In an article in Glam, Dr. Brynna Connor is one family medicine specialist who knows a thing or two about sleep issues. “Drug-induced insomnia is just what it sounds like –– insomnia, or difficulty sleeping, caused by taking certain medications,” she told SingleCare. So, is there a way to solve this problem? Read the article to find out.
If you would like to discuss sleep issues further with Dr. Connor, please make an appointment.
For some people, laying down to sleep comes with uncomfortable sensations that make them feel like they have to move their legs. This experience, called restless leg syndrome (RLS) or Willis-Ekbom Disease, can keep a person awake at night, often tossing and turning as they cannot get comfortable. Don’t confuse RLS with leg cramps — these are two different conditions. Leg cramps are sharp pains that develop when muscles in the legs suddenly contract. Leg cramps may last a few seconds to a few minutes. On the other hand, RLS leads to ongoing feelings of discomfort. About five to 10 percent of adults in the U.S. have restless leg syndrome. The condition also affects two to four percent of children. Women develop this condition more often than men. Additionally, older adults are more likely to develop RLS and to have worse symptoms. More than four out of five people with RLS also develop another sleep disorder called periodic limb movement of sleep (PLMS). PLMS causes the legs or arms to regularly move and jerk while a person is sleeping.
RLS causes uncomfortable feelings in the lower limbs. People with RLS feel like they can’t control the urge to move their legs. Often, moving around makes the discomfort disappear, but the feelings usually return once movement stops. People with RLS may also describe feelings of pulling, twitching, crawling, throbbing, burning, or itching. Occasionally, RLS may also affect muscles in the arms or other parts of the body. RLS symptoms often appear later in the day, in the evening or at night. A person may notice restless legs when they are sitting or lying down. Some people may wake up in the middle of the night with twitchy legs and have a hard time falling back asleep. RLS symptoms may also pop up during the day when a person has been sitting for a long time, such as on an airplane flight. Restless leg syndrome may also lead to additional problems during the day. RLS often prevents a person from getting a good night’s sleep, which can lead to memory loss, difficulty focusing, and mood changes. Additionally, when RLS goes untreated, it impacts productivity at work.
When people don’t get enough sleep, they are also at risk for physical and mental health problems, including diabetes and depression. One study found that people with restless leg syndrome were four times more likely to develop heart disease or experience a stroke. This group was also at risk for developing kidney disease.
Researchers have identified certain gene changes that increase a person’s risk of developing RLS. It’s not yet clear how these gene changes lead to RLS, but they may affect the way nerves develop before a person is born. There also may be other genetic factors that scientists have not yet discovered. This means that RLS can be passed down from parents to children. Most people diagnosed with the condition have a family member who also has RLS.
RLS is often linked to low levels of iron. The brain uses this mineral to make a dopamine, a brain chemical, often called a neurotransmitter. Dopamine is needed in order for the brain to control muscle movement. When a person doesn’t have enough iron in the brain, this process may be disrupted. Other vitamin and mineral deficiencies have also been linked to RLS. For example, people with low levels of magnesium or folate, a B vitamin, may also experience RLS symptoms. Other disorders may also lead to restless leg syndrome. These include:
Another RLS cause is pregnancy. In this case, the symptoms usually disappear a couple of weeks after giving birth. Some experts think that RLS happens during pregnancy as a result of low iron and folate levels, since pregnancy requires higher levels of these nutrients.
Restless legs may be a side effect of certain medications. These can include:
If you notice RLS symptoms after trying a new medication, talk to your health care team. Your doctor may be able to prescribe you an alternate medication that doesn’t lead to restless feet and legs.
Doctors can test iron levels with a simple blood test. These tests may show that low iron stores have caused red blood cell levels to drop, in a condition known as iron-deficiency anemia. Blood tests can also be used to look at other aspects of health, including kidney function.
Doctors often recommend a sleep study in order to diagnose sleeping problems. During this test, a person will stay overnight in a clinic or hospital. Also, home sleep studies can be conducted in one’s own bed. Electrodes can help measure body functions like heart rate and brain waves. A video camera may also be used to capture movements while a person sleeps. This test may indicate that a person has RLS or another sleep condition such as sleep apnea or narcolepsy.
