Darvishi N et al. 2020. The prevalence of Restless Leg Syndrome/Willis-ekbom disease (RLX/WED) in the third trimester of pregnancy: a systematic review. BMC Neurology 132. https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-020-01709-0 [Accessed November 2020]
Restless legs syndrome during pregnancy
Restless legs syndrome can be maddening when you’re trying to get to sleep. Some things – like caffeine, smoking, and certain medications – can make RLS worse. As for making things better, there are plenty of things to try, from exercise and relaxation techniques to bananas and vitamin supplements.
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IN THIS ARTICLE
- What is Restless Legs Syndrome?
- Is RLS bad for my pregnancy?
- When will RLS go away?
- What causes restless legs syndrome?
- Are there things that make restless legs syndrome worse?
- Does anything help RLS in pregnancy?
What is Restless Legs Syndrome?
If you feel an uncontrollable urge to move your legs to relieve crawling, tingling, or burning sensations, you probably have restless legs syndrome (RLS). It’s also known as Willis-Ekbom Disease (WED). Symptoms can be mild or severe enough to keep you from getting the rest you need.
You’re not alone. In addition to affecting a good number of pregnant women, RLS affects men, children, and women who aren’t pregnant. Women experience RLS twice as often as men, and 20 percent of women experience it at some point in pregnancy.
Symptoms usually get worse when you’re at rest, especially right before you fall asleep or when you’ve been sitting still for long periods, such as at the movies or during a long car ride. Most of the time, you’ll feel the symptoms of RLS in your lower legs, but some women feel it in their feet, thighs, arms, or hands, too.
Moving your limbs brings immediate relief, but the sensations return when you stop moving. Needless to say, this can be very uncomfortable and frustrating, especially when you’re trying to sleep.
Is RLS bad for my pregnancy?
RLS can certainly keep you from getting the sleep you need, leaving you seriously fatigued and less able to function well during the day. But no, you don’t need to worry about RLS harming your pregnancy or your baby.
When will RLS go away?
Fortunately for women who develop RLS during pregnancy, it’s temporary. The symptoms typically peak during the third trimester and disappear altogether by the time you deliver your baby or a month or so afterward. Some women experience symptoms for longer, though.
What causes restless legs syndrome?
No single cause has been identified, but research is ongoing. And it seems to run in families. For women who already have RLS, it usually gets worse during pregnancy.
No one knows why women who’ve never had RLS develop it during pregnancy, but there are a number of theories, including: iron deficiency, folate deficiency, hormonal changes (specifically a rise in estrogen), and circulatory changes.
Are there things that make restless legs syndrome worse?
Things to avoid
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- Even a small amount of caffeine can make RLS symptoms worse. If RLS symptoms are bothering you, you might try eliminating caffeine from your diet completely, if you haven’t already.
- Smoking isn’t good for you or your baby, and it can also trigger RLS.
- Some medications, such as the antihistamines in cold and allergy remedies, make the symptoms worse for some people. (So while Benadryl tends to make people sleepy, for example, it may actually intensify your RLS symptoms and make it harder for you to sleep.)
- Lying in bed reading or watching television before you go to sleep can make things worse. The longer you lie still, the more likely RLS will occur. Instead, get in bed only when you’re actually ready to go to sleep.
By the way, most drugs used to treat RLS are not recommended during pregnancy.
Does anything help RLS in pregnancy?
Many BabyCenter moms-to-be have been in this boat. Here are their best tips for getting relief from the discomfort of RLS.
Exercise & muscle work
- Regular exercise helps me. I got RLS even before I was pregnant. For me it usually means I have too much pent-up energy and I need to get outside and go on a run or a walk.
- The only thing that’s been working for me is getting out of bed and either walking around for a bit or just doing squats right by the bed.
- One thing that helps is strengthening exercises or “tensing up” the area of muscles that suffer from the problem. For example, my RLS is in my hips. If I’m in bed and feel the RLS coming on, I contract & hold that muscle group for about ten seconds, then relax, and then repeat four or five times. Don’t forget to breathe while you’re doing it.
