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Restless Legs Syndrome(RLS)

Alternative Name : Wittmaack–Ekbom syndrome

Definitipon:
Restless legs syndrome (RLS)  is a neurological disorder characterized by an irresistible urge to move one’s body to stop uncomfortable or odd sensations.  It most commonly affects the legs, but can affect the arms, torso, and even phantom limbs.  Moving the affected body part modulates the sensations, providing temporary relief.
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RLS sensations can most closely be compared to an itching or tickling in the muscles, like “an itch you can’t scratch” or an unpleasant “tickle that won’t stop.” The sensations typically begin or intensify during quiet wakefulness, such as when relaxing, reading, studying, or trying to sleep.  In addition, most individuals with RLS have limb jerking during sleep, which is an objective physiologic marker of the disorder and is associated with sleep disruption. Some controversy surrounds the marketing of drug treatments for RLS. It is a “spectrum” disease with some people experiencing only a minor annoyance and others experiencing major disruption of sleep and significant impairments in quality of life

Restless legs syndrome can begin at any age and generally worsens as you get older. Women are more likely than men to develop this condition.

A number of simple self-care steps and lifestyle changes may help you. Medications also help many people with restless legs syndrome.

Symptoms:
Commonly described sensations
People typically describe restless legs syndrome (RLS) symptoms as unpleasant sensations in their calves, thighs, feet or arms, often expressed as:

*Crawling

*Tingling

*Cramping

*Creeping

*Pulling

*Painful

*Electric

*Tense

*Uncomfortable

*Itchy

*Tugging

*Gnawing

*Aching

*Burning

Sometimes the sensations seem to defy description. Affected people usually don’t describe the condition as a muscle cramp or numbness. They do, however, consistently describe the desire to move or handle their legs.

It’s common for symptoms to fluctuate in severity, and occasionally symptoms disappear for periods of time.

NIH criteria
In 2003, a National Institutes of Health (NIH) panel modified their criteria to include the following:

1.An urge to move the limbs with or without sensations.

2.Improvement with activity. Many patients find relief when moving and the relief continues while they are moving. In more severe RLS this relief of symptoms may not be complete or the symptoms may reappear when the movement ceases.

3.Worsening at rest. Patients may describe being the most affected when sitting for a long period of time, such as when traveling in a car or airplane, attending a meeting, or watching a performance. An increased level of mental awareness may help reduce these symptoms.

4.Worsening in the evening or night. Patients with mild or moderate RLS show a clear circadian rhythm to their symptoms, with an increase in sensory symptoms and restlessness in the evening and into the night.
RLS is either primary or secondary.

*Primary RLS is considered idiopathic or with no known cause. Primary RLS usually begins slowly, before approximately 40–45 years of age and may disappear for months or even years. It is often progressive and gets worse with age. RLS in children is often misdiagnosed as growing pains.

*Secondary RLS often has a sudden onset after age 40, and may be daily from the beginning. It is most associated with specific medical conditions or the use of certain drugs

Causes:
Disease mechanism
Most research on the disease mechanism of restless legs syndrome has focused on the dopamine and iron system.   These hypotheses are based on the observation that iron and levodopa, a pro-drug of dopamine that can cross the blood-brain barrier and is metabolized in the brain into dopamine (as well as other mono-amine neurotransmitters of the catecholamine class) can be used to treat RLS, levodopa being a medicine for treating hypodopaminergic (low dopamine) conditions such as Parkinson’s disease, and also on findings from functional brain imaging (such as positron emission tomography and functional magnetic resonance imaging), autopsy series and animal experiments.  Differences in dopamine- and iron-related markers have also been demonstrated in the cerebrospinal fluid of individuals with RLS.  A connection between these two systems is demonstrated by the finding of low iron levels in the substantia nigra of RLS patients, although other areas may also be involved.

Heredity
RLS runs in families in up to half the people with RLS, especially if the condition started at an early age. Researchers have identified sites on the chromosomes where genes for RLS may be present.

Pregnancy
Pregnancy or hormonal changes may temporarily worsen RLS signs and symptoms. Some women experience RLS for the first time during pregnancy, especially during their last trimester. However, for most of these women, signs and symptoms usually disappear quickly after delivery.

