Restless legs in pregnancy affects as many as one in five women, particularly during the third trimester. This is because natural physiological changes that happen during this time can raise your risk of developing the condition.
It is important to know that, for most expectant mums, restless legs syndrome is nothing to worry about for either you or your baby. However, as we will explain, you should seek the guidance of a doctor or midwife if you think you might have restless legs in pregnancy - especially if the symptoms are negatively impacting your wellbeing.
To share evidence-based insight on this common condition, we consulted three practicing GPs, Dr Claire Phipps, Dr Asia Ahmed and Dr Nasir Hannan. They shared their expertise with us on what restless legs syndrome is, why the condition is much more likely during pregnancy and what a doctor may advise about safe lifestyle changes or treatment options.
If you believe you might be experiencing restless legs syndrome, you should first seek personalised advice from your doctor or midwife. It may also be helpful to check out resources compiled by the NHS or the dedicated charity RLS-UK. While the condition isn’t life-threatening or usually anything to worry about, it is imperative to rule out other triggers for symptoms, and ensure that the health of you and your baby isn’t being impacted.
What is restless leg syndrome?
"Restless legs syndrome is a neurological disorder which can cause uncomfortable sensations in the legs and leave sufferers with an irresistible urge to move their legs," explains Dr Phipps. It is also known as Willis-Ekbom disease.
The symptoms are as you would imagine - restless legs. "However, people often describe the sensations as a crawling, creeping, tingling or burning feeling deep within their legs," notes Dr Phipps.
While they can appear at any time, symptoms are usually experienced at a particular moment in the day. "They usually occur in the evening and at night," explains Dr Ahmed. As a result, the condition is often associated with sleep disturbance.
Can pregnancy cause restless legs?
Anyone can experience restless legs syndrome. "Often there is no cause found for the condition, however it is important to rule out possible triggers," explains Dr Hannan.
"Genetics are thought to be a primary cause within the general population," explains Dr Ahmed. "However, it can also be brought on by a range of conditions such as chronic kidney disease, Parkinson’s disease, thyroid disease and diabetes. Vitamin deficiencies including iron, B12, folate or magnesium may also be responsible, along with consuming too much caffeine."
Restless legs are particularly common during pregnancy. "It affects one in five expectant women," explains Dr Hannan. "It typically occurs in the last trimester and often resolves after delivery." According to RLS-UK, symptoms usually peak at seven or eight months along, although some women may experience them earlier on in their pregnancy.
The link between pregnancy and the condition is still not fully understood, notes Dr Ahmed. "However, it’s thought to be due to hormonal fluctuations which can affect the neurotransmitters in the brain, including dopamine," she explains. This chemical helps the brain regulate and coordinate movement, and it is thought that when levels are reduced it can lead to muscle spasms and involuntary movements.
Iron deficiency is also a known risk factor for restless leg syndrome. "Pregnant women are more prone to low levels of the mineral due to increased blood volume and the physical demands of pregnancy to support foetal growth, which may then lead to restless leg syndrome," adds Dr Ahmed. According to the NHS, symptoms usually disappear after a woman has given birth.
Can you treat or stop restless leg syndrome?
Restless leg syndrome can be frustrating - particularly if you’re trying to get enough sleep during pregnancy - and fortunately there are some things you can try to help relieve symptoms.
"Stretching or going on a short walk can help," suggests Dr Ahmed. "Massaging the affected area will also bring relief, as well as practising relaxation exercises such as deep breathing and meditation."
However, the most effective way to stop restless leg syndrome is to speak to your GP about treating the underlying cause. "I would advise checking for iron deficiency," says Dr Hannan. "It may be also worthwhile undertaking blood tests for fasting glucose, magnesium, vitamin B12 and folate levels, as well as checking thyroid and renal function."
Additionally, it is important to consider lifestyle factors that could be raising your risk. "Improving your sleep quality is hugely important," explains Dr Ahmed. "Make sure to avoid caffeine before bed, keep your bedroom at an optimal temperature, introduce moderate exercise - such as walking - during the day, and try to get seven hours of sleep every night."
Dr Hannan continues: "If the symptoms are particularly severe and bothersome and still not resolved by these measures, then there are various drug treatments available. The difficulty is that the safety of dopamine agonists in pregnancy has not been established, so in these cases there would need to be agreement with your doctor and with your midwifery and consultant team."
