Painful night time leg cramps can wake you up at night and ruin a perfectly good episode of sleep! When they actually wake you, they can linger for half an hour or so and make going back to sleep very difficult indeed.
If they happen frequently enough, you can begin to dread bedtime.

When cramps occur during sleep, it’s usually because of a magnification of a muscle reflex that happens normally. As you roll over in your sleep, your calf muscles involuntarily contract and along with them, the tendons stretch. Nerve stretch receptors in the tendon come alive and relay a message to the spinal cord instructing the calf muscles to contract, or spasm. You may not be aware of this at times, but at other times, the muscles will not relax and they will cause pain.

Other causes of night time leg cramps can include a pinched nerve, muscle damage, mineral deficiencies, in particular potassium and magnesium, diabetes or hormonal fluctuations, peripheral vascular disease and diuretic medication. If you feel any of these may be contributing to your cramps, see your doctor and he or she will examine your general health before probing further into your medical background if he or she deems it necessary.

The first thing you’ll probably want to know is what to do if you get a cramp and then how to reduce the chances of it happening again.

When pain strikes stretch the contracted muscle and flex your foot. If you are flexible enough pull your big toe towards you. Then try to stand up and straighten out your leg and massage your leg to get the blood flowing. The muscle may try to contract again almost instantly so keep it straight and continue to massage it for five or ten minutes. Fortunately, most cramps go away within five or ten minutes but if your cramping is more prolonged or occurs more than two or three times a week consult your GP.

Calf stretching exercise

Stand about 3 feet from a wall, facing it.
Step forward with your left foot.
Put your hands on the wall at chest level. Bend your elbows slightly and have shoulders, hips and feet aimed towards the wall.
Bend your left knee gently and feel the stretch in your right calf muscle as you do so. Keep both heels on the ground at all times.
Hold the stretch for at least 15 seconds.
Repeat with the other side.

Research may not have identified the exact cause of leg cramps but a little prevention can go a long way to improving your nocturnal quality of life. Applying a heat pad to your muscles for 10 to 15 minutes before sleep can be of assistance. Stretching your calf muscles before bedtime can also help to exhaust the stretch reflex.

A multi vitamin and mineral containing potassium, calcium, vitamin E and magnesium or adding foods to the diet that are rich in these elements could reduce the incidence of night time leg cramps if deficiency identified. Maintaining your hydration levels is important, especially if you’ve been exercising vigorously. When you sweat, you lose salts from your body and a sports drink can help to replace the electrolytes lost. Regular exercise and stretching can also help reduce the risk of cramping at night.

Pins and needles

Pins and needles (paraesthesia) are a sensation of uncomfortable tingling or prickling, usually felt in the hands or feet. The affected area is sometimes said to have ‘fallen asleep’. Waking up in the middle of the night with a painful attack of pins and needles in your arms, hands or legs can interfere with a good night’s sleep not only because it obviously wakes you up but because it is uncomfortable and distressing and it can take a while to get comfortable and relaxed again.

The best way to deal with pins and needles is to prevent them happening in the first place. A common cause is leaning or lying awkwardly on a limb, which either presses against the nerves or reduces the blood supply to the local area. To prevent this happening position pillows between your legs or under your arms. Less commonly, nutritional deficiencies, particularly low calcium levels can cause pins and needles so make sure your diet is healthy. Excessive amounts of alcohol can also trigger an attack. Pins and needles in the feet can be a sign of nerve damage or caused by poorly controlled diabetes. Recurrent bouts of pins and needles should always be discussed with your doctor as more sinister causes include neurological disorders such as stroke.

If you do get an attack change your position immediately to restore the blood supply. In some cases, rocking your head from side to side will painlessly remove the sensation in less than a minute. A tingly hand or arm is often the result of compression in the bundle of nerves in the neck. Loosening the neck muscles releases the pressure. Compressed nerves lower in the body govern the feet, and standing up and walking around will typically relieve the sensation. An arm that has fallen asleep may also be awoken more quickly by clenching and unclenching the first several times; the muscle movement increases blood flow and helps the limb return to normal.

Restless legs syndrome (RLS)

This is a form of sleep related movement disorder and often involves an irresistible desire to move your legs. The sensations may be pain, discomfort, itching, tingling or prickling and when the legs are moved there is often a relief of this sensation, but symptoms return when the leg movements stops.

Up to 15 per cent of the population suffers from restless leg syndrome and the peak onset period is middle age. Unlike snoring, it is more common in women. People who are anaemic are at higher risk and for this reason iron supplementation may be advised. The syndrome may also be caused by an underlying neurological or medical disorder such as diabetes so it is always important to have this ruled out by your doctor if attacks are severe.

Simple lifestyle changes, such as walking and stretching, warm baths, massage and relaxation exercises can help correct the disorder. Studies also have shown that maintaining a regular sleep pattern can reduce symptoms. Some individuals, finding that RLS symptoms are minimized in the early morning, change their sleep patterns. Dietary supplementation with iron, foliate, magnesium and calcium may also be advised and if none of these strategies can help prescription medication, and referral to a sleep movement disorders specialist may be the best solution.

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