RLS and Sleep Positioning: A "Heimlich Maneuver" (Manoeuvre) for Relief

Hi, All. The following is based on my personal experience as an RLS sufferer for more than 50 years. Though my findings are preliminary, the results thus far are promising. If borne out by the experience of others, the suggested regimen may offer a prompt, no-cost, easy to apply, home remedy to bring night-long relief to others suffering from RLS. For those who prefer not to read the entire comment, I have described the regimen in a discrete paragraph at the end.

When I was experiencing the worst of DAWS, I gained temporary relief while laying on my loveseat, with the calves of my legs draped over the loveseat's firm arms at about a 45 degree angle. I wasn't quite sure whether it was the angle of elevation or the pull of gravity against my calves that was my benefactor. But my loveseat was for watching TV; the bedroom was for sleeping. Somewhere between the end of an episode of The Cisco Kid and the start of an episode of The Californian, I would gather my bedding during each morning's early hours and trundle off to bed.

In bed, I elevated the calves of my legs atop a firm, King-size pillow that I had purchased for that purpose. To enhance the angle of elevation, I first surrounded the King-size pillow with blankets. Still not convinced that its height was sufficient, I gently placed a spare Standard-size pillow at its highest point, much as a baker might do with a cherry placed to adorn a culinary presentation or as a mountaineer atop Mt. Everest might do with their country's flag.

Though I believed that the properly configured King-size pillow offered a measure of relief, the relief proved to be a "weak sister" (apologies of that term is not allowed) of the loveseat's arms. In time, I relegated the King-size pillow to a use favored by my now former wife: the dreaded "crotch pillow." To be sure, doing so was not without some benefit: the parallel placement of my legs on either side of the pillow did provide a measure of relief. Still, when the worst of RLS struck during my lengthy experience with DAWS, I adjourned from the bed to my loveseat, anxious for the anticipated relief, however brief and delusional.

With DAWS behind me, I now rely solely on pregabalin. My relief with pregabalin has been idiosyncratic, unpredictable and often evanescent. In desperate attempts to find a comfortable position, I nightly transit my bed, completing multiple orbits during my journey. From time-to-time, I cease this undertaking only so long as may allow me to reorient my position so that I may view the clock atop my nightstand. I arise from my bed, divert myself for an hour or two, and then return to my bedroom. But sometimes I am so weary with exhaustion that my return is not fully completed. On these occasions, I collapse on the bed, face down, with the greater part of my legs suspended mid-air. More often than not, I then sleep soundly for hours on end.

As an experiment, in today's early morning hours, I tested my hypothesis: I would simulate my collapse atop my bed. I did so with only my torso resting firmly in place as I lay face-down on my bed; from mid-thigh to my feet, both legs were suspended mid-air, with only flesh, bone, muscle and sinew resisting the pull of gravity against my calves. The immediate sensations were reminiscent of the sensations felt while "stretching" my legs as I stood in a doorway, offset by my arms. Only this time, there was no need to get out of bed, nor was the relief temporary. I promptly fell asleep and slept soundly from ~4:00 AM - ~9:30 AM.

Be well.

[Madlegs1]

Wow. It's going to take me a while to fully absorb all that!I can only imagine Raff's reaction. (Sadly he has disappeared, I miss him!)

I'm glad you've achieved a form of relief. Long may it continue for you!

😎

[Hidden in reply to Madlegs1]

Thanks, per usual, Madlegs1. If you want to read a really long comment, please search for my satire on the recommendation made by another of our number. I wrote a Twilight Zone episode regarding yet another supposed means of RLS-relief posted by SueJohnson. Enjoy.

Be well.

[ChrisColumbus]

When I was really suffering from RLS, I found two positions that helped to relieve it: lying on my bed with legs elevated against a wall as close to vertical as possible; kneeling on the floor with torso face down on bed. I'd generally fall asleep and wake up a bit later with RLS gone so could then return to a more normal sleeping position.

Nowadays - when RLS is much milder and rarer - I find that if I go to sleep lying on my front with one leg stretched out and one bent at the knee RLS is very unlikely to start. Lying on my side, perhaps with a 'crotch pillow' is nearly as good. Lying on my back, mild RLS is by no means inevitable, but more likely if I've done something inadvisable - not taken magnesium, or had a sugary pudding, or drunk a 'diet' drink etc...

[Hidden in reply to ChrisColumbus]

Good morning, ChrisColumbus, and thanks for your reply. Isn't it odd that sleep position (and yoga?) sometimes offer relief. To me, it belies the argument suggesting that RLS is only a "neurological" disorder. At one point, I thought that perhaps some of the positions that offered relief either "cut-off" the circulation to the affected limb or, if indeed RLS is a neurological disorder "pinched" the affected nerves. This may warrant further research?