Stretching and yoga
- The only thing I’ve found that helps is to do some yoga at night. It’s the stretching that really helps. I don’t need to do the whole half-hour video. Just ten to 20 minutes and it drastically reduces my RLS. Otherwise I lie in bed all night shaking my leg trying to fall asleep.
- The only relief is if I get up and do some yoga stretches, stretching my entire leg from hip to toe.
- I’m 32 weeks pregnant and get RLS symptoms about every other night. It’s very annoying, and my legs can tingle and then twitch on their own. If I get up out of bed and do some deep leg stretches using the major muscle groups (thighs, calves, etc.) for about five or so minutes, I can alleviate the issue long enough to get to sleep. Yoga positions seem to help.
- The only thing that helps me sleep is stretching my legs really well before bed. If I don’t spend five to ten minutes stretching them out, I can’t get to sleep at all.
Relaxation techniques
Editor’s note: For more ideas, see our article on relaxation techniques for better pregnancy sleep.
- Once I do fall asleep, it doesn’t come back. So I try my hardest to get into the mind-set of not thinking about it. I try thinking of something peaceful, and before I know it I fall asleep. I also noticed the later I go to sleep, the worse it is.
- I’ve dealt with RLS all of my life, but it gets worse during pregnancy. I found a relaxation technique and it’s a miracle worker! I swear by this: Step 1: Starting with your toes, flex them as hard as you can while you breathe in. Hold for five to ten seconds, then relax as you exhale. Move through every section of your body (careful not to forget anything), all the way up to your face. Step 2: After your flex routine, close your eyes and count down from ten. Tell yourself (your partner can help) that with every number you’ll feel yourself sink deeper into the bed and your body will feel more and more relaxed. Repeat as many times as needed. With practice you’ll fall asleep on the first try.
Massage
- I had RLS with my last pregnancy, and massages helped me. Mainly my feet and legs but also hips. I went every other week from the time I was I was 6 months pregnant and that was great. I couldn’t have done without it.
- Massage, massage, massage! That is the only thing that helps me. My hubby even sits up in the middle of the night when he notices me twitching and kicking and rubs my legs until either he falls asleep or they stop moving. What a guy!
- I have found that massage helps. I was a massage therapist and had pregnant clients that would come in once or twice a month and claimed that it was really effective. I have received massages since I started getting RLS with my pregnancy, and it has helped.
Heat
- The one and only thing that seems to help me is taking a hot bath while rubbing my legs. (Just make sure the water isn’t too hot.)
- I am 34 weeks along and find that heat helps my restless legs. I put a heated microwavable pillow just above my knees (doesn’t fix, but helps) when I’m trying to get to sleep.
- I’ve tried everything, and the only thing that even remotely helps is hot showers (baths if you have them, we don’t). My skin is getting dried out (so I’m relying on lotion more and more these days), but a long, hot shower right before I head to bed often helps calm my legs enough to get me to sleep.
- I got RLS very badly with my first pregnancy. What helped me get to sleep more than anything else was a plug-in heating pad. Plug it in, set it between your calves or ankles, and turn up the heat so that it is almost too hot to handle. The burning feeling distracts from the RLS and you will eventually doze off to sleep. That is the only thing that consistently worked for me besides foot massages
- I am 33 weeks pregnant. I soak in the tub every night then jump into bed. This is the only relief I have found!
- It helps to take a warm bath before bed. While you are floating, your legs are moving but you can still relax. If I wake up in the middle of the night and can’t get back to sleep, I put a heating pad behind my knees. I use the kind that you heat in the microwave.
Cold
- When I’m having an “episode,” I soak my feet in the bathtub with the coldest water possible. This seems to be very effective!
- What really helps is to cool my feet down. Yes, that’s what I said. I put an ice pack against the bottom of my feet for a few minutes, and it seems to relieve my symptoms enough to where I can fall asleep.
- I am 28 weeks pregnant in my second pregnancy, and RLS has been a problem for me, as it was in my first pregnancy. It left me very sleep deprived before the birth of my first – not how you want to be when you bring home a new baby. This time around I have a remedy that is working for me very well. If I settle into bed and it starts (usually with a sudden rush of heat to my feet), I put my feet in very cold water for a couple of minutes. Then I put a bit of Bengay on my legs. It is the menthol-only kind that makes your skin feel cool instead of hot. It sounds funny, but it really works for me!
