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Because poor sleep can aggravate RLS, be sure you are getting good rest. Exercise also appears to decrease symptoms, as can reductions in caffeine. Doing mental activities during a person’s evening “down time,” such as crossword puzzles, can reduce the focus on symptoms.

Medication that binds dopamine receptors, such as the ropinirole that you’re taking, can decrease the symptoms of restless legs. Such medications are started at night and, although they can initially cause drowsiness, this subsides after 10 to 14 days. One problem with such drugs is that they can lead to rebound symptoms — that is, the restless leg sensations — in the morning. An even bigger problem is that long-term use can lead to decreased effectiveness, a shorter duration of action, symptoms noted earlier in the day and a spread of symptoms into the arms; these problems can worsen with increased dosages. To reduce the likelihood of this, I’d recommend staying on low doses of the drug and not taking it on a nightly basis, if possible.

You might also want to consider the anti-seizure medications gabapentin or pregabalin. They may not be as effective as ropinirole, but there is less likelihood of rebound or worsening of symptoms. Benzodiazepines, such as clonazepam, can be used for RLS, but can lead to tolerance or even dependency.

In summary, have your doctor check your blood ferritin level, a marker for iron stores. If it’s low, consider iron supplementation. Also, be sure to increase your levels of exercise, decrease your caffeine intake and try mental activities at night.

If you feel that your symptoms are worsening on the ropinirole, talk to your doctor further. You have other options.