Night muscle cramps, especially in the calf, are commonly referred to as a “charley horse” and are extremely painful and will wake you up out of peaceful sleep. These muscle cramps are referred to as nocturnal muscle cramps and can occur in the toes, ankle, and even the Achilles tendon.
Fortunately, nocturnal muscle cramps only last from seconds to a minute or two. If they last any longer than this, you should see your doctor as they could be a sign of something more serious.
There are many causes of nocturnal muscle cramps, and that is why it can be frustrating trying to find a solution to stop these types of cramps.
One of the most common causes of nocturnal muscle cramps is supposedly magnesium deficiency. Unfortunately, the research does not show magnesium deficiency as a leading cause of nocturnal cramps.
To avoid nocturnal muscle cramps, I have taken magnesium before bedtime and even during the night when I had a muscle cramp. Sometimes it helped, but in most cases it did not.
What does help with nighttime muscle cramps?
Many factors can into play with muscle cramps, including age, activity level, diet, medications, and simply not drinking enough water. Most of these causes impact our electrolyte status, and muscles depend on a balance of electrolytes.
Electrolytes play a critical role in our muscle function and include sodium, calcium, magnesium, potassium, and chloride. Our muscles depend on calcium for contraction and magnesium for relaxation or release. At the same time, potassium works by signaling blood flow to our muscles; a lack of blood flow can easily lead to a cramp even at night.
Looking at the research, the number one culprit of muscle cramps is dehydration. And, dehydration almost always leads to electrolyte imbalances. Maybe the factors that lead to dehydration might be the cause and not just a magnesium or potassium deficiency.
Who is More Likely to Experience Night Time Muscle Cramps?
Certain factors are going to put you at more risk for NC. Most of these factors affect our electrolyte balance, circulation, and in some cases, our nerve health.
- elderly – tight muscles, medications, dehydration
- health conditions – cardiovascular, kidney disease, cancer treatment, liver failure, osteoarthritis, peripheral neuropathy, vascular diseases, type-2 diabetes, hypothyroidism
- nerve diseases – multiple sclerosis, Parkinson’s
- athletes – especially those that do not adequately hydrate
- salt and potassium avoidance
- vegans/vegetarians – low B12
The elderly are more at risk due to numerous reasons. First, as we age, we lose our thirst mechanism, and this can lead to dehydration. Our muscles also tighten and become stiff, especially with lower activity levels.
In addition, the average 70-year-old is on five medications to treat health conditions like hypertension (high blood pressure), cardiovascular disease, and diabetes. Salt avoidance is also common in the elderly, especially those with high blood pressure and cardiovascular disease.
Does a Lack of Sodium Cause Nighttime Cramps?
The number one food source of sodium is table salt which contains sodium and chloride. Sodium is the most abundant electrolyte playing a significant role in keeping our minerals, most notably magnesium and potassium, in balance, helping to prevent nighttime muscle cramps.
We don’t often think about deficiency in sodium as the typical American diet is so high in salt, especially from processed foods, preserved meats, and restaurant meals.
Sodium deficiency, however, can occur with:
- salt avoidance
- medications especially diuretics
- strict or restrictive food plans
- excessive sweating without replenishment of electrolytes
It is not uncommon to see clients going from a highly processed food diet to cooking at home experience symptoms of sodium deficiency, especially if they are not using salt in their cooking. Enjoy using moderate amounts of salt in your cooking if you are avoiding processed foods and restaurant meals.
Can Magnesium Help with Nighttime Cramps?
Our muscles get the signal to release from magnesium, so it would make sense that this mineral would help with muscle cramps. And that muscle cramps at the beginning of exercise when you are warming up is a sure sign that you are deficient in magnesium.
Magnesium deficiency is also very prevalent in America, with a projected 65% of Americans not getting enough magnesium in their diet, as noted in my blog, Magnesium – Diva of Nutrients. So it would make sense that magnesium deficiency might be the cause of nocturnal muscle cramps.
But does magnesium help with muscle cramps, especially at night? Unfortunately, the research does not show that magnesium can help with nocturnal or nighttime muscle cramps.
Maybe the studies did not consider what might be causing the magnesium deficiency. For instance, medications like Gabapentin are known to increase the need for magnesium.
Nonetheless, it would not hurt to supplement magnesium through an electrolyte beverage or low dosage supplementation at bedtime.
There are many different forms of magnesium, and it is important to take the form of magnesium that will be most effective for you and is less likely to cause digestive disturbances. Thorne Magnesium CitraMate combines two different forms of magnesium that relaxes the muscles while reducing the chance of digestive disturbances.
Magnesium malate is very effective at relaxing muscles especially tight and sore muscles. On the other hand, some forms of supplemental magnesium may lead to diarrhea.
What Role Does Potassium Play in Nighttime Cramps?
Since potassium plays a role in muscle contraction and signaling blood flow to muscles, potassium deficiency may lead to muscle cramps. A diet rich in fruits, vegetables, and nuts should provide sufficient potassium; however, some conditions and medications can lead to a deficiency.
Muscle cramping at the end of exercise or after prolonged endurance activity is mainly the cause of lack of potassium and not magnesium. Lack of potassium has not been directly linked to nighttime muscle cramps.
However, with kidney failure, dialysis, and certain medications, potassium may play a role in nocturnal night cramps. A very low potassium diet could be the underlying cause of muscle cramps with these conditions as this dietary protocol is mandatory with kidney failure and dialysis.