- A shower before bed with a blast of cold water on my head right at the end is the only thing that works reliably.
Old wives’ tales?
- My mom told me about this old wives’ tale remedy she uses for her RLS. Two hours before bed, soak your feet in hot water and Epsom salts for a good 30 minutes. Make sure you have a towel handy. As soon as you dry off your feet, put a light coating of Vicks VapoRub all over your feet, in between your toes, on the balls of your feet, and around your ankles, then sit for 15 minutes with your feet up. I swear by this – it works! No more RLS for me.
- This will sound bizarre, but what do you have to lose? Put a bar of soap under your sheet. Or more than one. I put a few pieces of “soap scraps” (the almost used-up bars). I don’t know why it works, but it really does make the restless leg stuff go away!
- Everyone will think I am crazy after they read this, but it worked. Take a bar of soap and put it under the sheet at the foot of the bed where you sleep. It works! My grandmother told me about it.
Orgasm
- I am 8 months and I have RLS, and the only thing that helps me to relax enough to get to sleep is having an orgasm. I’ve tried a lot of things but for some reason that specific release is enough to calm my body down to fall asleep.
- Only one thing has worked for me: having sex or at least having an orgasm.
Bananas
- Bananas are amazing for this! Almost since day one of this pregnancy (I’m now 35 weeks), I’ve eaten half a banana every morning and another half a banana before I go upstairs to get ready for bed. It’s the only thing that has helped at all.
- I hate bananas but was getting desperate, so I tried it. I eat a banana every night, and it has been working. Now I can actually fall asleep and have a good night’s rest.
- I was getting desperate. So about three weeks ago, I started eating two bananas every night before I go to bed. It works! I stopped having RLS! Completely. I can’t believe I suffered through the previous pregnancies and it could have been avoided by eating bananas.
Editor’s note: Bananas are an excellent source of potassium, which plays an important role in sending nerve impulses and helping your muscles contract. If you don’t like bananas, there are plenty of other great food sources. And they’re good for you even if they don’t calm your restless legs. See our list of potassium-rich foods.
Vitamin supplements
- My doctor put me on calcium and magnesium. It has all but completely taken RLS away. I still get that feeling like it’s coming on, but it doesn’t actually start and I’m able to fall asleep.
- Calcium-magnesium supplement helped, but I really got rid of the problem by taking iron supplements. I’m on my second pregnancy now and have been using iron supplements since the beginning. No sign of restless legs (yet!).
Editor’s note: Some studies have shown iron supplements provide relief from RLS in those who are iron-deficient. Ask your doctor or midwife about trying supplements such as magnesium, iron, vitamin B12, vitamin D, or folate. Depending on the quantities in your prenatal vitamin, your practitioner may or may not want you to take more. Consult your doctor before taking any supplements while pregnant.
Try, try again!
- I have tried two things that seem to work. First of all, I use Tiger Balm on my calves before I go to bed. They might burn for a little while, but it seems to relax my legs. I also got an acupuncture treatment, which really did the trick.
- I found that these things helped, although not reliably:
- swimming laps
- eating bananas before bed
- keeping the legs elevated higher than the body
RLS is one problem that can make it nearly impossible to sleep. Nausea, leg cramps, and heartburn or indigestion are other culprits. Read our tips for getting comfortable in bed when you’re pregnant.
Learn more:
- Sleep aids during pregnancy
- Sleep problem: Waking up hungry
- What’s the best sleep position during pregnancy?
