neurologic disorders
Parasomnias
Sleep related leg cramps
Muscles of the calf or foot muscles often cramp during sleep in otherwise healthy middle-aged and older patients. Diagnosis of sleep-related cramps is based on the history and lack of physical signs or disability. Prevention includes stretching the affected muscles for several minutes before sleep. Stretching as soon as cramps occur relieves symptoms promptly and is preferable to drug treatment. Numerous drugs (eg,quinine, calcium and magnesium supplements,diphenhydramine, benzodiazepines,mexiletine) have been used; none is likely to be effective, and adverse effects may be significant (particularly withquinineandmexiletine). Avoidingcaffeineand other sympathetic stimulants may help. 