Restless legs syndrome (RLS) can keep you awake at night with the overwhelming urge to move your legs. Leg movement offers some relief from the discomfort, but at the expense of your ability to rest. It can also affect your partner, who may wake up multiple times per night because of the movement.

Research shows that around 25 percent of people with diabetes have RLS, so it’s no surprise that DiabetesTeam members often discuss how restless legs keep them up at night. “I have been getting restless legs and can’t stay still some nights, I just have to get up and move. I have always had pain in my legs, but this is different,” said a member. Another member commented, “Restless night, restless legs.”

Discover what science says about the possible link between RLS and diabetes, as well as what you can do about it.

What Is Restless Legs Syndrome?

RLS is a condition that begins in the brain and nervous system, often primarily affecting sleep. The causes aren’t well understood, but health experts believe it has something to do with a part of your brain called the basal ganglia. The basal ganglia control your movements.

To help your body move, the basal ganglia use a neurotransmitter called dopamine. When the basal ganglia don’t get enough dopamine to properly control your movements, RLS can occur. Some people notice that their RLS symptoms flare up in response to specific triggers like drinking alcohol, taking certain medications, or being stressed.

Restless Legs Syndrome Symptoms

Restless legs syndrome causes sensations in your legs that make you want to move them, because moving your legs temporarily reduces the sensations. You might feel these sensations in one leg, both legs, or in other parts of your body in addition to your legs.

People describe the unpleasant sensations as:

• Aching
• Itching
• Tingling
• Burning
• Throbbing
• Pulling

Typically, these sensations feel worse when you’re at rest. They can lead you to jerk your legs without thinking about it. You might also stretch, walk around, or wiggle your legs in an attempt to reduce your discomfort.

How Restless Legs Syndrome Affects Your Life

Since RLS symptoms tend to be worse in the evening, they can stop you from getting a good night’s sleep. You might have trouble falling asleep in the first place, or you might wake up periodically during the night because of your discomfort.

Trouble sleeping because of RLS can affect your quality of life during the day, too. Because of sleep disturbances, you might experience:

• Daytime tiredness
• Depression
• Anxiety
• Trouble paying attention
• Memory and concentration problems

Are Restless Legs Caused by Diabetes?

Experts don’t fully understand the causes of RLS, but they believe there may be a few factors that contribute to it. Diabetes raises your risk of developing RLS and may be one of its causes. Some features of diabetes can contribute to RLS or cause similar symptoms.

Diabetic Neuropathy

Restless legs syndrome isn’t the same as diabetic neuropathy (nerve damage from diabetes), but it’s considered a type of neuropathy. It’s possible to have both types at the same time.

Both diabetic neuropathy symptoms and RLS symptoms tend to get worse at night and might share some of the same symptoms, like tingling or burning in the legs.

Low Iron Levels

Many people with RLS have iron deficiency anemia, or low iron levels, which suggests it could be a cause. Iron deficiency anemia is common in people with diabetes, especially those with kidney disease as a complication of diabetes. Kidney disease can make it difficult for you to absorb enough iron, which leads to iron deficiency anemia. This could be a reason why so many people with diabetes experience RLS.

Blood Sugar Imbalances

It’s easy to assume that blood sugar imbalances or poor glycemic control cause RLS in diabetes since controlling your glucose (blood sugar) prevents diabetes complications like nerve damage, kidney disease, and cardiovascular disease.

So far, research hasn’t found evidence of a connection between blood sugar imbalances and restless legs syndrome. However, it’s possible for RLS to be misdiagnosed as diabetic neuropathy, which can come from blood sugar imbalances.

Managing Restless Legs Syndrome With Diabetes

RLS doesn’t have a cure, but treatments can help you manage symptoms and get better sleep.

Managing underlying health conditions might help reduce symptoms of restless legs syndrome. If you have iron deficiency anemia associated with diabetes, for example, your doctor might recommend taking iron supplements with vitamin C or iron infusions. Be sure to talk to your doctor before starting any new medication or supplement. There are multiple types of iron supplement, and blood test results can help doctors pinpoint which type you should take.

Medications that mimic dopamine in the brain, or dopamine agonists, are often a main treatment to reduce RLS symptoms. Dopamine agonists work similarly to natural dopamine and can activate dopamine receptors in your brain. They might help your basal ganglia control your movements to treat restless legs syndrome and other movement disorders like Parkinson’s disease.

Anti-seizure medications like gabapentin (sold as Horizant, Gralise, and Neurontin) can also treat RLS by affecting how neurotransmitters work in your brain.

What Helps Restless Legs at Night?

If your restless legs keep you up at night, you might want to try at-home therapies to improve your sleep. Not getting enough sleep can ultimately make RLS symptoms worse.

Beyond medications and supplements, these strategies might help your restless legs at night:

• Getting moderate daytime exercise — Regular exercise can also increase insulin sensitivity to help you manage your diabetes.
• Managing stress — Stress is a trigger for RLS symptoms. It’s also a diabetes risk factor. Reducing stress with mental healthcare and other strategies can help you sleep better and manage RLS symptoms at night.
• Avoiding substances that affect your sleep — Drinking caffeinated beverages during the day can keep you awake at night. Even caffeine in the morning, which you might use to overcome tiredness associated with RLS, can worsen RLS symptoms when you go to bed. Caffeine and other substances, like nicotine or alcohol, trigger RLS symptoms and can affect your sleep.
• Massaging your legs — Massaging your legs can give you some quick relief from RLS symptoms without having to get out of bed or kick your legs, which can be disruptive to a co-sleeping partner.

What Members Say

Some DiabetesTeam members have shared their tips for managing restless legs and getting better sleep:

• “My doctor told me to take gabepentin twice at night instead of taking it once in the morning and once at night.”
• “I am going to try tea — lemon ginger with probiotics. I have restless legs and my feet will sometimes burn.”
• “Magnesium supplements help me.”
• “I can tell you what makes mine worse. Alcohol, caffeine, coffee, too much exercise. I suffered this for years.”

Talk to Your Doctor

Talk to your doctor if you experience symptoms of restless legs syndrome with diabetes, especially if RLS symptoms stop you from getting a good night’s sleep or if your symptoms haven’t improved with home care. Your doctor might prescribe medications or supplements to help you manage the symptoms.

They might also adjust your current diabetes treatment plan to help you manage diabetes symptoms and complications, like iron deficiency anemia, that might contribute to RLS.

Always consult your healthcare provider before taking new medications or supplements to manage RLS.

Join the Conversation

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