- How to sleep like a baby when you’re expecting one
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Cochrane. 2019. Iron for the treatment of restless legs syndrome. https://www.cochrane.org/CD007834/MOVEMENT_iron-treatment-restless-legs-syndrome [Accessed November 2020]
Darvishi N et al. 2020. The prevalence of Restless Leg Syndrome/Willis-ekbom disease (RLX/WED) in the third trimester of pregnancy: a systematic review. BMC Neurology 132. https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-020-01709-0 [Accessed November 2020]
Dunietz GL et al 2017. Restless Legs Syndrome and sleep-wake disturbances in pregnancy. Journal of Clinical Sleep Medicine 13(7). https://jcsm.aasm.org/doi/10.5664/jcsm.6654 [Accessed November 2020]
Innes KI et al. 2016. The relationship of restless legs syndrome to history of pregnancy-induced hypertension. Journal of Women’s Health (Larchmt) 25(4): 397-408. https://pubmed.ncbi.nlm.nih.gov/26913940/ [Accessed November 2020]
Ma S et al. 2015. Restless legs syndrome and hypertension in Chinese pregnant women. Neurological Sciences 36(6):877-81. https://pubmed.ncbi.nlm.nih.gov/25647293/ [Accessed November 2020]
MayoClinic. 2020. Restless legs syndrome. https://www.mayoclinic.org/diseases-conditions/restless-legs-syndrome/symptoms-causes/syc-20377168 [Accessed November 2020]
Medscape. How is restless leg syndrome (RLS) treated during pregnancy? https://www.medscape.com/answers/1149405-164892/how-is-restless-leg-syndrome-rls-treated-during-pregnancy [Accessed November 2020]
Mother-to-Baby. 2018. A not-so-silent night: Restless legs syndrome and pregnancy. https://mothertobaby.org/baby-blog/a-not-so-silent-night-restless-legs-syndrome-and-pregnancy/ [Accessed November 2020]
Oyieng’o DO et al 2016. Restless legs symptoms and pregnancy and neonatal outcomes. Clinical Therapy 38(2): 256-64. https://pubmed.ncbi.nlm.nih.gov/26740290/ [Accessed November 2020]
Srivanitchapoom P et al. 2015. Restless legs syndrome and pregnancy: A review. Parkinsonism & Related Disorders 20(7): 716-722. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4058350/ [Accessed November 2020]
Karen Miles is a writer and an expert on pregnancy and parenting who has contributed to BabyCenter for more than 20 years. She’s passionate about bringing up-to-date, useful information to parents so they can make good decisions for their families. Her favorite gig of all is being “Mama Karen” to four grown children and “Nana” to nine grandkids.
What can I do about restless legs syndrome during pregnancy?
Some women develop restless legs syndrome in pregnancy, usually in the third trimester. This can’t be treated with medication, but there are some things you can do to try to ease the symptoms.
What is restless legs syndrome?
Restless legs syndrome, also known as Willis-Ekbom disease, is a common condition of the nervous system that causes an overwhelming irresistible urge to move your legs.
What are the symptoms of restless legs syndrome?
The main symptom is the overwhelming urge to move your legs. But you may also have uncomfortable and unpleasant sensations in your legs. Some people describe these as:
- tingling
- burning
- itching
- a ‘creepy-crawly’ sensation, like ants moving up and down the legs
- like fizzy water in the veins.
These sensations are often worse just below the knee and can sometimes be painful.
Your symptoms may be worse when you’re resting and may feel better when you move. They may be worse in the evening or at night.
Restless legs syndrome can be very frustrating, but it should not affect your health or pregnancy. However, it can make it more difficult to get a good night’s sleep. A lack of sleep won’t hurt your baby, but it can make your day-to-day life a bit more difficult. We have some tips that may help you sleep better.
Restless legs syndrome caused by pregnancy usually develops during the third trimester (the last 3 months of pregnancy). At this point, sleeping on your side is the safest thing to do for your baby because research shows it can reduce the risk of stillbirth.
How is restless legs syndrome diagnosed?
Unfortunately, there isn’t a test that can confirm whether you have restless legs syndrome. Instead, your doctor or midwife will talk to you about your symptoms and medical history.
What causes restless legs syndrome?
Sometimes the cause for restless legs syndrome is not known. These cases are known as idiopathic.
Pregnancy
About 20% of pregnant women develop restless legs syndrome, usually in the third trimester. This is possibly caused by a change in hormones.
Iron-deficiency anaemia
Anaemia (a blood condition) can sometimes cause restless leg syndrome and iron-deficiency anaemia can be common in pregnancy.