Related conditions
For the most part, restless legs syndrome isn’t related to a serious underlying medical problem. However, RLS sometimes accompanies other conditions, such as:

*Peripheral neuropathy. This damage to the nerves in your hands and feet is sometimes due to chronic diseases such as diabetes and alcoholism.

*Iron deficiency. Even without anemia, iron deficiency can cause or worsen RLS. If you have a history of bleeding from your stomach or bowels, experience heavy menstrual periods or repeatedly donate blood, you may have iron deficiency.

* Kidney failure. If you have kidney failure, you may also have iron deficiency, often with anemia. When kidneys fail to function properly, iron stores in your blood can decrease. This, along with other changes in body chemistry, may cause or worsen RLS.

Risk Factors:
RLS can develop at any age, even during childhood. Many adults who have RLS can recall being told as a child that they had growing pains or can remember parents rubbing their legs to help them fall asleep. The disorder is more common with increasing age.

Complications:
Although RLS doesn’t lead to other serious conditions, symptoms can range from barely bothersome to incapacitating. Many people with RLS find it difficult to get to sleep or stay asleep. Insomnia may lead to excessive daytime drowsiness, but RLS may prevent you from enjoying a daytime nap.

Diagnosis:
The diagnosis of RLS relies essentially on a good medical history and physical examination. Sleep registration in a laboratory (polysomnography) is not necessary for the diagnosis. Peripheral neuropathy, radiculopathy and leg cramps should be considered in the differential diagnosis; in these conditions, pain is often more pronounced than the urge to move. Akathisia, a side effect of several antipsychotics or antidepressants, is a more constant form of leg restlessness without discomfort. Doppler ultrasound evaluation of the vascular system is essential in all cases to rule out venous disorders which is a common etiology of RLS. A rare syndrome of painful legs and moving toes has been described, with no known cause.

Treatment:
Treatment of restless legs syndrome involves identifying the cause of symptoms when possible. The treatment process is designed to reduce symptoms, including decreasing the number of nights with RLS symptoms, the severity of RLS symptoms and nighttime awakenings. Improving the quality of life is another goal in treatment. This means improving overall quality of life, decreasing daytime somnolence, and improving the quality of sleep. All of these goals are taken care of through nonpharmacologic and pharmacologic therapies. Pharmacotherapy involves dopamine agonists as first line drugs for daily restless legs syndrome; gabapentin (Horizant™) and opioids for treatment of resistant cases.

An algorithm created by Mayo Clinic researchers and endorsed by the RLS Foundation, provides guidance to the treating physician and patient, including non pharmacological and pharmacological treatments. Treatment of primary RLS should not be considered until possible precipitating medical conditions are ruled out, especially venous disorders. RLS Drug therapy is not curative and has side effects such as nausea, dizziness, hallucinations, orthostatic hypotension and daytime sleep attacks. In addition, it can be expensive (about $100–150 per month for life), and needs to be considered with caution.

Secondary RLS may be cured if precipitating medical conditions (anemia, venous disorder) are managed effectively. Secondary conditions causing RLS include iron deficiency, varicose veins, and thyroid problems. Karl-Axel Ekbom in his 1945 doctoral thesis on RLS suspected venous disease in about 12.5% of cases. But due to the unavailability of Doppler ultrasound imaging technology (the diagnostic tool detecting abnormal blood flow in the veins, “Venous Reflux”, the pathological basis for varicose veins) at that time, Ekbom may have underestimated the role of venous disease. In uncontrolled prospective series, improvement of RLS was achieved in a high percentage of patients presenting with a combination of RLS and venous disease and had sclerotherapy or other treatment for the correction of venous insufficiency.   In Nonpharmacologic treatments there are ways patients may be able to reduce the symptoms or decrease the severity of the symptoms. One thing that may worsen the symptoms is fatigue. Therefore using relaxation techniques, soaking in a warm bath or massaging the legs can all help aid in relaxation and relief of symptoms. Another technique is avoiding caffeine, alcohol, and tobacco. Also exercising every day and maintaining a schedule of relaxation and avoiding heavy meals before bed will all help with relief of symptoms. These techniques can be used with medication or just by themselves for those who do not want medication. For symptoms that occur in the evening patients may find that activities that alert the mind like crossword puzzles, and video games may reduce symptoms. Many patients may also benefit from RLS support groups.

