Written By Filip
Sleep Advisor
29 March 2024
10 min read
We've had those pesky leg cramps disturb our beauty sleep a million times. Know those sharp squeezes in calf muscle that make you want to suddenly move your legs? Inhale-exhale muscle cramps are a normal phenomenon. But, we will make an exception when we talk about muscle cramps in the legs at night. Nocturnal leg cramps are irritating, and more severe underlying health conditions are possible.
So we are not talking about just any cramps. What is strangest of all is the time of their appearance. They target only the leg muscles during the night. Why?
It may seem like spasms are playing hide and seek with relaxation, but there is actually an explanation for this phenomenon. Picture this: you try to stretch a rubber band too far, and then it happens – ouch! The same can happen to your muscles if you haven't given them enough attention during the day.
It is enough to stay hydrated, stretch a little before bed, and eat potassium-rich food like bananas. However, you'll need a detailed plan to keep those legs happy and cramp-free. Well, we have one of those!
Harmless cramps at rest should be distinguished from a similar feeling in the calf muscles and other affected muscles during exertion or restless legs syndrome. We know legs cramps can be very painful, and they occur even in perfectly healthy people.
So, let's go deeper when it comes to understanding muscle cramps and diagnosing nocturnal leg cramps.
What is a leg cramp?
Leg muscles consist of bundles of fibres that alternately contract and expand to move. Night leg cramps – spasms are sudden, purposeless and involuntary contractions of affected muscle. They can be mild or intense enough to wake you from a sound sleep and last from a few seconds to a few minutes.
These muscles normally contract only under the influence of our will, and spasms are most often registered in the legs, the muscles of the back of the lower leg and the front of the upper leg. Much less often, spasms can affect other skeletal muscles. In science, it still needs to be clarified why and how these leg cramps occur, but several factors are known that are important for their occurrence.
Causes of muscle cramps
Cramps can be caused by a disorder at the level of the muscle cells themselves but also at the level of nerves and neuromuscular synapses. The most common cause is an electrolyte imbalance – a change in the concentrations of potassium, magnesium, sodium and calcium ions. Without a sufficient concentration of these ions, your nerve and muscle cells cannot function. So, we can talk about several of the most important factors that affect the imbalance and contribute to the occurrence of cramps.
Electrolytes are responsible for numerous functions (such as heart rate, fluid level regulation, as well as the secretion of various hormones), not only for muscle contraction. Their loss or deficiency can cause various symptoms: fatigue, altered heart rhythm, and cramps. This imbalance occurs if, for example, more fluid is lost during the day than is taken in.
Care should be taken not to cause dehydration, on the other hand, excessive amounts of water are not recommended either. Electrolyte imbalance is affected by intense sweating, insufficient food and fluid intake, use of laxatives or diuretics, vomiting, diarrhoea.
The best way to prevent dehydration is to drink enough fluids. As for nutrition, food intake should be based on nutrition that will stimulate intestinal peristalsis.
Overuse or muscle fatigue
Too intense physical activity (especially before bedtime) and improper exercise are common risk factors for leg cramps. Muscle spasms indicate muscle fatigue or insufficient warming up. As a result of intense muscular contractions, a large amount of lactic acid is produced, responsible for the prolonged pain in the muscle and for the relaxation of the spasm itself.
That is why it is best to massage the muscle in which the spasm occurred, and one of the preventions is a sports massage. What should definitely be practised and what will reduce the chance of cramps are adequate stretching exercises before and after physical activity.
Although it is the same phenomenon, cramps are more frequent in summer than in winter. This can be explained by the greater need for adequate hydration, i.e., the body's water intake during summer days, which is sometimes not respected.
Poor circulation and blood flow
Blood circulation is very important so that nutrients and oxygen reach all the organs of your body. Poor circulation means your organs are “hungry” for these essential substances and oxygen. Do you often feel that your hands or feet are cold, or do you feel like needles are pricking you?
It is one of the most frequently described symptoms of poor circulation. In itself, it is not a disease. However, it can also be a symptom of a more serious illness β including peripheral artery disease, stroke, heart attack, blood clot or scleroderma. But let's cool it down a bit.
