You’re finally comfortable in bed and start drifting off when — bam! You’re hit with pain. Your calf muscle tightens, becomes rock solid, and you get a sharp shot of intense pain that feels like it lasts forever. This is nocturnal leg cramps.
You might expect leg cramps after a long day of hiking or at the finish line of a marathon. But nocturnal leg cramps hit you when you’re peacefully sleeping or just drifting off.
Not only is the episode of cramping itself distressing, you might be left with leg pain and soreness for hours after. And leg cramps can either keep you from falling asleep in the first place, wake you up in the night, or the anxiety of waiting for them to hit (if they’re a common occurrence) can impact your sleep. And we don’t need to tell you that when your sleep is impacted, everything from your ability to concentrate to your mood to your energy levels are affected the next day.
Below, we’ll dive into what exactly leg cramps are, what causes them at night, and what you can do about them.
Leg cramps at night, also called nocturnal leg cramps, NLC, or charley horses, are exactly what they sound like: cramps in your legs that happen during the night.
Your muscle spasms and suddenly contracts. You might feel these cramps in your calves or feet, or less commonly in your thighs or hamstrings. And it can come out of nowhere, even while you’re asleep.
Cramps usually last for an average of nine minutes and 40% of people have cramp episodes more than three times a week, with an unlucky 6% having at least one episode a day or night.
It is a common condition, with up to 60% of adults saying they’ve had nocturnal leg cramps, but it’s a difficult one to diagnose.
Not only are the causes unknown, symptoms can look similar to other leg-related problems you might have at night. These include restless leg syndrome (RLS), a nerve condition where you get an irresistible urge to move your legs, or periodic limb movement disorder, where your limbs move involuntarily while you’re asleep.
There’s no clear definition of nocturnal leg cramps. But, according to a 2017 paper that looked at 18 studies, these are the characteristics to diagnose them:
Though nocturnal leg cramps mostly happen at night — the clue’s in the name — 20% of people experience leg cramps while resting during the day, too.
And while not an official symptom, you may experience tiredness, lack of concentration, and low mood the next day if you regularly have nights where leg cramps keep you up.
With nocturnal leg cramps, it’s much harder to meet your sleep need — the genetically determined amount of sleep you need each night to be at your best during the day. You can use the RISE app to find out your individual sleep need. RISE users on iOS 1.202 and above can click here to access their sleep need on their Profile.
Most of the time, the cause of leg cramps is unknown. But there are a few risk factors and possible causes:
Nocturnal leg cramps are not due to a lack of electrolytes, however.
Richard E. Allen and Karl A. Kirby write in American Family Physician:
“The exact mechanism is unknown, but the cramps are probably caused by muscle fatigue and nerve dysfunction rather than electrolyte or other abnormalities.”
They go on to say that nocturnal cramps haven’t been associated with a lack of things like potassium, sodium, or magnesium. A doctor may not even test your electrolyte levels and may instead focus on other more likely causes.
Plus, the researchers say nocturnal muscle cramps are not associated with dehydration, either.
Treating night leg cramps is hard as the cause is often not known and research hasn’t found a conclusive treatment option yet.
The common treatments of nocturnal leg cramps are:
It won’t stop cramps from happening, but painkillers like ibuprofen can help with the post-cramp soreness and help you fall back to sleep.
As well as trying some of the methods above to ease nighttime leg cramps themselves, there’s something else you can do to improve your sleep – focus on sleep hygiene.
Sleep hygiene is the healthy sleep habits you can do to help you fall asleep faster and wake up less often in the night. But they’re not just habits you do before bed, sleep hygiene begins the moment you wake up.
With excellent sleep hygiene, you’re more likely to meet your sleep need — and therefore maximize your next-day energy levels — even if you experience leg cramps at night.
Here’s what to do:
RISE can remind you to do 20+ sleep hygiene behaviors and tell you when exactly you should do them based on your circadian rhythm.
The timing of your circadian rhythm (the roughly 24-hour cycle that dictates things like energy levels) can change slightly each day based on things like how long you slept for the night before. RISE works this out for you and shows you a handy prediction. The app then tells you when to limit caffeine or have your last meal for the day, for example.
Plus, you can check RISE to check your Melatonin Window each night. This is the roughly one-hour window of time when your rate of melatonin production peaks. Go to bed in this window and you’ll have an easier time falling and staying asleep, something you want to prioritize if leg cramps disturb you regularly. RISE users on iOS 1.202 and above can click here to set up their Melatonin Window notification.
Leg cramps during the day aren’t fun, but at night they can easily keep you up, meaning your productivity, mood, and energy levels all take a hit the next day. Plus, if your sleep is regularly being impacted, you’ll be doing some serious health damage.
As well as trying out some of the treatments or speaking to a doctor, keep in mind sleep hygiene. Use RISE to find out your unique sleep need and time 20+ sleep hygiene behaviors to your circadian rhythm.
By improving your sleep hygiene, you can give yourself the best chance of meeting your sleep need on nights without cramps and make the most of the sleep you do get when they hit. All this leads to better nights, and therefore better days.
You may not be lacking anything. Research suggests a lack of electrolytes isn’t associated with leg cramps at night and more research needs to be done to see if magnesium, vitamin E, or calcium salt supplements could help.
To prevent severe leg cramps at night, try stretching before bed, getting enough exercise, limiting alcohol, and taking breaks if you stand for long periods of time at work. Speak to a doctor about treatment options or changing your medication.
Stop excruciating leg cramps by stretching the affected muscle. For example, to do a calf stretch, extend your leg and stretch your foot up as if you’re trying to point your toes towards you. Massaging the muscle may also help.
Leg cramps can be a sign of medical conditions like motor neuron disease, Parkinson’s disease, hypothyroidism, diabetes, peripheral vascular disease, hypokalemia, and coronary artery disease. But the cause of most leg cramps is unknown.
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