By Ann L. Rappoport
You may be one of millions of older Americans suffering from Restless Legs Syndrome (RLS), although unfortunately, your primary care physician may be overlooking the problem.
Among women in their 70s, approximately 20 percent have RLS; among men in that age group, one in 10.
Although trivial-sounding, this serious neurological abnormality accounts for enormous discomfort and sleep deprivation, contributing to mood swings, depression and anxiety, and possibly weakened immunity to disease, driving accidents and compromised lifestyle and function.
You can usually recognize Restless Legs Syndrome (RLS) by an irresistible need to move your legs (and sometimes arms), peaking at about the time most people are either going to bed or have just fallen asleep, notes Dr. Karl Doghramji, medical director of Thomas Jefferson University Hospital’s Jefferson Sleep Disorders Center in Philadelphia. This is different from the twitching, tossing and turning we all experience, in that RLS literally compels you to move about to deal with the distress.
A vicious cycle
Furthermore, about 80 percent of RLS sufferers also experience Periodic Limb Movement Disorder (PLMD), which disrupts the little sleep they do get. PLMD is a surge of nerve activity that causes muscles to jerk as often as every 30 to 40 seconds, interfering with the sleep of the patient, as well as a partner.
Sleep loss creates its own vicious cycle.
The prevalence and severity of RLS increases as people age. Also, some conditions tend to provoke RLS — such as diabetes, kidney disease, and vitamin and mineral
deficiencies.
In addition, certain antidepressants and stimulants can produce RLS symptoms.
Self-help strategies:
- Eliminate or reduce caffeine and alcohol.
- Exercise early in the day.
- Take hot or cold baths near bedtime.
- Massage limbs/body near bedtime.
- Increase nutritious foods that contain iron and vitamin C, if there’s reason to expect that you’re not getting enough iron.
- Take your mind off urges with distraction techniques, such as reading.
- Improve your sleep habits.
Good sleep habits are those that strengthen your natural day/nighttime rhythms — the so-called circadian rhythms. These habits include going to bed and getting up at the same times each day, sleeping in the dark and working in strong light.
Ironically, severe RLS may make it easier to sleep after 3 a.m., then most of the morning, notes Doghramji. That may help with RLS, but such habits disrupt circadian rhythms. This may promote the bizarre sleep/wake patterns to which older people may be subjected. Such disruptions may cause confusion and behavior that mimics dementia.
Try a sleep center
If you’re having symptoms, Doghramji suggests, “Inform your doctor. Get to a sleep center for a complete examination.”
He says a variety of effective pharmaceuticals treat RLS.
Not sure where to find a convenient sleep center? He suggests contacting the American Academy of Sleep Medicine, http://www.aasmnet.org or 708-492-0930.
Despite past lifestyle, it’s not too late to start ‘eating right’ and exercising
Since you’ve eaten unhealthily and exercised little over your lifetime, there’s little point in trying to turn things around in these later years, right?
Wrong, says Dr. Andrew Mustin. “No matter when you start, living a healthy lifestyle can help prevent heart problems — adding years to your life.”
Exercise and “eating right” take on added importance later in life, says Mustin, a cardiologist at Holy Redeemer Hospital in Meadowbrook. “Increased age and obesity are major risk factors for heart disease, so it is crucial to manage what you eat and how much.”
He urges a low-fat, low-carb diet: fish, chicken, turkey, fruits, vegetables, whole grains, low-fat dairy foods.
As for exercise, suggests Mustin, “ease into a program after you get medical clearance,” then slowly work up to about 30 minutes of physical activity a day, three to five days a week.
You can’t control age and family history, he says, but “the sooner you begin a healthy lifestyle, the longer and stronger your heart will beat.”
An excuse for grumpiness
Grumpy old men: You have an excuse.
Low testosterone, the male hormone, makes men “miserable to live with,” Dr. David Greenberg of Toronto told the World Congress on the Aging Male in Tampa, Fla. “They fall asleep after dinner and snap at everyone.”
Studies associate low levels with reduced muscle mass, bone density, sexual function and vitality, increasing fatigue, depression, Type II diabetes and obesity. Evidence is accumulating that medication restoring testosterone to normal can alleviate such problems, but there’s debate over what’s “normal,” which of the three forms of testosterone to measure and where the element of aging fits in.
Also, there is concern that testosterone could fuel prostate cancer, but recent studies find no correlation.
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Good for heart — and prostate
A new study shows that a heart-healthy diet may also be good for the prostate.
A diet low in fat, high in vegetables and lean protein, with moderation in alcohol — the kind prescribed for cardiac patients — appears to decrease the risk of benign prostatic hyperplasia (BPH), according to findings published in the American Journal of Epidemiology.
BPH, associated with frequent and uncomfortable urination, affects about half of all men by the time they reach 50 and nearly all men by age 70.
“The results of this study clearly show a link between a high-fat diet and increased risk of BPH,” reports the study’s lead author, Dr. Alan Kristal.
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ACL tears should be fixed
Just because you’re along in years doesn’t mean you can’t benefit from reconstruction of injured tissues in your knees, known as anterior cruciate ligaments (ACL).
Years ago, surgeons didn’t fix such injuries in people over 50, because it was assumed that over a certain age, your athletic life was done, so it wasn’t necessary to fix the ACL, but older people today work out and remain physically active. A new study finds that men and women in their 50s and 60s do well after such surgery.
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