Moving around usually leads to instant relief for restless legs. If you are having a hard time falling asleep because of RLS symptoms, try getting up and walking around for a little bit. Massaging or stretching the leg muscles may also calm the uncomfortable sensations.
Some people also feel better after taking a hot bath. Using a hot water bottle or ice pack may calm restless legs.
RLS may be partly caused by environmental or lifestyle factors. Some substances, including alcohol, caffeine, and tobacco, may cause RLS or worsen symptoms. Drinking less alcohol and coffee and quitting smoking may help symptoms appear less often. Additionally, getting more physical activity throughout the day can relieve symptoms.
Practicing good sleep hygiene may also make it easier to fall asleep. Try to follow a regular sleep schedule, laying down to bed at the same time each night and setting an alarm for the same time each morning. Additionally, try to keep your sleeping area cool, dark, and quiet.
When RLS is caused by another health condition, diagnosing and treating that condition often provides relief. A good first step when looking for RLS treatments is visiting your doctor and making sure you are in good health.
When RLS is caused by low iron levels, taking iron supplements can help. These supplements can be purchased over-the-counter. For those with very low levels of iron, intravenous (IV) iron treatments can also help boost iron levels.
Even when blood tests show that a person has normal iron levels, doctors may still recommend iron supplements. Studies have shown that iron treatments can help everyone, regardless of iron test results. Researchers think that some people may have normal levels of iron in the blood, but low levels of this mineral in the brain. For this reason, iron supplements are often the first treatment a doctor will suggest.
Researchers have found that taking folate supplements may also improve RLS symptoms. This treatment has been effective both in people with genetic cases of RLS that run in families, as well as RLS that develops due to underlying health conditions. Folate deficiencies may also be responsible for RLS symptoms during pregnancy. One study found that pregnant women who took folate supplements were much less likely to experience RLS symptoms.
It’s possible that magnesium levels may also be linked to RLS. However, studies have reported conflicting results — some have found that magnesium supplements help people with RLS get a better night’s sleep, while others have not found magnesium to be effective. However, these supplements may be worth a try for some people. Make sure to take the recommended dose of any vitamin or supplement, as high doses can make you sick.
There are several different drug options that may change the levels of certain brain chemicals in order to help with restless leg syndrome. Doctors may prescribe:
These medications often work in different ways. They may affect different brain chemicals or change the way different sensations feel. Additionally, each of these drugs can lead to varying side effects. People with RLS may need to try more than one option before they find something that works well for them.
Drugs that alter dopamine levels often work well short-term but may increase symptoms in the long run. People who use these drugs regularly may need to take increasingly higher doses in order to feel an effect. If this side effect develops, a person may need to stop taking the medication and switch to a different one. Anti-seizure medications don’t have this effect and seem to work better over time to keep restless legs under control.
Researchers have developed a couple of devices for RLS treatment. Some have even been approved by the U.S. Food and Drug Administration (FDA). You need a prescription from your doctor in order to get these devices.
One device, the Relaxis pad, is a pillow-sized pad that is placed under the legs. The device vibrates as you fall asleep. Some researchers think that the vibrations cause the leg muscles to send certain signals back to the brain. These signals may override the other signals caused by RLS that lead to discomfort. One study found that the Relaxis pad worked as well as RLS drugs, and came with fewer side effects.
The Restiffic foot wrap is another device designed to treat RLS. The wrap puts pressure on muscles in the bottom of the foot. Scientists believe that this feeling of pressure sends signals to the brain, which then tells the leg muscles to relax. In one small clinical trial, the device improved RLS symptoms to a greater degree than medication.
If you are plagued by restless legs at night, it may help to talk to your health care team. Your doctor can recommend or prescribe various treatments and check to make sure RLS isn’t caused by another health problem.
For many people, restless leg syndrome can be treated with simple at-home solutions, including taking iron supplements, getting more exercise, and avoiding alcohol, caffeine, and tobacco. When these strategies don’t work well enough to manage RLS, medications or devices may be effective.
If you would like to discuss RLS, please make an appointment.
There are many factors — both within our bodies as well as in our environment — that can lead to a poor night’s sleep. Some people who experience restless nights may need to schedule an exam with their doctor, while others may sleep better after improving their bedtime surroundings. There are many steps that you can try to take if you are dealing with restless sleep.
