Sleep-related leg cramps

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By Pasquale Montagna MD

Sleep-related leg cramps are also known as or subsume Charley horse and Nocturnal leg cramps. -ed.

Sleep-related leg cramps are a sleep-related movement disorder whereby painful contractions of the calf muscles arise at sleep onset and during sleep and awaken the patient, interrupting sleep. Sleep-related leg cramps may be associated with muscle cramps during wakefulness and are encountered at all ages, but they are especially prevalent among the elderly. They result from a variety of pathologies, metabolic muscle and nerve disorders, electrolyte disturbances, vascular disease, and toxic and drug side effects. Sleep-related leg cramps may sometimes mimic and need to be differentiated from the manifestations of restless legs syndrome.

Key Points

  • Sleep-related leg cramps represent a common sleep-related movement disorder characterized by painful contractions of the muscles of the lower limbs during sleep.
  • This disorder can be either idiopathic or secondary to metabolic, vascular, or neurologic diseases or medications.
  • Diagnosis is clinical and requires exclusion of secondary forms; polysomnography may be helpful to rule out other conditions.
  • Treatment comprises nonpharmacological and pharmacological therapies.


In This Article

Historical note and nomenclature
Clinical manifestations
Clinical vignette
Pathogenesis and pathophysiology
Differential diagnosis
Diagnostic workup
Prognosis and complications
References cited