Stretching and shaking legs
Stretching the leg muscles can bring relief lasting from seconds to days.   Walking around brings relief also. Tiredness can be a factor and some sufferers may find going to bed usually stops the discomfort. Bouncing or shaking the legs/feet in an up and down motion, with the ball of the foot on the floor when sitting down may bring temporary relief.

Iron supplements
According to some guidelines, all people with RLS should have their serum ferritin level tested. The ferritin level, a measure of the body’s iron stores, should be at least 50 µg for those with RLS. Oral iron supplements, taken under a doctor’s care, can increase ferritin levels. For some people, increasing ferritin will eliminate or reduce RLS symptoms. A ferritin level of 50 µg is not sufficient for some sufferers and increasing the level to 80 µg may further reduce symptoms. However, at least 40% of people will not notice any improvement. Treatment with IV iron is being tested at the US Mayo Clinic and Johns Hopkins Hospital. It is dangerous to take iron supplements without first having ferritin levels tested, as many people with RLS do not have low ferritin and taking iron when it is not called for can cause iron overload disorder, potentially a very dangerous condition

Medication therapy:
Several prescription medications, most of which were developed to treat other diseases, are available to reduce the restlessness in your legs. These include:

*Medications for Parkinson’s disease. These medications reduce the amount of motion in your legs by affecting the level of the chemical messenger dopamine in your brain. Two drugs, ropinirole (Requip) and pramipexole (Mirapex), are approved by the Food and Drug Administration for the treatment of moderate to severe RLS.

Doctors commonly also use other Parkinson’s drugs to treat restless legs syndrome, such as a combination of carbidopa and levodopa (Sinemet). People with RLS are at no greater risk of developing Parkinson’s disease than are those without RLS. Side effects of Parkinson’s medications are usually mild and include nausea, lightheadedness and fatigue.

*Opioids. Narcotic medications can relieve mild to severe symptoms, but they may be addicting if used in too high doses. Some examples include codeine, oxycodone (Roxicodone), the combination medicine oxycodone and acetaminophen (Percocet, Roxicet), and the combination medicine hydrocodone and acetaminophen (Lortab, Vicodin).

*Muscle relaxants and sleep medications. This class of medications, known as benzodiazepines, helps you sleep better at night. But these medications don’t eliminate the leg sensations, and they may cause daytime drowsiness. Commonly used sedatives for RLS include clonazepam (Klonopin), triazolam (Halcion), eszopiclone (Lunesta), ramelteon (Rozerem), temazepam (Restoril), zaleplon (Sonata) and zolpidem (Ambien).

*Medications for epilepsy. Certain epilepsy medications, such as gabapentin (Neurontin), may work for some people with RLS.It may take several trials for you and your doctor to find the right medication and dosage for you. A combination of medications may work best.

Caution about medications:
One thing to remember with drugs to treat RLS is that sometimes a medication that has worked for you for a while becomes ineffective. Or you notice your symptoms returning earlier in the day. For example, if you have been taking your medication at 8 p.m., your symptoms of RLS may start at 6 p.m. This is called augmentation. Your doctor may substitute another medication to combat the problem.

Most of the drugs prescribed to treat RLS aren’t recommended for pregnant women. Instead, your doctor may recommend self-care techniques to relieve symptoms. However, if the sensations are particularly bothersome during your last trimester, your doctor may approve the use of pain relievers.

Some medications may worsen symptoms of RLS. These include most antidepressants and some anti-nausea drugs. Your doctor may recommend that you avoid these medications if possible. However, should you need to take these medications, restless legs can still be controlled by adding drugs that manage the condition.

