Restless Legs Syndrome
Restless legs syndrome (RLS) — an uncomfortable urge to move the legs, usually worse at night and in the evening — affects up to 26% of pregnant women, making it a common cause of sleep disruption.
Common Causes
- Iron and folate deficiency — the most important contributors in pregnancy
- Dopamine pathway disruption by pregnancy hormones
- Genetic predisposition
- Third-trimester hormonal changes
- Spinal and pelvic changes compressing nerves
- Circulation changes that may trigger nerve sensations
Remedies That May Help
Iron Supplementation
If iron levels (ferritin) are low, iron supplementation significantly improves RLS symptoms. Ask your provider to check iron status.
Leg Stretches Before Bed
Calf stretches and thigh stretches reduce nighttime leg restlessness.
Warm Bath Before Sleep
A warm bath relaxes leg muscles and can reduce RLS symptoms at bedtime.
Leg Massage
Deep massage of the calves and thighs before bed can ease the sensation.
Avoid Caffeine and Antihistamines
Caffeine and some antihistamines worsen RLS symptoms.
Light Evening Walking
Gentle exercise in the evening can reduce RLS onset, though intense exercise may worsen it.
When to Call Your Doctor
- RLS symptoms are severely disrupting your sleep every night
- You suspect iron deficiency — ask for a ferritin level test
- Your symptoms continue or worsen significantly postpartum
- You also have periodic limb movements during sleep (involuntary leg jerks)
Frequently Asked Questions
What does restless legs feel like during pregnancy?
It is typically described as a crawling, creeping, tingling, or itching sensation deep in the legs that creates an irresistible urge to move. It is relieved temporarily by moving.
When does RLS start in pregnancy?
It most commonly starts or worsens in the second and third trimesters, peaking around weeks 30–38.
Is pregnancy RLS caused by iron deficiency?
Iron deficiency is the most common and treatable cause. Getting a ferritin blood test and treating low iron has the best evidence for improving RLS in pregnancy.
Will RLS go away after I give birth?
In most cases, pregnancy-related RLS resolves within weeks to a few months after delivery. In some women it persists, especially if the underlying iron deficiency is not treated.
Are there safe medications for RLS in pregnancy?
The first-line approach in pregnancy is non-pharmacological. Iron supplementation (if deficient) and lifestyle measures are safest. Discuss with your provider before taking any medication.