Restless sleep occurs when a person doesn’t sleep well. People may experience tossing and turning, trouble falling asleep or staying asleep, or waking up not feeling well rested. Both adults and children may experience restless sleep.
For a long time, restless sleep was not a medical term, but rather a general term for poor sleep quality. Recently, doctors have come up with a medical definition that describes a disorder seen in children.
In order to get a diagnosis of restless sleep disorder (RSD), children need to meet certain criteria. In children with RSD, the body regularly makes large movements during sleep. This may include kicking, arm flailing, or rolling around. These symptoms happen often — at least five large movements an hour, at least three times per week, for at least three months. Doctors also need to rule out other possible sleep disorders before giving a diagnosis of RSD.
Currently, restless sleep disorder has not been defined in adults, and people over the age of 18 cannot receive a diagnosis of RSD. However, this does not mean that adults don’t experience restless sleep. It’s possible that RSD will become an officially recognized diagnosis for adults in the future. It’s also possible that a restless night’s sleep is actually caused by other sleep disorders.
Up to one out of ten Americans have restless leg syndrome (RLS). People with RLS experience uncomfortable sensations that make them feel like they have to move or massage the legs. These feelings often appear in the evening or at night, and can make it hard to get to sleep. Many people with RLS also have a related condition called periodic limb movement of sleep (PLMS). People with PLMS experience arm or leg twitching while sleeping.
Another common sleep disorder is insomnia. Insomnia may cause someone to stay up very late or wake up very early in the morning and be unable to go back to sleep. Many people go through short periods of time where sleep is more difficult. It is less common to experience chronic insomnia, which lasts for at least one month. Insomnia may be caused by stress, mental health problems, medications, or other illnesses.
Sleep apnea is a condition in which a person regularly snores, snorts, or gasps while sleeping. This leads to poor-quality sleep that leaves a person feeling very tired the next day. Sleep apnea may develop on its own or as the result of other conditions like congestive heart failure.
There are also several other types of sleep disorders. Some conditions, like narcolepsy, make it hard for a person to stay awake during the day. Circadian rhythm disorders affect the body’s internal clock. Parasomnia occurs when a person performs unusual activities in their sleep, such as talking, eating, or walking.
Different sleep disorders cause different symptoms. These may include:
Some symptoms of poor sleep can only be noticed by someone else, such as a partner or a parent. You may experience sleep problems if someone tells you that you are making gasping or choking noises while sleeping, you stop breathing for a short amount of time, or your limbs are making large jerking movements.
Getting good sleep is very important. The body needs sleep to grow, heal, fight infection, learn, concentrate, and remember. Too little sleep can lead to both physical and mental health problems. If you are experiencing any symptoms of poor sleep, talk to your doctor, who can help you figure out whether you may have a sleep disorder.
Restless sleep is sometimes caused by health problems. Treating these underlying conditions may help improve sleep. In other cases, people can improve sleep with medications, supplements, or medical devices. Sometimes, more restful sleep can be achieved simply by practicing better habits, both at night and during the day.
A good first step in addressing sleep problems is making sure you are in good health. Heart disease, lung disease, pain, nerve problems, and other medical conditions can all lead to worse sleep. Additionally, some medications can cause sleep problems as a side effect.
Sleep problems can also happen as a result of mental health disorders. For example, children with attention deficit/hyperactivity disorder (ADHD) are often restless when they sleep. Anxiety and depression can also make sleep difficult.
If you are experiencing restless sleep, talk to your doctor. Your doctor can help you figure out what is causing sleep problems, detect any underlying health conditions, and diagnose any sleep disorders.
The body needs the mineral iron to carry oxygen around the body and to build proteins and enzymes that have many different roles in the body. When a person doesn’t have enough iron in the body, they may be diagnosed as iron-deficient.
Iron deficiency may play a role in several sleep disorders, including RLS, PLMS, and general sleep disturbances (GSD). One study also found a connection between iron deficiency and restless sleep disorder in children.
Most people aren’t iron deficient. However, children who are picky eaters or adults who don’t eat balanced meals may not be getting enough of this mineral. Women who have heavy periods may also be iron-deficient. Your doctor can measure iron levels with a basic blood test. If you have low levels of iron, your doctor may recommend taking iron supplements or eating more iron-rich foods.