Lifestyle and home remedies

Making simple lifestyle changes can play an important role in alleviating symptoms of RLS. These steps may help reduce the extra activity in your legs:

*Take pain relievers. For very mild symptoms, taking an over-the-counter pain reliever such as ibuprofen (Advil, Motrin, others) when symptoms begin may relieve the twitching and the sensations.

*Try baths and massages. Soaking in a warm bath and massaging your legs can relax your muscles.

*Apply warm or cool packs. You may find that the use of heat or cold, or alternating use of the two, lessens the sensations in your limbs.

*Try relaxation techniques, such as meditation or yoga. Stress can aggravate RLS. Learn to relax, especially before going to bed at night.Establish good sleep hygiene. Fatigue tends to worsen symptoms of RLS, so it’s important that you practice good sleep hygiene. Ideally, sleep hygiene involves having a cool, quiet and comfortable sleeping environment, going to bed at the same time, rising at the same time, and getting enough sleep to feel well rested. Some people with RLS find that going to bed later and rising later in the day helps in getting enough sleep.

*Exercise. Getting moderate, regular exercise may relieve symptoms of RLS, but overdoing it at the gym or working out too late in the day may intensify symptoms.

*Avoid caffeine. Sometimes cutting back on caffeine may help restless legs. It’s worth trying to avoid caffeine-containing products, including chocolate and caffeinated beverages such as coffee, tea and soft drinks, for a few weeks to see if this helps.

*Cut back on alcohol and tobacco. These substances also may aggravate or trigger symptoms of RLS. Test to see whether avoiding them helps.

*Stay mentally alert in the evening. Boredom and drowsiness before bedtime may worsen RLS. Mentally stimulating activities such as video games or crossword puzzles can help you stay alert and may reduce symptoms of RLS.

Alternative Medication:
Because restless legs syndrome is sometimes due to an underlying nutritional deficiency, taking supplements to correct the deficiency may improve your symptoms. Your doctor can order blood tests to pinpoint nutritional deficiencies and give you a good sense of which supplements may help.

Doctor may also tell you whether certain dietary supplements can interfere with the way your prescription medications work or may pose health risks for you.

If blood tests show that you are deficient in any of the following nutrients, your doctor may recommend taking dietary supplements as part of your treatment plan:

*Iron
*Folic acid
*Vitamin B
*Magnesium

More research is needed to reliably establish the safety and effectiveness of all of these supplements in the treatment of RLS.

Prognosis:
RLS is generally a lifelong condition for which there is no cure. Symptoms may gradually worsen with age, though more slowly for those with the idiopathic form of RLS than for patients who also suffer from an associated medical condition. Nevertheless, current therapies can control the disorder, minimizing symptoms and increasing periods of restful sleep. In addition, some patients have remissions, periods in which symptoms decrease or disappear for days, weeks, or months, although symptoms usually eventually reappear. Being diagnosed with RLS does not indicate or foreshadow another neurological disease.

Prevention:
Other than preventing the  causes, no method of preventing RLS has yet been established or studied.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.mayoclinic.com/health/restless-legs-syndrome/DS00191
http://en.wikipedia.org/wiki/Restless_legs_syndrome
http://www.sleepdisordersguide.com/restless-leg-syndrome-causes.html

Homeopathy for Restless Legs Syndrome

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Movement Disorders

Introduction:
Movement disorders are a group of nervous system (neurological) conditions that cause you to have abnormal voluntary or involuntary movements, or slow, reduced movements.
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Even a simple action such as picking up a pencil engages several different parts of the brain. The conscious thought areas of the brain trigger the motor area to send signals to the muscles of the arm.

As the movement begins, sensors in the arm are activated, sending signals back into different areas of the brain that interpret them and then send further messages to the motor area to fine tune power, speed, coordination and balance.

Given such complexity, problems with the control of movement are understandably widespread. Essential tremor – the most common movement disorder – affects one in 20 people under the age of 40 and one in five people over 65. Up to one in ten people has restless legs syndrome.

Other conditions such as Parkinson’s disease (which affects one in 500 people) are less common, but can severely impair quality of life because they reduce the independence of those affected.