This time we will focus on leg cramps due to poor circulation. So, imagine blood vessels as highways for the life-sustaining blood to travel. The blood flow can slow down if you sit or stand still for a long time. Such stagnation can lead to discomfort – cramps!
Medications and medical conditions
Some spasms can be the result of other diseases, such as amyotrophic lateral sclerosis
- cirrhosis of the liver
- diabetes
- kidney weakness
It should be known that certain drugs have painful leg cramps as side effects. If cramps start to occur more often after the introduction of a drug in the therapy, it is necessary to report this to your doctor. Some of these drugs are primarily diuretics, but also some statins, gabapentin, or pregabalin.
Vitamin and mineral deficiencies
Vitamin D, calcium and magnesium deficiency can be the main reason for idiopathic leg cramps. They have an essential angle in maintaining the proper function of muscles (contraction and relaxation). If their concentration is lower than recommended, the ability of nerve cells to fire correctly decreases. This leads to muscle fibres contracting excessively and uncontrollably, resulting in cramps.
Therefore, it would not be bad to start by checking the vitamin levels in your body. In this way, you will more easily identify the problem and solve the problem by using the appropriate supplements/special nutrients. Therefore, vitamins and minerals are preventing leg cramps.
The impact on sleep
Well… No one can sleep while in pain. Even low-intensity sudden pain can cause sudden awakening. If this interruption continues, more serious problems can arise that disrupt sleep continuity.
Disrupting Sleep Patterns
Muscle cramps episodes usually manifest during nocturnal hours, which means that they affect sleep stages. In fact, they have a negative impact on the overall sleep architecture.
- Sleep Onset Interruption – transition an individual from drowsiness to full wakefulness, delayed returning to the state of slumber
- Fragmentation of Sleep – inability to achieve the requisite deep sleep and REM sleep, both of which are crucial for physical and cognitive rejuvenation
- Increased Arousal Threshold – the anticipation of cramps raises the arousal threshold, as well as the chances of waking up at the slightest discomfort.
- Anxiety and Stress – this condition can further exacerbate sleep disruption and perpetuate a cycle of fragmented rest
- Daytime Consequences – sleepless nights cause daytime fatigue, impaired concentration, diminished mood, and reduced productivity
Sleep Deprivation and Muscle Cramps
Cramps can cause a lot of discomfort and therefore influence sleep. But sometimes they switch roles! How? During sleep, immunity is strengthened, and the body's combat readiness to respond and prevent inflammatory processes increases. If it is missing, the risk of inflammation in the body increases. This results in muscle aches and pains and can worsen inflammatory conditions such as arthritis.
Strategies to alleviate muscle cramps at night
There are days when we all just ache. Sometimes the matter is very clear, as when it comes to physical exertion. However, it has its own gradation and passes after a certain time. We should take action when we have muscle cramps episodes for a long time. Fortunately, there are several strategies for treating leg cramps and helping with muscle cramps at night.
It can be recognized by dry mouth, decreased urine output, headache and constipation are symptoms of dehydration. As you already know, muscle cramps can also be a symptom. Regardless of your health condition and ailments, you should hydrate properly. Fluid intake mostly depends on weight, physical activity and weather conditions. By losing fluids, you also lose electrolytes like potassium, magnesium, and calcium, paramount for muscle contraction and relaxation.
Don't forget to get fluids through food too, which means you should pay attention to the nutritional value of foods. Replace or enrich heavy and fatty dishes with salads: tomatoes, cucumbers, fresh peppers, types of green salads, and even raw spinach.
Stretching and warm-up techniques
You don't have to be a professional athlete constantly under strain and intense training to have a muscle cramp wake you up. Try stretching and warm-up techniques even if you don't engage in physical activity. Anyway, before going to bed, apply gentle stretching of the muscles of the whole body, and especially the extremities. Light stretching exercises also reduce stress, stimulate the secretion of happiness hormones and help us fall asleep more easily.
