Developing a Bedtime Routine to Manage RLS

Restless legs syndrome (RLS) is – for me quite literally – a right royal pain in the backside.

In my experience, many people underestimate the potential level of distress that can accompany severe and chronic RLS. It can be utterly disruptive and have an impact on the things we choose to do – or not do – each day. I have to think twice about traveling, going to the cinema, eating out, waiting at the doctor’s office, or any activity with an expectation for me to sit still for more than a few minutes.

Why a bedtime routine matters

The restlessness is not only there when I’m awake, but it is also significantly disruptive for my sleep. In fact, for me (with multiple and complex insomnia issues), it is basically impossible to have an unmedicated sleep. Despite medications, I still have to pay attention to my environment.

In addition to lifestyle modifications like avoiding caffeine and alcohol, ensuring I have adequate levels of magnesium and iron, and exercising regularly, I like to have a clear and consistent bedtime routine. To maximise my chance of actually getting some sleep.

My bedtime routine to manage restless legs syndrome

My routine targets all the different components of my sleeplessness and I am rather fond of structure.

Allowing enough time for digestion

I like to make sure I finish eating at least 3 hours before I go to bed. I don’t consume caffeine or alcohol of an evening, but if any other foods – like perhaps sugar or preservatives – have snuck into my evening meal, then it’s good for them to have a solid chance of digestion before heading off to bed.

No exercising right before bed

I need plenty of movement throughout the day – the more sedentary my day, the bigger chance I have of experiencing RLS symptoms. But much like meals, I won’t exercise 3 hours before bedtime. I’m not sure if it’s the endorphins but exercising too much can have a counter effect.

Stretching

I love stretching. This is something I should do even more of. Stretching out the glutes and hamstrings and calves. But for me – as the RLS symptoms originate in my lower back then run down through my butt and leg – glute stretches are definitely a must. Sometimes I stretch out on the loungeroom floor. Sometimes I loll around on my foam roller, putting deep pressure onto all those twitchy spots that just don’t want to be stilled. A stretching routine – on and off throughout my evening – has a really positive impact on my sleep.

Distraction

Distraction can be my best friend. RLS sometimes seems like an itch – the more attention it gets, the worse it becomes. So engaging myself in riveting television, reading, or conversation can offer reprieve from the symptoms. Or even if they’re still there, my legs will often fidget without me even noticing. And then, at the very least, the RLS doesn’t get worse.

Taking a hot bath

If time and motivation allow, I find a hot bath deeply soothing. Especially if I throw in a couple of handfuls of magnesium flakes. The heat seems to help the symptoms and I am able to relax for a time. Baths are very exciting for me as I have waited 20 years (yes, 20) for my husband to finally put the bath back in after starting a renovation. I want to soak up every moment of heated, peaceful bliss.

Massage

When all else fails, I can beg my husband for a massage. It’s very hard to massage yourself – although sometimes I will massage my calves, but a back massage is tricky on our own. As my restlessness can have a fairly negative impact on my husband’s sleep, I sometimes try to convince him that it’s in both our vested interest for me to have a massage. However, the trouble with massage is that I don’t seem to have long-lasting benefits. It eases the discomfort in the moment but doesn’t continue to ease symptoms. It feels good, though.

Just the right amount of fatigue

The only other thing I try to do is make sure I don’t get overly tired. I need the Goldilocks amount of fatigue – enough that I’m sleepy and ready to slip into blessed rest. But not too exhausted as that seems to make me less likely to sleep well and will often exacerbate my restlessness.

Good habits pay off

It may sound like a convoluted list, but really it’s not. Habits are habits – be they good or bad. Over time I have learned to develop good habits and it has paid off.

My RLS has not disappeared, but it is now very well managed. And when it is not, I can almost always pinpoint the reason.