Why leg cramps occur in sleep ?
A sudden cramp in the calves with unbearable pain and then inability to move the leg and inability to sleep with slight relief from massaging and application of warmth to the calf for a while. This is a condition experienced by many individuals and they might not have any signs of the distress after they wake the next morning. This condition usually occurs at night and is more commonly seen in women and men over the age of 35 to 40 years.
Some people believe that this is due to cold, some kind of infection, or due to the deficiency of vitamin D. Some small children may complain of this issue at night after playing a lot during the day.
These cramps occur due to the sudden contraction of the calf muscle and associated region. The most common reason for this is standing for prolonged periods of time during the day, which leads to excessive strain of the muscles in this region.
People who work in a standing posture such as the traffic police, tailors who stand and cut the clothes to be stitched, the gardeners, people who work in shops, people who work in sales, children who run and play a lot with other children at home and don’t get a chance to rest during the day may end up straining the muscles excessively during the day and have discomfort in the muscles at night due to the excess strain. Often, when they turn around in bed, this muscle suddenly contracts and a cramp sets in.
The sudden contraction leads to slight inflammation of the nerve and blood vessel underneath the muscle, subsequently causing sudden pain that might be felt in the region of the contracted muscle or may radiate towards the foot, heel, or behind the knees. Some people may have this pain radiate up to the posterior part of the thighs. Massaging reduces the inflammation in this region and gives slight relief to the complaint. This pain is commonly known as Charlie Horse Pain.
The second reason for this pain is dehydration. Often, the women in our houses work for long hours standing in the kitchen, but might not drink enough water. If there is not enough supply of water to the body, the muscles of the legs and body may experience dehydration and cramping. This occurs more often in the legs during sleep. The body may have an aching pain as if beaten up when waking in the morning.
The third reason is long distance travel which may require hanging the legs down for long time, especially in people over the age of 40 to 50 years. In people having hypertension, the feet may show swelling in the evening. The slight changes occurring to the blood flow to the legs in such people leads to the formation of very small clots in the blood vessels supplying the legs that in turn lead to inflammation in the small capillaries of the legs.
This causes pain in the legs during sleep at night. The painful region may be reddish in appearance with slight heat to touch. The leg cramps and pain after a long journey is often due to this reason. The problem is seen to reduce by massaging the region and application of heat.
The next important reason is varicose veins. The veins that carry the impure blood from the legs to the heart are the long saphenous veins and its branches which have small valves to prevent backflow of the blood. When these valves are blocked, the condition is known as varicosity, and the veins are seen to swell up. This condition is seen in young and old alike and heredity plays an important role too. People who have varicosity, may experience pain at night due to the strain during the day.
Other than this, the compression of the nerves in the legs which go from the spinal cord to the legs may lead to tingling, numbness and pain in the legs during sleep. The compression of the sciatic nerve which moves downwards along the buttocks or the compression or diseases of the nerves that supply the muscles of the legs may also cause pain in the legs.
The most common disease that leads to tingling and pain in the legs at night is diabetes. Almost 80% of the people who have uncontrolled diabetes may have such pain and cramps in the legs. The reason for this being the changes in the circulation due to the diabetes and the damage to the nerves due to the persistent rise in blood sugar.
People with chronic kidney failure also may have persistent pain and ache in legs at night. Women may have this pain in the premenstrual period which is the period just before the onset of their monthly periods. This is more commonly seen in younger girls as aching pain in the legs, thighs, and in calf muscles and these complaints are often relieved with the onset of their periods.
Women during pregnancy, as part of the development of the fetus, may have compression of nerves in the hip region and also obstruction of the blood vessels in this region. This may lead to aches and discomfort in the legs since around the fourth month of pregnancy.
People who have conditions like rheumatoid arthritis and gout (condition due to increase in uric acid level in blood) may have inflammation in the feet and there may be severe pain in the calf at night that disturbs sleep.
The most important preventive method for the leg cramps is to take abundant amounts of foods that contain magnesium, because magnesium stimulates the functioning of our muscles and nerves. Foods containing magnesium include all varieties of nuts, leafy vegetables, seeds like flaxseeds, pumpkin seeds, chia seeds etc. These must be regularly included in the diet.
Also, legumes like peas, soya bean and lentils must be included regularly in the diet. Grains that have bran like wheat and red rice must be consumed regularly. Also, fishes like mackerel, tuna, sardines, etc. must be included regularly for sufficient supply of magnesium to the body that would reduce these problems of the legs.
Similarly, at least 3 l of water must be taken per day. When the body is sufficiently hydrated, the muscle pain and cramps can be controlled to a very large extent. Regular stretching exercises will help expand and contract all the muscles of the body and thereby these problems can be prevented largely.
Use of very tight shoes regularly may cause lot of strain to the muscles and nerves of the legs and this may lead to the discomfort in the feet and calf with aches and pains at night. The use of alcohol and tobacco must be reduced considerably too.
The alcohol reduces the fluids in the blood especially if consumed in the evening. There may be great discomfort in the legs which may extend for up to a week. People who smoke may have small blocks due to small blood clots in the vessels of the legs similar to those formed in the heart or brain. This may lead to conditions like DVT and cramps of muscles and inflammation. Also, the vitamin D level in the blood must be checked and if deficient, must be supplemented to relieve the leg cramps at night.
In absence of satisfactory improvement in the condition with all the diet and lifestyle modifications, medical management may be opted to relieve the symptoms.