People who have sleep problems because of an iron deficiency may start sleeping better once they fix the iron imbalance. Children with RSD have fewer symptoms and better sleep after increasing their iron levels. However, this strategy may not be effective for people who have normal levels of iron in the blood.
Some sleep aids are available over the counter (without a prescription). These medications may work in the short term, but often become less effective over time. They may also cause side effects like daytime sleepiness or problems remembering things. OTC sleep medications often have long term side effects so please check with your physician about any of these OTC options you are taking or are considering.
More powerful sleep medications can also be prescribed by a physician. These medications can be addictive, so it’s important to follow your physician’s instructions when you take them. Don’t use them at higher doses or more often than prescribed. Prescription sleep aids should generally not be used more than three days a week. These medications may lead to side effects like tiredness during the day, having trouble balancing, or confusion.
Doctors also sometimes recommend medications for specific types of sleeping disorders. For example, people with restless leg syndrome sometimes get relief from anti-seizure drugs or from medications that increase dopamine.
Medical devices such as foot wraps or vibrating pads can also help calm restless feet at bedtime for people with RLS. A continuous positive airway pressure (CPAP) machine is another device that can help treat sleep apnea.
Some people with milder sleep problems may want to try taking natural or herbal supplements. One popular supplement is melatonin. Melatonin is a hormone that is made by the brain once it gets dark outside. It helps you feel sleepy, and may help treat certain sleep problems.
Experts are also studying other natural products to help with sleep. Research into these supplements is still in the early stages, and not all supplements have been tested in humans. It’s not always clear how well these work or who they may help. However, there is some evidence that the following herbs may help improve sleep:
If you choose to use a natural or herbal supplement, it is important to let your physician know. Occasionally, natural supplements can cause health problems or prevent other medications from working correctly.
Often, sleep is interrupted due to things in the environment. A noisy household or loud city can often wake people up. In one survey, nearly two-thirds of New Yorkers said that loud noises woke them up at least once a week. Among people who were frequently disturbed by noise, three out of four people said they had problems concentrating during the day because they were so tired.
In order to make the most of your hours asleep, you can try adopting better sleep habits and creating a more restful environment. Tips include:
Try to develop a consistent sleep schedule by going to bed at the same time each night and setting your alarm for the same time each morning. Try not to deviate too far from this schedule on the weekend or on days off of work or school.
Eating a nutritious, balanced diet is a good way to get the best possible sleep. Research has found that not getting enough protein can make it harder to fall asleep and eating too much protein makes it more difficult to stay asleep. Likewise, eating either too many sugary carbohydrates or not enough complex carbohydrates changes sleep. People who follow very low-carb diets such as keto may experience different sleeping patterns than they used to. Finally, researchers have found that people who eat a high-fat, low-fiber diet have more restless sleep.
One way to help ensure you are getting the right balance of nutrients is to follow a healthy eating plan such as the Mediterranean diet. Studies have found that people who follow the Mediterranean diet have longer, higher-quality, less restless sleep. If you would like to read more on the Mediterranean diet, please visit my post Superfoods Part 3: Critical Superfoods for a Health Heart.
Alcohol and caffeine can also cause restless sleep. Avoiding these substances, especially later in the evening, may help you sleep throughout the night.
Researchers don’t yet know exactly how much exercise or which types of exercise are needed in order to improve sleep. However, several studies have found that participants experienced sleep benefits after they followed general expert recommendations for physical activity.
Many expert recommend getting 150 minutes of exercise each week. These minutes can be divided however you want. You can work out for 50 minutes three times a week, or you can exercise for a half an hour five days a week. You can also break up physical activity throughout the day. For an easy way to get more physical activity, try taking a short walk a couple of times a day on each weekday!
Many people experience restless sleep from time to time. However, long-term sleep problems can lead to physical and mental health problems and decrease quality of life.
If you are experiencing restless sleep, the first step is to talk to your physician about this situation. Restless sleep may be the cause of another health condition. Alternatively, you may have a sleep disorder that can be better treated once it is diagnosed. Medications, natural supplements, better sleep habits, a balanced diet, and exercise may all improve the quality of your sleep. If you are having sleep troubles and would like to discuss them with me, please make an appointment.
