Restless Legs Syndrome (RLS) Discussion Board

Hi again,

question #5 is: Is there a pattern in the environmental triggers (food, activities, climate, stress) that we have? (I'd like to pick up the discussion from http://bb.rls.org/viewtopic.php?f=5&t=8928.)
Numerous patients report on certain things that triggers their WED. We do have a list of foods that is known to influence WED symptoms (for some of us it makes the symptoms worse, but it might even help others), but every patient seems to be individual which environmental factors trigger WED symptoms. And there are some patients who don't have these triggers at all.

I think there are two issues to discuss:
(1) Are there patterns in the environmental influences? Are there patient "types", who tend to have certain triggers while not reacting to other triggers? Is there a connection to the way the drugs are effective or not, and to the likelyness of augmentation?
(2) Is there a cause and effect relation to these triggers, or are they just correlated with WED symptoms? There are environmental triggers that are most likely unrelated to WED (like exercising), so if exercising has a reliable and reproducable effect on the symptoms (positive or negative) we can safely assume that the exercising is the cause for the change.
The situation is different with food, since we know that there are things like cravings/appetite, or stress-induced eating . If people eat chocolate and experience WED symptoms, is it really the chocolate that caused the symptoms, or are the factors that cause appetite for chocolate just identical to the factors that cause WED symptoms? In other words, if WED symptoms are caused by something (say dopamine deficiency), perhaps we are more likely to eat chocolate (which is a kind of self-treatment, since eating chocolate will produce dopamine) when we have this something?

As far as I'm concerned, I think that sugar (sweets) and chocolate may influence my WED symptoms, but I haven't found a relation between symptom severety and caffeine or alcohol. But the funny thing with chocolate is: If I eat chocolate well before I go to bed, there seems to be a good chance for severe WED symptoms. However, if I didn't eat chocolate in the evening and get up due to severe WED symptoms, sometimes eating chocolate calms the symptoms immediately.

I have seen a number of comments of a correlation between seasons and WED. Most comments are that their problems are worse during the summer.

I have a seasonal trigger , but it is not during the summer. My problems are worse during the spring and fall pollen seasons. I am always on allergy meds, so it isn't correlated to that. I suspect that it has something to do with the massive quantities of pollen and mold that we have here on the coast of the Gulf of Mexico simply overwhelm my body's medically supplemented defenses. The neurochemistry texts say that histamine doesn't cross from the blood into the brain, but I suspect that the statement has to do with "normal" histamine levels and not the massive concentrations of histamine in my blood during the two increased pollen seasons.

That simply means that I have one more reason to pray for the first good cold front of the season that will come and kill all the massive stands of ragweed in the area.

A dear friend of mine has periodic mild symptoms. He swears that if he avoids sugar, he NEVER has symptoms. As a birthday party, he never has the cake, for example. He said it was quite apparent to him.

Sugar has a slight influence once in awhile - but since it's relatively rare, I think there must be something else happening, too.

Alcohol worsens it, but I don't think it's the actual alcohol, I think it's that alcohol is a central nervous system depressant. It makes me sleepy; sleepy makes me have symptoms. Same with medications that make me sleepy.

Otherwise, nothing that people often mention on this board is an issue for me.

The only clear "food" trigger I have is coffee, and it took me a long time (years) to be convinced of that, because it creeps up insidiously over days or weeks.

What if food triggers for WED are like food allergies, where the negative effects can take 2 or 3 days to show up? Then you have to think of all the things you've consumed in the last 3 days to detect if there might have been a food-related cause. I and many others could be walking around suffering WED from food-related triggers and never realized it because of the delay.

It might be even more complicated, which I'm pretty sure is the case with my WED and coffee. One coffee or even coffee three days in a row does not seem to have a negative effect, but I think something builds up and eventually it begins to have a negative effect. So there's an even longer time span to be looking at, making it even harder to work out relationships.

I am thinking, because of the beneficial effects of the diet I've been on for 7 months now, that single triggers might not be as much of an issue as the whole package - everything you eat, and neglect to eat.

Alcohol worsens it, but I don't think it's the actual alcohol, I think it's that alcohol is a central nervous system depressant. It makes me sleepy; sleepy makes me have symptoms. Same with medications that make me sleepy.

Yup , I totally agree on this one.

One thing that makes my WED/PLM worse is riding in the car for over an hour. I've had to travel a bit this week, so I have paid for it this week. This afternoon, my WED/PLM started around 2 PM. I had to take my methadone early (be 3 hours) and walk around for a bit, before we could drive the rest of the way home (another 45 min). We had already driven 2 hours in the morning and had been in the car for a bit longer, plus sitting in a doctors office. All of that sitting does me in. I'm fine this evening. Will see how the night goes.
When I'm at home, I sit in my recliner. That doesn't seem to bother me.