Types:
There are various types of  Movement disorders and that include :

*Ataxia. Ataxia is a neurological condition that affects the part of your brain that controls coordinated movement (cerebellum). Ataxia may cause uncoordinated movements, imbalance and other symptoms.

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*Dystonia. Dystonia is a neurological condition in which your muscles contract involuntarily and may cause twisting and repetitive movements. Dystonia may involve the entire body (generalized dystonia) or one part of the body (focal dystonia).

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*Essential tremor. Essential tremor is a neurological condition that causes involuntary shaking (tremors). Your hands often are affected, but other parts of your body also may be affected.

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*Huntington’s disease. Huntington’s disease is an inherited progressive, neurodegenerative disorder that causes certain nerve cells in your brain to deteriorate. This condition may cause uncontrolled movements, decreased thinking abilities (cognitive abilities), and emotional and mental health disturbances (psychiatric conditions).

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*Multiple system atrophy. Multiple system atrophy is an uncommon, progressive neurological disorder that affects many areas of your brain and nervous system. Multiple system atrophy may cause ataxia or parkinsonism. This condition frequently impairs body systems that modulate your blood pressure, heart rate and bladder function (autonomic function).

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*Myoclonus.:  Myoclonus is a condition in which you have sudden, jerky movements, twitching, or intermittent spasms of a muscle or group of muscles.

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*Parkinson’s disease. Parkinson’s disease is a progressive neurological disorder that affects your movement and may cause shaking (tremor), muscle stiffness (rigidity), slowing of movement, impaired balance or other symptoms. Parkinsonism describes a group of conditions that has symptoms similar to those of Parkinson’s disease.

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*Progressive supranuclear palsy. Progressive supranuclear palsy is a rare neurological disorder that causes you to have problems with walking, balance and eye movements. It resembles Parkinson’s disease but is a distinct condition.

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*Restless legs syndrome. Restless legs syndrome causes unpleasant, abnormal feelings in your legs while you’re relaxing or lying down. Your symptoms often are relieved by movement.
Tardive dyskinesia. Tardive dyskinesia is a neurological condition caused by long-term use of certain drugs used to treat psychiatric conditions (neuroleptic drugs). Tardive dyskinesia causes repetitive and involuntary movements such as grimacing, eye blinking and other movements.

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*Tourette syndrome. Tourette syndrome is a neurological condition which starts between childhood and teenage years and is associated with repetitive movements (motor tics) and vocal sounds (vocal tics).

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*Wilson’s disease. Wilson’s disease is an inherited (genetic) disorder that causes excessive amounts of copper to build up in your body, causing neurological problems.

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Treatment :Treatment depends upon the underlying disorder

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://en.wikipedia.org/wiki/Movement_disorder
http://www.bbc.co.uk/health/physical_health/conditions/movementdisorders1.shtml
http://www.ganeurosurg.org/specialties/movementdisorders.htm
http://www.mayoclinic.org/movement-disorders/

Dystonia


http://wiki.ggc.usg.edu/mediawiki/index.php/Essential_Tremor
http://www.bothbrainsandbeauty.com/academic-discussions/huntingtons-disease-991
http://www.chelationtherapyonline.com/anatomy/p3.htm

http://fisioterapiananeurologia.blogspot.com/2011/05/ataxia-de-friedreich.html

http://www.movementdisorders.org/james_parkinson/early_atypical.html

Homeopathy for Restless Legs Syndrome

http://worldsstrongestlibrarian.com/9257/tourettes-syndrome-pictures/

http://www.eurowilson.org/en/living/guide/what/index.phtml

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Sleep Eating

Introduction:
Sleep eating is a sleep-related disorder, although some specialists consider it to be a combination of a sleep and an eating disorder. It is a relatively rare and little known condition that is gaining recognition in sleep medicine. Other names for sleep eating are sleep-related eating (disorder), nocturnal sleep-related eating disorder (NS-RED), and sleep-eating syndrome.

