Possible for Seniors
RLS symptoms can be annoying, stressful, and harmful to one’s mental and physical health, but pharmacological and non-pharmacological options may control symptoms and greatly increase quality of life for seniors with Restless Legs Syndrome.
This article is for informational purposes and is not intended to be medical advice. Contact your healthcare provider regarding specific concerns related to RLS treatments and before starting, altering, or stopping any course of treatment.
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