Managing medications and underlying conditions
Since some medications can contribute to sleep leg cramps as a side effect, do not ignore the symptoms. Of course, they can result from many other factors such as electrolyte imbalances, dehydration and all of the above. But, if you suspect a specific medication, be sure to discuss it with your healthcare provider. If this is the cause, you will feel great relief after changing the dosage, switching to an alternative medication or another doctor's recommendation.
However, sometimes underlying conditions are why you must perform necessary tests. Remember, each individual's situation is unique, so giving your healthcare provider as much information as possible is important. It is possible to assess your situation based on medical history, medications and overall health.
Sleep environment and positioning
First things first, get rid of the uncomfortable bed… wait, everything is fine with it? Tell that to your legs, which experience leg cramps every night. Well, if you are right, your bed should meet the key requirements.
The mattress should be comfortable and supportive. However, there is no universal product. You need to find the best mattress for yourself. The choice of a mattress depends on your physical characteristics, sleep position and personal feeling. But a mattress that is too firm or too soft can contribute to frequent leg cramps.
That's why it wouldn't be wrong to use additional support – pillows. For example, place a pillow between your knees if you are a side sleeper. This will keep your spine in a neutral position. In general, avoid awkward positions and keep your body aligned and supported.
Of course, we must not forget about bedding and blankets. If you are always cold, use blankets that provide adequate heat without causing you to overheatβextreme temperatures, whether too hot or too cold, can increase the likelihood of muscle cramps.
Sleep hygiene practices
Sleep hygiene is important! In addition to room temperature, it is vital to take care of other potential disruptors of sleep. Luckily, you won't have to look far for them because they're in your room. So, it could be electronic devices, too much light, or poor ventilation.
Okay, maybe not everything in your room, like choosing a meal before bed. Avoid large meals, so you don't have an unpleasant feeling in your stomach. Instead, choose a healthy nighttime routine that includes relaxation activities. This will help you stick to your sleep schedule.
Consistent sleep schedule
Why are we telling you all this? Because going to bed and waking up at the same time every day, even on weekends, will significantly improve your body's internal clock. Our circadian rhythm helps the brain keep track of when we should be awake and when we should go to sleep. But first, we have to help him!
It uses sunlight to influence the production of melatonin, one of the main hormones that regulate sleep. It seems easy to manipulate it – simply darken the room and turn off electrical appliances. The good news is that the human body likes to live in a steady rhythm. If you persist, it will get used quickly and you won't have to wait long to fall asleep.
So, don't give up. Maybe a disturbed sleep schedule is the only cause of your muscle cramps!
Relaxation techniques before bedtime
How to get rid of stress and prepare for sleep? There are several possibilities. Relax physically – take a warm shower. A hot shower will help you relax your muscles and create a mini wellness atmosphere. After your body cools down, its reaction will be sleepiness. If you don't like a hot shower or it's too hot for you, try other techniques.
For example, it can be yoga with breathing exercises. Instead, you can do moderate-intensity exercise, but not right before bed. Light aromatic candles, pick up a relaxing book or series/movie and don't stay up too long. Once you're comfortable in bed, try targeted muscle relaxation. Some will fall asleep before they reach their head!
When to seek medical help?
Although nocturnal leg cramps and cramps, in general, are mostly harmless and can often be managed with self-care measures, they should be taken seriously. There are certain situations in which medical help should be considered. These are:
- Frequent and Severe Cramps – it might be a sign of an underlying medical condition
- Prolonged Duration – If a muscle cramp lasts for an unusually long time (more than 15 minutes)
- Debilitating Pain – If the cramp interferes with your daily activities
- Muscle Weakness or Numbness – it could be indicative of a nerve-related issue
- Swelling or Discoloration – swelling, redness, or other changes in the appearance of the affected area
Conclusion
If you are going through this distressing and disruptive experience involving leg cramps at night, you have no choice but to seek a solution. But first, pay attention to the potential causes of nighttime leg cramps: electrolyte imbalances, dehydration, medication side effects, and underlying medical conditions.
If you are not sure, seek medical help. Regardless of the condition, try to maintain proper hydration, balanced nutrition, regular exercise and relaxation techniques. Combining self-care strategies and medical consultation offers the best chance to find relief.
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