How to Stop Restless Leg Syndrome While Pregnant

Restless leg syndrome (RLS) can happen during pregnancy. Here's what causes it and what pregnant people can do about it.

top view of pregnant woman in black pajamas lying in bed with pregnancy pillows

Felix Chacon/Stocksy

When you're visibly pregnant, you’ll often hear that tongue-in-cheek reminder to "sleep while you can." That can get a bit challenging if you can't get your legs to settle down. 

I would know—I developed restless leg syndrome (RLS), formally known as Willis-Ekbom Disease. Every night when I tried to go to sleep, I felt like ants were slowly marching up my legs while they periodically spasmed.

About 7% to 10% of people in the U.S. have RLS, and it can happen at any age, according to the National Institute of Neurological Disorders and Stroke. Some 2015 data indicates it may be more prevalent in pregnant people, affecting 10% to 34% of them. It’s also linked with an increased risk for preeclampsia and C-sections, and found to coincide with iron deficiency

Here's what else experts say about restless leg syndrome, including why it happens, what you can do about it, and whether it'll stop postpartum. Also, is there a way to stop restless legs immediately?

What Is Restless Leg Syndrome?

As the name suggests, restless leg syndrome is a sleep disorder that causes a strong urge to move parts of the body, especially the legs, in the evening. It can also present with uncomfortable sensations in those limbs. It occurs “most often when the person tries to go to sleep," says Brian Koo, M.D., the director of the Yale Center for Restless Legs Syndrome.

It turns out feeling like I had ants crawling on my legs as I ran through my mental pregnancy to-do list every night was par for the course.

"It's this overriding, anxious feeling of the leg that you feel like you can't stop moving," says Joseph W Bacchi, III, M.D., MBA, an obstetrician at Stony Brook Medicine. "Some people will describe it as a creepy, crawly, bug-like sensation."

Joseph W Bacchi, III, M.D.

Some people will describe it as a creepy, crawly, bug-like sensation.

— Joseph W Bacchi, III, M.D.

Restless Leg Syndrome Symptoms

RLS in pregnancy has the same symptoms it would outside of pregnancy, notably the following:

  • Jittery feelings in the leg
  • Persistent itchiness, like you have an itch that can't be scratched
  • Cramping
  • Pain
  • Inability to get comfortable in any position
  • Problems sleeping
  • Complaints from bed partners

And pregnant people also say it interferes with their sleep. "Once they do get to sleep, they toss and turn,” says Dr. Bachhi. If they have partners, they “complain about it as well,” adds Dr. Bachhi.

A small 2018 study suggested RLS becomes more prevalent as pregnancy progresses. According to the research published in 2015, RLS symptoms were also found to be most common in the third trimester, although symptoms were reported in the second and first trimester as well. 

What Causes Restless Leg Syndrome in Pregnancy?

Iron deficiency is a leading cause of restless leg syndrome in pregnancy, says Dr. Koo. According to the American Society of Hematology, mild anemia is common in pregnancy, particularly in the second and third trimesters, and is the result of increased blood flow needed to sustain the fetus.

The authors from the 2015 study mentioned above listed other causes of RLS in pregnancy as:

  • Family history of RLS
  • Vitamin D deficiency
  • Calcium metabolism
  • High estrogen levels

Having restless leg syndrome in a previous pregnancy increases your likelihood of having it again, adds Dr. Bacchi. Additionally, underlying mental health issues, including depression and anxiety, may increase a pregnant person's risk of RLS.

Restless Leg Syndrome Diagnosis in Pregnancy

Pregnant people often undergo tons of tests, like the initial blood work to confirm a pregnancy, gestational diabetes testing, and ultrasounds. But there's no specific test for RLS.

"It's just a clinical diagnosis based on what patients describe to you,” says Dr. Bacchi. “No tests are needed. It's based on the patient's story.”

You will have your iron levels checked late in your second trimester along with the glucose test for gestational diabetes, typically sometime between 24 and 28 weeks, to rule out anemia.

Restless Leg Syndrome Treatment During Pregnancy

First, it's important for pregnant people and their providers to address any underlying issues, says Dr. Bacchi. If you're struggling with depression and anxiety, help is available. Speak with your provider, who can recommend a mental health professional.

As for anemia, it carries risks to the pregnant person and fetus, including shortness of breath and fainting for the pregnant person and low birth weight for the infant. Dr. Bacchi says first-line treatments often include taking an iron supplement and potentially a vitamin D supplement to help a person's body better absorb the iron. Making tweaks can also up iron intake, such as adding more leafy greens to a meal plan.

But what about cases without underlying issues? Non-pharmaceutical treatments for RLS in pregnancy can help:

  • Leg stretching before sleep. Calf stretches were useful for me, as that's where my RLS was most prevalent.
  • Reducing or eliminating caffeine. The American College of Obstetricians and Gynecologists suggests limiting caffeine to less than 200 mg per day.
  • Eliminating alcohol. The Centers for Disease Control and Prevention (CDC) stresses there is no safe amount of alcohol pregnant people can consume.
  • Massage. Leg massages can be helpful, although make sure to go to a professional with experience massaging pregnant people. I found foam rolling helped too.
  • Light exercise. Opt for low-impact activities. Water aerobics is a great option, according to Dr. Bacchi.

The 2015 study explains there is limited evidence that any of this actually helps but says none of these methods have been shown to have adverse effects on pregnant people or a fetus.

Does Ibuprofen Help Restless Legs?

Prescription medicines may carry risks for pregnant people and should be discussed with a provider, says Dr. Bacchi. As for an over-the-counter choice like ibuprofen, Dr. Bacchi says it likely won't work. That’s because RLS isn’t caused by pain or inflammation. 

"It is a jittery feeling. Some people can have pain if they have other things going on like excessive swelling,” Dr. Bacchi says. “But the first-line treatment is counseling on what restless leg syndrome is and treating any underlying issues."

When Does Restless Legs Syndrome Go Away?

The good news about RLS: It'll likely go away pretty quickly after giving birth. "Almost always, it will go away within the first couple of days postpartum," says Dr. Bacchi. "Most people do not have long-standing restless leg syndrome."

Unfortunately, it's just in time for something—someone—to wake you up (at least they're cuter, snugglier, and yours).

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  1. Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment. Acta Neurologica Scandinavica. 2015.

  2. The prevalence of restless leg syndrome among pregnant Saudi women. Avicenna Journal of Medicine. 2018.

  3. The impact of maternal iron deficiency and iron deficiency anemia on child’s health. Saudi Medical Journal. 2015.

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