Restless legs syndrome (RLS) is a neurological sensory conditioni that causes uncomfortable sensations in the legs and an overwhelming urge to move them. Symptoms tend to be most severe in the evening hours, making it hard to fall asleep or return to sleep after waking during the night. This is why it’s also classified as a sleep disorder.
Sleep myoclonus, on the other hand, is a condition in which the muscles suddenly and involuntarily jerk or twitch during the early stages of sleep.ii Those with RLS can also suffer from sleep myoclonus.
Here, we outline the symptoms, causes and treatment options for both RLS and sleep myoclonus to prevent limb twitches at night and promote restful sleep.
Restless legs syndrome
What are the symptoms of RLS?
RLS triggers an intense, irresistible impulse to move the legs due to unpleasant sensations, which have often been described as the following:iii
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Burning, itching, throbbing, or tingling
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“Pins and needles” or “creepy-crawly” feeling
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Feeling as though fizzy water is inside the blood vessels of the legs
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Painful cramping sensation in the legs, especially the calves
These pervasive sensations can range in severity, and – as aforementioned – are generally worse in the evening or during periods of inactivity.
Unsurprisingly, RLS can have a far-reaching impact on your sleep hygiene and energy levels.iv Find out more about your sleep hygiene and how poor sleep hygiene can affect you here.
What causes RLS?
The exact cause of RLS remains largely unknown, however, some research suggests that there may be a genetic component to the neurological condition.v Often, it can be found in families where the symptoms surface before the age of 40.
There’s also compelling evidence to suggest RLS is related to a problem with the area of the brain that regulates movement (the basal ganglia).vi The basal ganglia utilise the neurotransmitter dopamine to control muscle movement and activity. If the nerve pathways are disrupted, it can cause involuntary movements and spasms.
Experts also believe RLS can occur as a result of another health condition, such as an iron deficiency or stress, as well as longer-term conditions like diabetes or Parkinson’s disease. Sometimes, women experience RLS during the last trimester of pregnancy.xii
How to manage RLS
Improving your lifestyle can often support the reduction of RLS. Here are some of the best ways to minimise your symptoms.xiii
Establish good sleep hygiene and prioritise relaxation before bed by practising mindfulness and relaxation techniques in the evenings. Exercising regularly may also help to manage RLS symptoms, but avoid exercising too close to bedtime. Avoid stimulants in the evening, like nicotine, caffeine and alcohol. If you do smoke, try to quit.
Sometimes, certain medications that can exacerbate RLS symptoms, like anti-nausea, antipsychotic, or anti-allergy medication — although it’s important to consult with your GP before changing your medication. If your RLS symptoms are severe, your doctor might prescribe dopamine agonists that work by increasing your dopamine levels.ix
Sleep myoclonus
What are the symptoms of sleep myoclonus?
Sleep myoclonus causes shakes, spasms, and jerks that primarily affect the eyes, fingers, lips and toes during sleep. Often, these are sudden, involuntary movements occurring either all over the body or localised to one area.x
A fairly common condition, sleep myoclonus generally occurs just before deep sleep. It will rarely disturb the person or their bed partner to the point of waking, however, they may reveal the presence of another sleep-related disorder, like RLS.xi
What causes sleep myoclonus?
Like RLS, the aetiology of sleep myoclonus is unclear, but experts purport it may, again, involve issues with dopamine.xii The condition can develop in response to various underlying health problems or factors.xiii
Nervous system conditions, such as Huntington’s disease, Alzheimer’s, Parkinson’s disease, or medical conditions like kidney or liver failure and metabolic disorders.
Other sleep disorders, particularly Periodic Leg Movement Disorder and RLSxiv can also cause sleep myoclonus.
What treatment options are available for sleep myoclonus?
Most cases of sleep myoclonus aren’t serious and don’t require treatment. Generally, this condition is thought to be benign, with no short-term or long-term effects on health.xiv If, however, sleep myoclonus is interfering with your sleep hygiene or quality of life, there are various treatment options available.xv
To rule out any other sleep disorder that may be causing the sleep myoclonus — RLS, for instance — the first thing you should do is an overnight sleep study, whichyou can be referred to by your doctor.
Try to prioritise relaxation before bed to promote a healthy night’s sleep. Your doctor could also prescribe anti-seizure medication, like clonazepam or sodium valproate, to alleviate your symptoms if necessary.
Involuntary movements and twitches at night can, understandably, make sleeping problematic. Fortunately, implementing the necessary lifestyle changes, improvements to your sleep hygiene, and taking medication if needed, you can easily manage them.
To discover even more guidance on sleep health, explore the rest of our sleep health resources.
References:
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Ninds.nih.gov. (2019). Restless Legs Syndrome Fact Sheet - National Institute of Neurological Disorders and Stroke. Available online: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet
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Verywell Health. (2019). What Is the Definition of Sleep Myoclonus?. Available online: https://www.verywellhealth.com/what-is-sleep-myoclonus-3014807
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nhs.uk. (2019). Restless legs syndrome - Symptoms. Available online: https://www.nhs.uk/conditions/restless-legs-syndrome/symptoms
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Ninds.nih.gov. (2019). Restless Legs Syndrome Fact Sheet - National Institute of Neurological Disorders and Stroke. Available online: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet
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ScienceDaily. (2019). Researchers Discover Gene Responsible For Restless Legs Syndrome. Available online: https://www.sciencedaily.com/releases/2007/07/070719011318.htm
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nhs.uk. (2019). Restless legs syndrome - Causes. Available online: https://www.nhs.uk/conditions/restless-legs-syndrome/causes
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Ninds.nih.gov. (2019). Restless Legs Syndrome Fact Sheet - National Institute of Neurological Disorders and Stroke. Available online: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet
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nhs.uk. (2019). Restless legs syndrome - Treatment. Available online: https://www.nhs.uk/conditions/restless-legs-syndrome/treatment
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nhs.uk. (2019). Restless legs syndrome - Treatment. Available online: https://www.nhs.uk/conditions/restless-legs-syndrome/treatment
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Mayo Clinic. (2019). Myoclonus - Symptoms and Causes. Available online: https://www.mayoclinic.org/diseases-conditions/myoclonus/symptoms-causes/syc-20350459
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American Sleep Association. (2019). Sleep Myoclonus: Moving during sleep – American Sleep Association. Available online: https://www.sleepassociation.org/sleep-disorders/more-sleep-disorders/sleep-myoclonus
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Staedt. J., Stoppe. G., Kögler. A., et al. (1995). Nocturnal myoclonus syndrome (periodic movements in sleep) related to central dopamine D2-receptor alteration. Eur Arch Psychiatry Clin Neurosci. 245(1): 8-10.
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Mayo Clinic. (2019). Myoclonus - Symptoms and Causes. Available online: https://www.mayoclinic.org/diseases-conditions/myoclonus/symptoms-causes/syc-20350459
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Avidan. A. (2019). Parasomnias and Movement Disorders of Sleep. Seminars in Neurology. 29(04), 372-392.
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Verywell Health. (2019). What Is the Definition of Sleep Myoclonus? Available online: https://www.verywellhealth.com/what-is-sleep-myoclonus-3014807
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Tuck Sleep. (2019). Myoclonus - Periodic Limb Movements - Tuck Sleep. Available online: hhttps://www.tuck.com/periodic-limb-movements
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Olivia
Olivia Salter has always been an avid health nut. After graduating from the University of Bristol, she began working for a nutritional consultancy where she discovered her passion for all things wellness-related. There, she executed much of the company’s content marketing strategy and found her niche in health writing, publishing articles in Women’s Health, Mind Body Green, Thrive and Psychologies.
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