Restless Legs Syndrome in Pregnant Women

Reviewed by: HU Medical Review Board | Last reviewed: June 2020

Gestational restless legs syndrome (RLS) is the most common movement disorder that develops during pregnancy. It can be a minor nuisance to some and in others severe enough to disrupt sleep many times each week.1-3

When a pregnant woman develops restless legs syndrome (RLS), it is considered secondary RLS. This means the restless legs are caused by another health condition – in this case, pregnancy. Two-thirds of gestational RLS occurs in women who did not have RLS before.3

Women who had RLS before getting pregnant or a family history of the disorder are more likely to have it during pregnancy too.3

Many women assume their sleep troubles are a normal part of pregnancy. For women who do talk to their doctor about the odd sensations in their legs, studies have found they mention feelings of:1,3

  • Insects running across the skin
  • Hot flashes inside the legs
  • Creepy-crawly
  • Cannot get comfortable
  • Need to move

RLS is the third most common reason for insomnia during pregnancy, behind getting up to pee and general discomfort.3

Who gets RLS during pregnancy?

About 1 in 4 pregnant women develop RLS, most often in the third trimester. Only 1 in 7 women have RLS in the first trimester. The severity of symptoms varies widely from one woman to the next. It often disappears in the weeks after birth, often in the first month.1-3

Rates of RLS during pregnancy are different around the world. About 1 in 5 women in Europe and the Americas develop RLS in pregnancy. This compares to 1 in 3 women in the Eastern Mediterranean region, and 1 in 7 in the Western Pacific Rim. One study in Nigeria found no RLS in 310 pregnant women.3

Women who develop RLS during pregnancy are more likely to report symptoms of RLS within 8 years of delivery, compared to women who did not have gestational RLS. The thought is that pregnancy reveals a genetic predisposition to restless legs syndrome that would have developed later in life anyway.4

What causes RLS in pregnancy?

There are many unanswered questions for why restless legs syndrome crops up in pregnant women and not others. It may be caused by low iron levels (anemia) or a vitamin (folate) deficiency. Other suggestions for RLS during pregnancy include genetic predisposition, high estrogen levels, compressed nerves, or changes in dopamine levels in the brain.2,3

How is RLS treated during pregnancy?

Drugs are rarely prescribed for restless legs syndrome during pregnancy due to concerns for the baby. Doctors usually prefer for the woman to try exercise, sleep hygiene, leg massage, and cutting back on caffeine. Some women may need to take iron supplements if their iron levels are low.4

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