What aggravates restless legs syndrome?
As previously mentioned, restless legs during pregnancy can be caused by a number of factors relating to changes in the body. "Triggers can vary between each person, but some common aggravators include a lack of sleep, stress and anxiety, as well as prolonged periods of immobility," says Dr Ahmed.
"Caffeine close to bedtime can also bring on symptoms,” adds Dr Ahmed. “Certain medications may also aggravate the condition - which is something to discuss with your doctor if you think this could be the cause." These include antidepressants, antipsychotics and antihistamines.
If you’re unsure about what may be setting your restless legs symptoms off, then it could be worth identifying any patterns. "Keeping a symptoms and lifestyle diary can be really useful to track any potential triggers and note where you can make simple changes within your day-to-day life," recommends Dr Ahmed.
Should I be worried about restless legs in pregnancy?
Restless legs syndrome is not life-threatening. "It is very common and lots of women experience it throughout pregnancy," says Dr Ahmed. "However, it is important to seek advice from a doctor or midwife if it begins to affect your sleep or impact your wellbeing in other ways." Indeed, getting enough rest is important for both you and your baby.
In general, if you think you might be experiencing restless legs syndrome, you should speak to your GP or seek advice from your doctor or midwife.
Dr Ahmed adds: "You should also go to a medical professional for urgent guidance if you simultaneously notice symptoms such as leg swelling, pain in the calves, shortness of breath, lower back pain or weakness in the lower limbs." This could be a sign of something more serious and requires immediate medical attention.
Answers to frequently asked questions about restless legs in pregnancy
How long do restless legs symptoms last?
The length of time symptoms can last and their severity will range among pregnant people. "It can vary, but restless leg syndrome typically occurs during periods of rest or inactivity, such as lying down to sleep," says Dr Ahmed.
Some women may experience mild symptoms that are short in duration, while others may experience them daily and for longer bouts. "But be assured that restless leg syndrome throughout pregnancy is usually temporary and will resolve itself after birth," adds Dr Ahmed.
Is magnesium good for restless legs during pregnancy?
There have been suggestions that consuming more magnesium - either through supplementation or food - can help restless legs. This is because levels of the mineral naturally decline during pregnancy.
"However, the importance of magnesium for relieving restless legs syndrome is up for debate," notes Dr Ahmed. "Current evidence suggests it is not conclusively effective, so it can’t be advised as a reliable treatment - more research is needed."
A magnesium supplement is not currently recommended by the NHS for pregnant women. "Maintaining a balanced diet is important in pregnancy," says Dr Hannan. If you are unsure about what nutrients you should be getting at this time, speak to your GP or a dietitian.
Are there any foods that are good for restless legs during pregnancy?
"No specific food has been directly proven to alleviate restless legs syndrome, but a healthy, balanced diet can contribute to overall wellbeing," says Dr Ahmed. This is important for the health of mother and baby, and if you are unsure you should consult with your GP or a dietitian.
"Make sure to incorporate iron-rich foods such as lean meats and poultry, as well as plenty of legumes and green leafy vegetables," recommends Dr Ahmed. "Nuts, seeds, and whole grains are also essential to a well-balanced diet, along with dairy products and eggs to boost your vitamin B12 levels."
It is also vital to be aware of the foods to avoid or be careful of while you are expecting for reasons other than restless legs syndrome. According to the NHS, these include certain cheeses, oily fish and cold cured meats.
What makes restless legs worse at night?
"It is normal to find that restless leg syndrome commonly occurs at night, primarily due to the prolonged period of immobility," notes Dr Ahmed. Indeed some pregnant women often experience it after sitting or lying down for some time, which is why it is often experienced in bed.
"There are various theories around why restless leg syndrome is worse at night," explains Dr Hannan. "They relate to dopamine levels, which can lower at night-time in line with the circadian rhythm." It is important to talk to your doctor if symptoms are negatively impacting your overnight rest.
Does drinking water help restless legs?
There isn’t a link that has been identified between restless legs syndrome and dehydration. "Drinking water won’t directly help symptoms," says Dr Ahmed.
"However, staying hydrated is essential for overall health, particularly during pregnancy, and it’s important to sip on plenty of water throughout the day." According to pregnancy charity Tommy’s, expectant mothers should be aiming for six to eight medium (200ml) glasses of water or fluid - or 1.6 litres - per day.
