Charley horse is a common term for muscle cramps particularly those in the calf muscle. Anyone who is an athlete has probably had a cramp in a muscle at some point due to overuse or dehydration. But what about those cramps that occur at night while in bed? Nocturnal recumbancy leg cramps is the medical term for these episodes. These also usually affect the calf muscle but can also affect the small foot muscles or the thigh muscles. Each episode can last up to 10 minutes and often wakes the person from sleep. The initial episode can be followed by recurrent cramps that can last several hours. Some residual pain may be notices the following day upon waking. Up to 60 percent of adults have reported these cramps in their lifetime. The exact cause of nocturnal leg cramps is not known. Exercise induced cramping of muscles is usually due to muscle fatigue. Nocturnal cramping is more prevalent in people with certain medical conditions such as liver disease, kidney disease, peripheral arterial disease, venous insufficiency, spinal stenosis, peripheral neuropathy and people undergoing cancer treatment. Certain medications are related to an increase in muscle cramps such as intravenous iron sucrose, levalbuterol, raloxifene, conjugated estrogens and naproxen. Dehydration and mineral imbalances are thought do be a potential cause of nocturnal leg cramps although the medical literature does not provide convincing support for this theory. So what is there to do for nocturnal cramps? If an underlying medical condition or medication can be uncovered them modification of the treatment plan may reduce the incidence of cramping. Remaining well hydrated and supplementing mineral intake is a good health strategy despite the weak link with nocturnal leg cramps. A stretching program for the calf muscle should be undertaken. Stretching the calf before bed for a few minutes can be helpful. Night splints may be used to provide a passive stretch in resistant cases. The splint also keeps the ankle from dropping down during sleep which can cause the calf muscle to contract. Warming the muscle before stretching can improve the stretch. In resistant cases, muscle relaxant medications can be employed. To break the actual cramp, try pulling the ankle upward with the muscles on the front of the leg. Activating the front muscles can cause a reflex inhibition of the calf muscle contracture.