Treatment of the cause

The doctor first tries to find the cause and treat it. For example, in case of anemia, taking suppléments de fer can fix the problem. Same thing in case of deficiency in folic acid. If the symptoms are due to taking a drug, the doctor will suggest another. In people with chronic kidney disease who are on dialysis, symptoms often go away after a kidney transplant.

Unfortunately, treatment of the cause is not always possible. If the cause is genetic, it is nevertheless possible to eliminate the aggravating factors.

Life habits

In the event that the symptoms are mild to moderate and do not interfere too much with everyday life, many people manage to reduce the intensity and frequency of their symptoms by modifying certain life habits. You must first be aware of the circumstances surrounding the times of absence and exacerbation of symptoms, and then adapt your life accordingly. See section Prevention to know some tracks.

Aerobic and lower extremity exercise 3 days per week showed noticeable decrease in symptoms in research with 28 patients¹⁵.

pharmaceuticals

When’insomnia significantly interferes with daytime activities (and this is usually the case if 2 or more nights per week are disrupted), doctors may prescribe various pharmaceuticals. None of them treat the syndrome in a specific way. However, they can help you sleep better, decrease the severity of symptoms, and minimize involuntary leg movements at night. Their effectiveness varies from person to person.

• First and foremost, one should try to reduce or eliminate the drugs that are known to worsen or unmask the disease.
• Dopaminergic agents. These are usually the first drugs you try. These drugs, sometimes called antiparkinson drugs, work by mimicking the action of dopamine (dopamine agonists), such as pramipexole (Mirapex®), pergolide (Permax®) and ropinirole (ReQuip®). Dopaminergic agents are consumed in low doses compared to the doses prescribed for Parkinson’s disease. They can cause side effects, such as nausea and vomiting, or in some cases increase the symptoms of the syndrome. Some research has shown a link with these agents and behaviors such as compulsive shopping.¹⁶.

  If you have any side effects, talk to the doctor, who will correct the problem by adjusting the dosage or prescribing another medication.

• Anticonvulsants. In cases where sleep is regularly disrupted by involuntary movements of the legs, an anticonvulsant can inhibit the neurons that cause these movements. For example, gabapentin or pregabalin (Neurontin®, Lyrica®). Usually they are used only in cases where dopaminergic agents are ineffective.
• Sedatives. Sedatives, such as benzodiazepines (Clonazepam®, Diazepam®, Valium®, etc.) help you sleep better and relieve symptoms at night. They are often taken at bedtime. However, these drugs create physical habituation; their therapeutic effect therefore diminishes over time. Doctors only use it in certain situations, for a limited period of time.
• Narcotic pain relievers. If the symptoms are unbearable and are accompanied by pain, narcotic-type pain medications (opioids) may be used. For example, codeine (only in generic form) and oxycodone (OxyContin®). These drugs work in the brain and spinal cord and interfere with the transmission of pain messages. Their effect is more powerful than that of non-narcotic pain relievers, such as non-steroidal anti-inflammatory drugs (NSAIDs), which act locally. They are only prescribed very rarely, given their potential for abuse and side effects.