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Sleep eating is characterized by  sleepwalking and excessive nocturnal overeating (compulsive hyperphagia). Sleep eaters are comparable to sleepwalkers in many ways: they are at risk for self-injury during an episode, they may (or may not) experience excessive daytime sleepiness, and they are usually emotionally distressed, tired, angry, or anxious. Sleep eaters are also at risk for the same health complications as compulsive overeaters, with the added dangers of sleepwalking. Common concerns include excessive weight gain, daytime sleepiness, choking while eating, sleep disruption, and injury from cooking or preparing food such as from knives, utensils, or hot cooking surfaces. There is also the potential for starting a fire.

As with sleepwalkers, sleep eaters are unaware and unconscious of their behavior. If there is any memory of the episode, it is usually sketchy. A sleep eater will roam the house, particularly the kitchen, and may eat large quantities of food (as well as non-food items). In the morning, sleep eaters have no recollection of the episode. However, in many cases there are clues to their behavior. One woman woke up with a stomachache and chocolate smeared on her face and hands. Candy wrappers littered the kitchen floor. The next morning her husband informed her that she had been eating during the night. She was shocked and distressed because she had no recollection of the event.

As in the case described above, food consumed by sleep eaters tends to be either high sugar or high fat. Odd combinations of foods, such as potato chips dipped in peanut butter or butter smeared on hotdogs, as well as non-food items, have been reported. Oddly, one person was discovered cutting a bar of soap into slices and then eating it as if it were a slice of cheese!

Sleep eating is classified as a parasomnia. It is a rare version of sleepwalking, which is an arousal disorder. In 1968, Roger Broughton published a paper in Science (159: 1070-1078) that outlined the major features of arousal disorders. They are:

•Abnormal behavior that occurs during an arousal from slow wave sleep;
•The absence of awareness during the episode;
•Automatic and repetitive motor activity;
•Slow reaction time and reduced sensitivity to environment;
•Difficulty in waking despite vigorous attempts;
•No memory of the episode in the morning (retrograde amnesia); and
•No or little dream recall associated with the event.

How Common is Sleep Eating?
The actual number of sleep-eating sufferers is unknown; however, it is estimated that 1 to 3 percent of the population is affected by sleep eating. A higher percentage of persons with eating disorders, as many as 10 to 15 percent, are affected. For this reason, sleep eating is more common in younger women. Symptoms typically begin in the late 20s. Episodes may reoccur, in combination with a stressful situation, or an episode may occur only once or twice. Additionally, many parasomnias seem to run in families, which may indicate that sleep eating is genetically linked.

When Should you See a Doctor?
In many cases, sleep eating is the outward sign of an underlying problem. Many sufferers are overweight and dieting. When their control is diminished by sleep, these individuals binge at night to satisfy their hunger. Some sleep eaters have histories of alcoholism, drug abuse, or a primary sleep disorder, such as sleepwalking, Restless Legs Syndrome, or sleep apnea. An article in Sleep (October 1991: 14(5): 419-431) suggested that sleep eating is directly linked to the onset of another medical problem.

Because sleep eating occurs in people that are usually dieting and emotionally distressed, attempts at weight loss may be unsuccessful and cause even more stress. Compounded with the dangers of sleepwalking, compulsive eating while asleep is a sleep disorder that results in weight gain, disrupted sleep, and daytime sleepiness. As these consequences of sleep eating impact daily living, the necessity of seeing a healthcare professional becomes more important.

Parasomnias are complex and often serious in nature. If you think you suffer from sleep eating, consult with your physician or a healthcare professional who can refer you to a sleep disorders treatment center. It is strongly recommended that a sleep specialist carry out the diagnosis and treatment. Medical or psychological evaluation should also be investigated.

Treatment:
The first step in treating any sleep disorder is to ascertain any underlying causes. As with most parasomnias, sleep eating is usually the result of an underlying problem, which may include another sleep disorder, prescription drug abuse, nicotine withdrawal, chronic autoimmune hepatitis, encephalitis (or hypothalmic injury), or acute stress (Sleep 1991 Oct; 14(5): 419-431).

It is important to keep in mind that throughout life, people experience varying patterns of sleep and nutrition during positive and negative situations. Problems with eating are defined as overeating or not eating enough. Problems with sleeping can be simplified with two symptoms, too much or not enough sleep. Medical attention is required for abnormal behaviors in either or both areas.