“There are a whole lot of other bad choices we’re making, and, over time, they are possibly doing a lot more damage than an occasional cheeseburger. Read on for 7 habits worse than fast food—and to ensure your health and the health of others.” Look for Dr. Connor quoted in the article!
To further discuss, make an appointment with Dr. Connor.
“We’re all trying to do our best when it comes to staying healthy. But it seems that sometimes it’s a losing battle—we try to eat right and exercise, yet we’re still not feeling our best. Turns out there are a lot of other things we are doing to ourselves that aren’t helping—from not getting enough sunlight or sleep to just not coping well with stress.” Look for Dr. Connor quoted in the article!
To further discuss, make an appointment with Dr. Connor.
Especially this year, as we have been faced with so much illness and pandemic fears with the COVID pandemic, I have been asked over and over again, “am I doing enough to stay healthy? What else do I need to do to keep my immune system strong?”
Now more than ever, the phrase “boosting our immune system” seems to be all the buzz these days.
Your immune system is the part of your body that helps you fight off infection. If and when you get sick, it is your immune system that keeps any infection under control, kills the infection, and removes it from your body. We definitely want to keep this incredible system of ours running at an optimal performance level.
How do you do this? Here are some basic steps you can take that might seem small, but these are manageable things that you can do to actually help your immune system and its immune cells.
Sleep deprivation can increase the effects of stressors, and, as a result, external stressors can seem much worse than they otherwise might. Depression and anxiety often follow closely behind. In addition, if we don’t get enough sleep, physical health is often affected; blood pressure changes, our metabolism is affected, and our diet can be negatively affected (hello carbs and sugar to stay alert!). If sleep-deprived, we often don’t have time – or make the time – to exercise. Hence, our physical activity level suffers which directly affects our brain and even our emotional regulation.
Sleep is actually involved in the regulation of the immune cells mentioned above, and these cells are responsible for fighting off infections, like Covid-19. So, those of us who are sleep deprived actually have an increased risk of contracting a virus or bacterial infection when exposed to these pesky germs.
Also, we often cannot think clearly or make sensible decisions without proper sleep. This affects our concentration in school and work. For example, I am the quintessential “napper” and I chuckle when I admit that power naps are THE way I got through medical school. I could literally shut my brain off in two minutes, close my eyes, and take a power nap for 25 minutes – and then wake up and hit the books again! Get your sleep. It is precious and good for your immune system!
Remedy the bedtime routine and practice good sleep hygiene. This sounds bizarre but it IS a thing. Establish that bedtime routine to unwind and use your bed for sleep and sex only. Try to go to sleep and wake up at the same time daily. Most adults need 6-8 hours of good quality sleep per night.
This is because our liver does a beautiful job of detoxifying when we are young but when we are a bit older, not so much. This is just simply part of life and aging and can cause us to have lighter sleep , which is less restorative, and not to mention the trips to the bathroom in the middle of the night.
Vitamin B6, which is crucial to support biochemical reactions in the immune system. B6 rich foods include chicken, cold water fish, (salmon/tuna) and green veggies, chickpeas. (Yum! Hello, hummus!)
Vitamin C, which is one of the biggest immune system boosters of all, is crucial. The lack of Vitamin C can make you more prone to illness. Foods rich in Vitamin C include oranges, grapefruit, tangerine, strawberries, bell peppers, kale, broccoli, spinach. Also remember, your body does not store vitamin C so you need to take it in daily, but it’s in many foods. And if you don’t get enough, you can always supplement with a high-grade supplement. A study on the efficacy of vitamin C on the immune system you can read is here.
Vitamin E is a powerful antioxidant that helps the body fight off infection and some foods rich in vitamin E include, nuts, seeds and spinach.
Zinc helps the immune system too. Zinc, known as an anti-inflammatory and antioxidant, helps the main immune cells perform their job, and, in turn, helps our bodies recover from and respond to illness. Adding a zinc supplement to your regimen, especially right now, helps to ensure that you are better prepared for those pesky germs we discussed earlier.
For more on supplements, keep an eye out for my next “Ask the Doctor” article at NorthWestPharmacy.com.
You can find some of our favorite supplement recommendations on our Market page and order them online.
If you like, you can learn more and schedule a consultation with Dr. Brynna Connor.
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