You almost dread lying down because you know you’ll soon feel that creepy-crawly, achy-tingly sensation in your legs. Moving your legs brings relief, so you can’t resist the urge—but that makes it hard to fall asleep. The culprit is restless legs syndrome (RLS), a malady that affects about 10% of the population, with women being twice as prone to the problem as men. In many patients, RLS is primarily a neurological disorder. But in some, RLS has a different underlying cause that doctors often overlook—varicose veins.

Erez Salik, MD, codirector of the Greenwich Vein Center in Greenwich, Connecticut, explained that varicose veins develop when the one-way valves inside the leg veins, which are supposed to keep blood moving toward the heart, start to leak or fail. This allows blood to flow back toward the feet and pool in the legs. The increased pressure stretches the veins, causing them to become enlarged, twisted and bumpy. This inefficient circulation in the legs leads to a buildup of metabolic waste and can trigger the throbbing, itching, gotta-move-or-go-crazy sensations of RLS. Good news: Treating the underlying vein problem also relieves RLS symptoms for many patients.

A simple, inexpensive, noninvasive treatment is to wear compression stockings (sold at drugstores and medical supply stores) because the stockings exert pressure that helps prevent the backflow and pooling of blood. Stockings are particularly helpful during long periods of standing but can be worn throughout the day and even at night, Dr. Salik said.

cantsleepsmallIf compression stockings don’t bring sufficient relief, consult an interventional radiologist, dermatologist or vascular surgeon with special training in phlebology (vein disorders). Referrals: Society of Interventional Radiology (www.sirweb.org)… or American College of Phlebology (www.Phlebology.org). A physical exam and perhaps an ultrasound evaluation can help determine the most appropriate treatment.

Varicose veins often can be treated with minimally invasive procedures that are done in the doctor’s office, involve minimal discomfort and take less than an hour, after which you walk out of the office. Options may include…

  • Endovenous laser ablation, in which the doctor inserts a tiny tube into the vein, then heat energy from the device permanently seals the vein shut. This procedure is done using local anesthesia. In one study published in the journal Phlebology, patients who underwent this procedure experienced an average 80% improvement in their RLS symptoms… and 31% of participants got complete relief from RLS. Average cost: About $2,000 per leg.
  • Sclerotherapy, in which the doctor injects the vein with a solution that causes the vein to scar, thus eventually closing the vein. No anesthesia is required. Some veins may need to be injected more than once in separate treatment sessions. Average cost: About $300 to $500 per session.

“With either treatment, the body automatically routes the blood to other, healthy veins, improving the circulation in the leg,” Dr. Salik said. When varicose veins are treated strictly for cosmetic reasons, insurance generally does not pay. However, insurance often does cover the cost of treatment when a patient suffers from varicose vein–related symptoms, including RLS—a fact that should help you sleep better at night.