Supplementing with potassium other than small amounts in multiple vitamins and electrolyte beverages should only be done with professional medical supervision.
Excessive potassium can lead to gastrointestinal symptoms, including nausea, vomiting, and abdominal discomfort. Other signs for excessive potassium or hyperkalemia include tingling of the hands and feet, muscular weakness, and temporary paralysis.
To assure that potassium is not the cause of your nighttime cramps, drinking an electrolyte beverage even without working out would be sufficient. Make sure that the electrolyte beverage does not contain artificial colors or sweeteners and is balanced with all electrolytes, including magnesium.
Catalyte by Thorne is an excellent electrolyte beverage that contains a balance of electrolytes with key nutrients that helps with hydration and recovery.
Is Your Medication Causing Your Night Cramps?
Many medications can cause imbalances in your electrolytes, lead to dehydration, affect circulation and nerve health. All of these can increase the risk for nocturnal muscle cramps. The top five medications that have been linked to nocturnal muscle cramps are:
- Intravenous Iron Sucrose (used for iron anemia)
- Conjugated Estrogens – hormone replacement therapy for postmenopausal
- Raloxifene – estrogen modulator and bone health
- Naproxen – OTC pain killer
- Albuterol & Levalbuterol – bronchodilators
Other medications that might play a role in muscle cramps are:
- Statin Drugs – cholesterol-lowering
- Ciprofloxacin, Levaquin – fluoroquinolone antibiotics
- Gabapentin – restless leg syndrome
- Prevacid – stomach ulcer
- Ambien – sleep
Always check with your doctor before going off of any medications. If you feel that your medications might be causing your night time muscle cramps, ask your doctor if there is another medication without this side effect.
What Are Other Causes of Night Cramps?
In addition to medications and health conditions, other causes of night cramps are readily resolved. Most have to do with lifestyle habits, lack of exercise, poor sleeping, or drinking alcohol.
Lack of movement can lead to muscle cramps because the muscles have been contracted for too long. They need to relax, recover and move again. If your job requires long periods of sitting or standing – try taking breaks throughout the day and get moving.
Alcohol consumption comes with a double whammy. First, it is very dehydrating, leading to electrolyte imbalances.
Secondly, during the metabolism of alcohol, lactic acid is produced. Lactic acid build-up can cause muscle spasms and soreness. If you drink alcohol, make sure to limit it to 1-2 drinks, drink plenty of water, and avoid drinking within 2 -3 hours before bedtime.
Not getting enough sleep can cause nighttime cramps; this is ironic because nighttime cramps lead to poor sleep. A lack of sleep leads to muscle fatigue, one of the leading causes of muscle cramps. Make sure to practice healthy sleep hygiene and get 7.5 – to 8 hours of sleep per night.
What Can You Do to Reduce Nighttime Cramps?
For me, it was an aha moment when I discovered that my nighttime cramps were a result of many different things, not just a magnesium deficiency as I thought. Start with these steps to begin resolving your nighttime cramps.
- Make sure you are properly hydrated and drink filtered water throughout the day. By drinking water every 20 to 30 minutes, your body will absorb it more readily. My favorite filtered water pitcher.
- Want to make you are hydrated? Purchase a scale that measures your hydration level and focus of getting that number up and less on how much you weigh. Did you know that as your hydration level increases; your fat percentage will drop.
- Try an electrolyte beverage like JigSaw Electrolyte Supreme or NutriDyn – Dynamic Hydrate, even if you are not working out. This will quickly replenish those key electrolytes and nutrients.
- Always drink an electrolyte beverage after a workout or even a long walk.
- Thorne Recovery Bundle is an excellent way to provide electrolytes and reduces inflammation speeding up your recovery and reducing muscle cramps.
- Make sure to get adequate magnesium and potassium from fruits, vegetables, and nuts. Are you getting 5-6 servings of fruits and vegetables?
- Are you taking medications? Do they have muscle cramps as a side effect? Check with your doctor to see if you might be able to do another medication without this side effect.
Still, struggling with nighttime cramps? Then it might be time for a Functional Nutrition Assessment to see what the underlying cause might be. Book a Discovery Chat to learn more.
- Nocturnal Leg Cramps, Richard E. Allen MD & Karl A. Kirby MD, St. Mark's Family Medicine Residency, Salt Lake City, Utah, 2012
- Criteria in diagnosing nocturnal leg cramps: a systematic review, Joannes Hallegraeff, Mathieu de Greef, Wim Krijnen, & Cees van de Schans, 2017
- Muscle Cramps during Exercise – Is It Fatigue or Electrolyte Deficit? Michael F. Bergeron, National Institute for Youth Sports & Health, Sanford, Sanford USD Medical Center, Sioux Falls, SD, 2008
Eileen Schutte, MS, CN, FMN – One of my biggest passions is to help clients overcome food intolerances like histamine intolerance and sensitivities so that they can enjoy food again. My other passion is nutrigenomics, speaking to your genes through nutrition with focus on digestive health, autoimmune conditions, and skin health. I hold a master's degree in functional nutrition from the University of Bridgeport, Connecticut graduating Summa Cum Laude. After completing my masters I went on to get my certification in Functional Medicine Nutrition, and am a Certified LEAP Therapist (food sensitivities program). In addition, I am pursuing advanced education in Nutrigenomics through the American College of Nutrition.