My decades-long problem with restless legs interrupted what should have been an unparalleled experience. Every time I traveled, I found myself squished into a confined space or confined with prolonged stillness—both triggers for my twitchy limbs.
Eventually I was diagnosed with restless legs syndrome (RLS), but the treatment plan to mitigate the symptoms during the trip was unclear. On trips, I implemented my own treatments to relieve the annoying contraction in my legs – meditation, marijuana, stretching and taking muscle relaxants. My remedies didn’t work reliably, and the struggle left me distracted, frustrated, and helpless.
They are not alone in the journey to alleviate the symptoms. According to Karla Dzienkowski, executive director of the Restless Legs Syndrome Foundation, nearly 12 million adults and children in the United States deal with the condition. And travel in particular is known to worsen RLS.
What causes restless leg syndrome?
“The hallmark symptom of RLS is the uncontrollable desire to move the legs. Individuals often describe the accompanying RLS sensations as throbbing, pain, contractions, blisters in the legs, or insects crawling under the skin,” Dzienkowski explained in an email. It is also known as Willis-Ekbom disease, and my doctor identified genetics as the main cause.
RLS is notoriously difficult to treat. Andy Berkowski, a doctor and founder of ReLACS Hello, says that RLS is unfortunately marginalized in the medical community, as the condition lacks a diagnostic treatment protocol. Berkowski said RLS is the third most common sleep disorder, “but it doesn’t get the attention it deserves.”
According to the Restless Legs Syndrome Foundation, a single unifying cause of RLS has not been identified. The group says that RLS often runs in families, and it does more common in people with type 2 diabetes. Also, until 25 percent of women develop the syndrome during pregnancy, but the symptoms often disappear after giving birth. Many experts say that RLS is neurological.
“RLS is not a leg condition; it’s a brain condition,” Berkowski said.
How can restless leg syndrome affect you while traveling?
Traveling creates conditions that make it more difficult to mitigate RLS symptoms – in particular, the inability to move freely. In a confined space with limited mobility, the legs can twitch with aggression. “People call airplanes a torture chamber for restless legs,” says Berkowski.
For me, RLS flares up in the evening, especially if I travel. If I am sleep deprived or otherwise anxious, the symptoms dominate with increased intensity. And, as someone who is on and off the planes frequently for work, my symptoms are exacerbated by sleep deprivation, limited mobility and increased alcohol and caffeine intake.
During an overnight flight from Chicago to Paris, my sleep was interrupted by sharp shocks that seemed to come from the bottom of my legs. Unfortunately, moving around the cabin, massaging my legs and flexing my toes offered no relief.
Experts say anxiety also plays a role when traveling with RLS. “There’s the psychological effect that makes things worse. As with any sensory condition, the more you draw attention to RLS, the more you notice it,” Berkowski said.
How to mitigate RLS when traveling
Brian Koo, associate professor of neurology at Yale and director of Yale Medicine’s Restless Legs Syndrome center, recommends avoiding evening or night trips altogether, if possible. Koo explains that sleep and RLS are intrinsically linked. “Try to get a good night’s sleep in the days leading up to the trip,” Koo said. “If you change time zones, adjust your schedule several days before the trip.” Koo warns patients that if they do not get quality sleep, they are likely to have a bad attack with RLS during the trip.
Koo also voiced a strict warning for patients who plan to use over-the-counter sleep aids. “OTC sleep aids that contain antihistamines will make RLS worse,” he says. It is recommended to manage your sleep schedule before a trip and has seen improvement in people who avoid alcohol and sugar while traveling.
Berkowski agrees: “You’re not on the same schedule. You wake up earlier, and you can grab that sugar-laden mocha latte at the airport before your flight. Be aware that caffeine, sugar, and alcohol are RLS culprits , especially when combined with sleep deprivation.
Berkowski tells her patients that while traveling, mobility is key. “Moderate to moderate activity throughout a trip is essential,” he advises. “Simple choices will alleviate symptoms: choose an aisle seat on a flight, avoid the moving walkway at the airport and instead walk next to it, board the flight or train as late as possible, stay at the airport early of your flight, and on the way. trips, get out and walk as quickly as necessary.”
An important accompaniment to movement is to ensure proper blood flow to the legs while walking. Sarah Hans, a doctor in Combined vein and vascular centers, treats patients with RLS. She advises wearing compression socks or stockings while traveling to help with blood flow. She says that “simple exercises like calf raises with your feet on the floor and pulling your knees toward your chest can help.” Hans also recommends staying well hydrated.
Over the past 20 years, I’ve learned that punching my quads and obsessing over the sensation are not productive coping mechanisms. For me, pre-adjusting my schedule to the destination, avoiding caffeine and with compression stockings helped more.
Andrea Javor is a writer based in Chicago. Follow her on X or Instagram: @AndreaEJavor.
