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Lifestyle modification is the first step in treating mild cases of restless legs syndrome (RLS). Avoiding alcohol, tobacco and caffeine can help reduce symptoms, as can avoiding medications that tend to trigger symptoms.
Many patients benefit from making modifications to their sleep routine. For example, patients are urged to make their bedroom as conducive to sleep as possible. This includes shutting out all unnecessary light and keeping the room cool and quiet. The bedroom should be used only for sleeping and intimacy, and patients are urged to go to bed and to arise at the same time every night and day. Many patients also find that going to bed later and waking later helps them feel more rested.
Regular, moderate levels of exercise may also help relieve symptoms. Walking and stretching or using heat (thermotherapy) and ice packs (cryotherapy) on the limbs also has been shown to relieve symptoms in some patients. Hot or cold baths may provide relief for some.
More severe cases of RLS may require medication. The U.S. Food and Drug Administration has approved two anticonvulsants (anti-seizure drugs) for the treatment of moderate to severe primary RLS: ropinirole (Requip) and pramipexole (Mirapex). These medications, known as dopamine agonists, are typically used to treat Parkinson’s disease.
Other medications that may be helpful for some patients include sedatives, opioids or other pain relievers, and supplements of iron or other minerals or vitamins.
Patients may find that some medications are more effective for them than others. Some drugs may work for a period of time before they need to be replaced by other drugs because they stop working or even begin to worsen symptoms, a condition known as augmentation. In addition, medications that bring relief to some patients may worsen symptoms in other individuals.
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