You’ll be checked for anaemia as part of your routine antenatal care, but you can have a test at any time during your pregnancy if there are any concerns.
If you have anaemia, you’ll probably be prescribed iron supplements as tablets or as a liquid to take every day. Eating a healthy, balanced diet will also help you get the iron you need to either prevent anaemia or manage your symptoms if you have it.
Other conditions
There are some conditions that may cause restless legs syndrome, although the scientific research to prove this is limited. These include:
- neurological conditions, such as Parkinson’s disease and multiple sclerosis
- rheumatoid arthritis
- diabetes
- hypothyroidism
- a very high BMI (body mass index)
Some medications
Some medications can cause restless legs syndrome or make it worse, including
- antidepressants
- some antipsychotics and lithium
- some antiepileptic drugs
- antihistamines
- dopamine receptor blocking agents such as metoclopramide and prochlorperazine
- beta-blockers.
But it’s important not to stop taking any medications without speaking to your doctor first.
Diet
There is also a theory that drinking excessive amounts of alcohol, caffeine, or eating too much chocolate can cause restless legs syndrome.
There isn’t enough scientific evidence to prove this is true. But we know for certain that drinking alcohol in pregnancy can cause serious complications in pregnancy. The more you drink, the greater the risk. There is no known safe level for drinking during pregnancy, so the safest approach is not to drink at all while you’re pregnant.
Caffeine is found in coffee, tea, some soft drinks, energy drinks and chocolate. Drinking a lot of caffeine in pregnancy has also been linked to miscarriage and low birth weight so the advice is to limit your intake to 200mg a day. You can check your caffeine intake with our pregnancy caffeine calculator.
What is the treatment for restless legs syndrome during pregnancy?
Medication isn’t generally recommended during pregnancy or while you are breastfeeding. But there are other things you can try. You may not be able to stop the symptoms completely, but you may be able to reduce them.
As well as reducing your caffeine intake and not drinking alcohol, you can try:
- stopping smoking (this can also reduce the risk of serious pregnancy complications)
- doing moderate, regular exercise (such as swimming)
- walking and stretching your legs
- relaxation exercises
- using heat pads on the legs, or having a hot bath
- using distraction techniques, such as reading
- massaging the legs.
Will restless legs syndrome go away after I give birth?
Yes. If your symptoms are caused by pregnancy, it’s likely that they will go away soon after giving birth. Unfortunately, women who have restless legs syndrome during pregnancy have an increased risk of developing the syndrome in later life.
Other conditions with similar symptoms to restless legs syndrome
Blood clots
The symptoms of restless leg syndrome can sometimes be confused with the symptoms of blood clots (deep vein thrombosis). However, they are different problems.
Deep vein thrombosis (DVT) can happen for no apparent reason, but you are more at risk during pregnancy and just after having your baby.
Call 111 or arrange an urgent appointment with your GP if you have these symptoms in your leg:
- throbbing or cramping pain in 1 leg (rarely both legs), usually in the calf or thigh
- swelling in 1 leg (rarely both legs)
- warm skin around the painful area
- red or darkened skin around the painful area
- swollen veins that are hard or sore when you touch them
These symptoms also happen in your arm or tummy if that’s where the blood clot is.
Your risk of developing DVT during pregnancy is even greater if you:
- or a close family member have had a blood clot before
- are over 35
- have a BMI of 30 or more
- have a condition that makes clots more likely
- are carrying twins or multiple babies
- have had fertility treatment
- have had a caesarean section
- smoke
- fly for more than 4 hours.
Call 999 or go to your nearest A&E if you have any of these symptoms, with chest pain or breathlessness. This may mean that the DVT has travelled to your lungs, which can be life threatening.
Staying as active as you can during pregnancy can help reduce the risk of a DVT.
Meralgia paraesthetica
Another condition that can cause uncomfortable or painful feelings in the leg is meralgia paraesthetica. This is a common problem caused by a trapped nerve in the thigh. The most common cause for this is recent weight gain or pregnancy. This causes a painful patch of burning, numbness or pins and needles on the outer side of the thigh (although the affected area can vary from person to person). This should get better after pregnancy but talk to your GP or midwife if you have this kind of pain.
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