For some people who have been diagnosed with sleep eating, interventions without the use of medications have proven helpful. Courses on stress management, group or one-on-one counseling with a therapist, or self-confidence training may alleviate the stress and anxiety that leads to nighttime bingeing. Although considered an alternative treatment, hypnosis may be an option for some sleep eaters. A change in diet that includes avoiding certain foods and eating at specified times of the day, as well as reducing the intake of caffeine or alcohol, may be therapeutic. Professional advice may also suggest avoiding certain medications.

If the underlying problem is diagnosed as sleepwalking, medications in the benzodiazepinefamily have had some success. In sleepwalkers, this class of drugs reduces motor activity during sleep. Another class of drug found to be effective for sleep eaters has been the dopaminergic agents such as Sinemet (carbidopa or levodopa) and Mirapex (pramipexole dihydrochloride). Refer to the chart in the Restless Legs section of this website for more information about dopaminergic agents and benzodiazepines.

If the underlying problem is a primary sleep disorder, such as sleep apnea or narcolepsy, check out the sections on this web site devoted to the treatment of these disorders.

Night Eating: Another Disorder of Sleep and Eating:
A similar sleep-related eating disorder has also been clinically described. It is different from sleep eating in that the individual is awake during episodes of nocturnal bingeing. This disorder has many names: nocturnal eating (or drinking) syndrome, nighttime hunger, nocturnal eating, night eating or drinking (syndrome), or the “Dagwood” syndrome. Affected individuals are physically unable to sleep without food intake.

The Merck Manual lists night eating under the heading obesity. It states that the disorder “consists of morning anorexia, excessive ingestion of food in the evening, and insomnia.” Because night eating is associated with increased weight gain as well as insomnia, this may cause the individual stress, anxiety, or depression.

Night eating or drinking may occur once or many times during the night. It is diagnosed when 50% or more of an individual’s diet is consumed between sleeping hours. Unlike sleep eaters, this person will eat foods that are similar to his/her normal diet.

People who are night eaters typically avoid food until noon or later, eat small portions frequently when they do eat, and binge in the evening. They are usually overweight and in adults, overly stressed or anxious. They will also complain of not being able to maintain sleep or not being able to initiate sleep. For night eaters, the urge to eat is an abnormal need, rather than true hunger, according to an article in Sleep by Italian researchers (September 1997; 20(9): 734-738).

Night eaters/drinkers are usually children, although the disorder can occur in adults. For children, eating or drinking at night is a conditioned behavior. This is a common occurrence for babies, but most infants can sleep the entire night by the age of 6 months. Sleep disturbance can persist to an older age if the child is allowed a bottle or drinks throughout the night. An older child may consistently wake up during the night and ask for a drink or something to eat and refuse to return to bed until the snack is consumed. In this case, the caregiver should identify actual need versus repeated requests.

According to the International Classification of Sleep Disorders, night eating is characterized as a dyssomnia (as opposed to sleep eating, which is considered a parasomnia). A dyssomnia is a disorder of sleep or wakefulness in which insomnia or excessive daytime sleepiness daytime sleepiness is a complaint. Within the heading of dyssomnia, night eating is classified as an extrinsic sleep disorder, which means that it originates, develops or is caused by an external source. Eating or drinking at night is usually a conditioned, conscious behavior; although it is a disorder, in many cases night eating is not caused by a psychological or medical condition.

Night eating may arise because of an ulcer, by dieting during the day, by undue stress or by a routine expectation (conditioned behavior). Hypoglycemia, or low blood sugar, has also been proposed as possible cause of nighttime bingeing in some people. This can be determined by a glucose tolerance test.
Click to see:->Night eating syndrome

Source:http://www.talkaboutsleep.com/sleep-disorders/archives/parasomnias_sleepeating.htm

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Night Leg Cramps

Definition:A muscle cramp is a sudden, uncontrolled contraction of a muscle. This type of pain is most commonly experienced in the legs, and therefore often called a leg cramp or a “charley horse.”

