What Benzodiazepines should I take for the restless legs syndrome?

While benzodiazepines are not typically the first choice for treating RLS, doctors usually reserve them for specific, tailored situations.  Benzodiazepines might be used in patients with intermittent symptoms, particularly in patients who suffer from sleep initiation insomnia.  They may also be prescribed as an additional medication for an acute RLS flare up.  Benzodiazepines work a bit differently than other RLS medications.  Instead of stopping the uncomfortable leg sensations themselves, they primarily act as a sleep aid to help you sleep through the symptoms as well as reducing the number of nighttime awakenings caused by involuntary leg movements (PLMD).    Benzodiazepines​ can help relax muscles and calm the anxiety or frustration that often builds up when trying to fall asleep with RLS.

​

While several Benzodiazepines exist, two are most frequently discussed for sleep and RLS:

• Clonazepam (Klonopin):  This is the most widely studied and prescribed benzodiazepine for RLS.  It has a long half-life (it stays in the system for a long time), which helps keep you asleep throughout the night.

• Temazepam (Restoril) / Alprazolam (Xanax):  Sometimes used, though shorter-acting options are usually preferred if daytime grogginess is a major issue.

 

Side effects of benzodiazepines

 

Side effects include:

• Daytime Somnolence (sleepiness):  Because long-acting drugs like clonazepam stay in the system, feelings of being groggy, tired, or uncoordinated the next morning may be experienced.

• Tolerance and Dependence:  Over time, the body can get used to the medication, meaning a higher dose might be needed to get the same sleep benefits.  They can also be habit-forming.

• Sleep Apnoea Risk:  Benzodiazepines relax the muscles in the throat, which can worsen sleep apnoea.

​

For other treatment options see the pages:​