What lifestyle modifications should I recommend to patients with Restless Legs Syndrome to alleviate symptoms?

For patients with Restless Legs Syndrome (RLS), recommend the following lifestyle modifications to help alleviate symptoms:

• Address underlying causes: Investigate and treat iron deficiency anaemia or low serum ferritin (less than 50–75 micrograms/L) by prescribing iron supplements with vitamin C to aid absorption.
• Good sleep hygiene: Encourage practices that improve sleep quality, such as maintaining a regular sleep schedule and creating a restful environment.
• Reduce caffeine and alcohol intake: Advise patients to limit or avoid caffeine and alcohol, as these can exacerbate symptoms.
• Stop smoking: Recommend cessation of smoking if relevant, as it may worsen RLS symptoms.
• Regular moderate exercise: Encourage undertaking moderate regular physical activity, which can help reduce symptom severity.
• Manage sleep-disrupting factors: Consider the impact of obstructive sleep apnoea and shift work on sleep quality and address these if present.
• Relief during episodes: Suggest walking and stretching affected limbs, applying heat (heat pads or hot baths), performing relaxation exercises, massaging limbs, and engaging in mental alertness distractions such as reading or games during rest periods.
• Provide patient information: Offer educational materials such as the NHS leaflet on RLS to support self-help and understanding.

These lifestyle measures may be sufficient for patients with mild symptoms, while those with moderate to severe symptoms may require further medical treatment consideration.

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