Leg cramps occur when the muscle suddenly and forcefully contracts. The most common muscles to contract in this manner are muscles that cross two joints. These muscles include the calf (crossing the ankle and knee), the hamstring (crossing the knee and hip), and the quadriceps (also crossing the knee and hip).

Leg cramps usually last less than one minute, but may last several minutes before the contraction subsides. In some patients, the leg cramps occur primarily at night, and can awaken the patient from sleep.

A muscle cramp is an involuntary, sustained tightening (contraction) of one or more of your muscles. It can result in intense pain and an inability to use the affected muscles. Night leg cramps are contractions of the leg muscles, usually in the back of the lower leg (calf). They often occur just as you’re falling asleep or just as you’re waking up.

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Causes:
The exact cause of night leg cramps isn’t known. Some experts believe they may be due to abnormal processing of electrolytes — essential elements and chemical substances your body needs for basic functions — by muscles. Almost everyone has occasional leg cramps. But they occur most often in older adults. Common causes of night leg cramps include:

Muscle overexertion
Prolonged sitting
Dehydration
Pregnancy
Diabetes
Decreased potassium levels
Neuromuscular disorders, such as Parkinson’s disease
Certain medications, such as albuterol, niacin, diuretics, and some calcium channel blockers and antipsychotic medications
Alcohol use

If you do get a leg cramp, you may be able to make it go away by:
1.Walking on the affected leg
2.Massaging the affected muscle
3.Straightening your leg and flexing your foot toward your knee until you feel the calf muscles stretch
4.Applying a cold pack to the affected muscle
5.Taking a hot bath

6.When your calf muscles cramp Flex your foot up (toes to ceiling) and hold until the cramping stops.

7.Apply heat to cramping muscles
8. Massage the cramped muscles
9. Make sure you eat plenty of potassium rich foods – (bananas,
tomatoes, potatoes, broccoli, cantaloupe, oranges, grapefruit)

To help prevent night leg cramps:
Drink plenty of fluids during the day.
Stretch your leg muscles before bedtime.
Get adequate potassium in your diet.
If you have frequent and severe leg cramps at night, talk to your doctor. Treatment results vary. But the most effective treatments based on current research are:

Vitamin B-12
Gabapentin
Night leg cramps should be distinguished from another common cause of night leg discomfort called restless legs syndrome, a condition in which your legs have a creepy, crawly or fidgety sensation unless you move them. The sensation often worsens as night approaches. Restless legs syndrome is a neurologic condition that requires different treatment from that of night leg cramps.


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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.mayoclinic.com/health/night-leg-cramps/AN00499
http://orthopedics.about.com/cs/sprainsstrains/a/legcramp.htm

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Body Clock ‘Cog’ Could End Jet-Lag

International travellers, who often complain of jet lag and sleeping disorders will soon have a treatment in hand, as scientists have now discovered a unique “cog” in the sleep-controlling human body clock which may help them avert these disorders.

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It is believed that the body clock governs the circadian rhythms of the body and connects the cycles of metabolism and behaviour to the cycle of day and night.

It often gets disrupted by old age, disease, international travel and shift work and such disturbance not only causes problems sleeping and eating, but also leads to serious illness.

And now, researchers have identified a molecule, known as c-AMP, a common signalling molecule, which plays a major role in keeping the body clock’s “rhythms” going. This molecule is located in the hypothalamus of the brain, which harbours cells that keeps the body clock in alignment with the other major organs including the heart, lungs and liver.

Led by Michael Hastings, at the Medical Research Council Laboratory of Molecular Biology in Cambridge, the study found that the body clock keeps ticking owing to the daily activation of this molecule, or “cog” in tandem with the body’s genes and proteins.
When the circadian day starts, genes are switched on which then produce proteins, which in turn go on to switch off the same genes at the end of the day. These proteins are then broken down over the circadian night and the process continues again beginning the next morning.

The scientists have claimed that this knowledge of the mechanism of circadian clock may pave the way for new treatments for jet leg and other sleep disorders, in which the body clock is effectively “reset”. The technology arm of the laboratory has applied for a patent application for looking after the pharmacological methods of manipulating the molecule.

Sources: The Times Of India

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