Incidentally, did you catch my "Twilight Zone" episode that was inspired by another potential for relief often suggested by SueJohnson? If interested (I think you may enjoy), you may find it under my earlier article about the brain being rewired after dopamine agonist withdrawal. Maybe I should have posted it separately for more attention?

Be well.

[ChrisColumbus in reply to Hidden]

I'll look for your Twilight Zone... And yes, I've moaned (to myself) about a couple of people recently who stated here that "RLS is purely neurological" implying that what the original poster said couldn't possibly be true.

It's "purely" nothing: in my view it's more a collection of syndromes with different triggers producing similar symptoms.

[coconutboy]

I’ve discovered a similar way to relieve RLS by lying face down on my bed with just my feet hanging over the bottom of the bed. Also stretching my legs before bed with various stretching exercises seems to usually prevent the disturbance of RLS. I also take magnesium glycinate before bed as a preventative. I haven’t taken any of the prescribed drugs, nor will I, as I have only heard about bad side effects and worsening of the problem rather than a solution. Hope this is helpful to someone out there.

[Hidden in reply to coconutboy]

Good afternoon, coconutboy, and thanks much for sharing your experience.

Regarding the magnesium glycinate (and iron and other supplements): I briefly tried a magnesium supplement and an iron supplement (bi-something or other). Belatedly, I learned that they were supposed to be taken at different times of day. And, of course, depending on the formulation of the iron supplement, you either were to take it on an empty stomach or with meals, and with orange juice or with water. Too confusing for me.

In time, I defaulted to taking only those two supplements that were recommended by my doctors following their equivocal conclusions that I either was or was not deficient on same: Vitamin B12; and Vitamin D3. And though there was room for debate, the consensus was that my "iron levels" were OK, so the continuation of iron supplementation was vetoed in any event by my current neurologist on the ground that it was both unnecessary and likely to cause constipation. I do, however, try to eat one ripe banana each day which, if I understand correctly, is rich in magnesium.

As to reluctance to take Rx medications: In general, I am in full accord with you. It is my goal to take not more than one Rx at a time (with exception of antibiotics, pain medicine for acute needs, etc.). As I just posted elsewhere on this website, on a hunch, instead of taking 3 x 75 mg pregabalin over the course of late evening/early morning, I reduced experimentally to only 1 x 75 mg within a 24 hour cycle. The results were encouraging. But not content to leave well enough alone, after I rose from bed this morning, I felt obliged to take a second 1 x 75 mg pregabalin. I am now the worse off.

Be well.

[SueJohnson in reply to coconutboy]

You are right to be afraid of dopamine agonists like ropinirole or pramipexole, but you should be afraid of gabapentin nor pregabalin. If they have side effects you can't stand, you can always come off them slowly without any withdrawal effects. Nothing ventured nothing gained! If you decide to try it Beginning dose is usually 300 mg gabapentin (75 mg pregabalin). It will take 3 weeks before it is fully effective. After that increase it by 100 mg (25 mg pregabalin) every couple of days until you find the dose that works for you. Take it 1 to 2 hours before bedtime. If you need more than 600 mg take the extra 4 hours before bedtime as it is not as well absorbed above 600 mg. If you need more than 1200 mg, take the extra 6 hours before bedtime. (You don't need to split the doses with pregabalin) Most of the side effects of gabapentin and pregabalin will disappear after a few weeks and the few that don't will usually lessen. Those that remain are usually worth it for the elimination of the RLS symptoms. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin (200 to 300 mg pregabalin) daily." If you take magnesium don't take it within 3 hours of taking gabapentin or pregabalin as it will interfere with the absorption of them. Check out the Mayo Clinic Updated Algorithm on RLS which will tell you everything you want to know including about its treatment and refer your doctor to it if needed as many doctors do not know much about RLS or are not uptodate on it at Https://mayoclinicproceedings.org/a...

[SueJohnson in reply to coconutboy]

Have you had your ferritin tested? Improving your ferritin to 100 or more helps 60% of people with RLS and in some cases completely eliminates their symptoms. If not when you see your doctor ask for a full iron panel. Stop taking any iron supplements including multivitamins that have iron in them 48 hours before the test, fast after midnight and have your test in the morning. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your transferrin saturation to be over 20% but less than 45% and your ferritin to be at least 100. If they are not, post them here and we can give you advice.

[SueJohnson]

I can't believe you haven't had your ferritin tested, and you know that if you do need iron, we are glad to explain it to you - ie heme iron and non-heme iron and when to take with food and when not.