Lifestyle modifications

NUTRITION

  • In some cases nicotine, caffeine and alcohol increase the symptoms. If these substances increase symptoms of RLS recommend to avoid/minimize the intake (1, 2).
  • Iron: Iron deficiency may cause restless legs syndrome. Start iron supplementation if ferritin is below 75mcg/l. Vitamin C increases iron absorption (2).
  • There is a significant association between vitamin D levels and restless legs syndrome. Normalize vitamin D levels if deficiency is present (3).
  • There is increased risk of restless legs syndrome among obese individuals (4)

PHYSICAL ACTIVITY

  • Moderate regular exercise (1)
  • For symptomatic relief – walking, bicycling, soaking the affected limbs, and leg massage, including pneumatic compression (1)

SLEEP

  • Reduced sleep may aggravate symptoms of RLS in many patients. Thus, improving sleep may possibly reduce symptoms of RLS (2).

OTHER

  • Mental alerting activities, such as working on a computer or doing crossword puzzles, at times of rest or boredom (2).
  • Stretching, warm baths before bedtime (1).

References

  1. 1) https://www.uptodate.com/contents/management-of-restless-legs-syndrome-and-periodic-limb-movement-disorder-in-adults
  2. 2) https://bestpractice.bmj.com/topics/en-us/65/management-approach
  3. 3) www.sciencedirect.com/science/article/abs/pii/S13899457203038161
  4. 4) https://pubmed.ncbi.nlm.nih.gov/29674254/

Resources

EXPLANATION TO EVIDENCE PRESENTATION

Figure: Evidence pyramid

​Evidence based on guidelines and evidence based Clinical Decision Systems is written in BOLD font

​Evidence based on meta analysis or systematic reviews is written in BOLD and CURSIVE font

​Evidence based on randomized controlled trials is written in PLAIN font

​Evidence based on observational / cohort studies is written in CURSIVE font