Pregnancy is a unique and special time — but it can come with many burdens, especially for your sleep quality. And if you've ever been pulled from your slumber by an overwhelming urge to move your legs, you're not alone.
The feeling, formally known as restless legs syndrome (RLS), can be described as an uncomfortable sensation — usually in the calves — alleviated by movement. And it's not just something that can happen during pregnancy. According to a poll, RLS affects about 15 percent of American respondents.
But while RLS can occur anytime, pregnancy appears to be a risk factor. A study published by Elsevier found that about 20 percent of pregnant women experience RLS symptoms.
In this article, we'll explore what RLS is, possible causes and risk factors during pregnancy, and some tips on managing the condition.
First, let's take a closer look at what restless legs syndrome is and point out what it is not.
What is Restless Legs Syndrome?
Restless legs syndrome is a common sleep disorder. It is also called restless leg syndrome, nocturnal leg cramps, or Willis-Ekbom Disease and is characterized by an urge to move the legs, often accompanied by an unpleasant sensation.
RLS one of many neurological disorders that affect sleep. Yes, that's right — it's not just in your head. The science behind this is still being studied, and there is no exact test to know if you have it. Doctors often ask about your family history and rule out other potential causes for your symptoms before making a diagnosis.
Nevertheless, RLS exists and can be a major pain — literally. Those with RLS often find it difficult to fall asleep and stay asleep. This can lead to major sleep deprivation, which then has a whole host of other consequences.
There are two types of restless legs syndrome: primary and secondary. Primary RLS is the most common type. Primary RLS is not an underlying cause but is thought to be genetic. Secondary RLS is less common and has an underlying cause, such as iron deficiency anemia, pregnancy (when it is experienced for the first time), or certain medications.
Below, we'll discuss the causes and theories behind RLS in greater detail.
Causes of and Risk Factors for Restless Legs Syndrome
RLS can be caused by several things, including genetics, low iron levels, pregnancy, and certain medications. Let's look at some of the theories and risk factors below.
One explanation behind RLS is that it's caused by an imbalance in the brain's chemical dopamine. Dopamine is a neurotransmitter that plays a role in the movement, and an imbalance can lead to involuntary movements associated with RLS.
With less dopamine, your brain cannot send the right signals to the muscles, which can cause an urge to move.
Another explanation is that RLS is hereditary. If you have a family member with RLS, you may be more likely to experience it yourself. Some gene variants have been associated with the development of RLS.
Some research suggests that iron deficiency may also play a role in RLS. Iron is essential for producing dopamine, so a lack of iron.) could lead to an imbalance.
There are also a few other factors that can trigger RLS:
- Being pregnant
- Often, RLS is first experienced during pregnancy. It's thought that hormonal changes during pregnancy may play a role in developing RLS. We will discuss this in more detail later. Certain pregnancy complications, such as preeclampsia, may trigger RLS as well.
- Being overweight or obese
- Excess weight can put pressure on your body and its work, which may contribute to RLS symptoms. Your body mass index (BMI) is a good way to determine if you're still in the normal weight range for your height.
- Smoking cigarettes
- Smokers beware. You are more likely to experience RLS than those who don't. Nicotine, a substance present in cigarettes, is a stimulant. Stimulants can increase the risk of RLS.
- Using alcohol or drugs
- Alcohol and drugs are also stimulants, as are caffeine and some cold and allergy medications.
- Your age and gender
- Women are more likely to experience RLS than men. This is likely due to hormonal changes. RLS is also more common in middle-aged adults and older adults. However, it can occur at any age.
- Having chronic diseases such as Parkinson's disease, diabetes, or kidney failure
Symptoms of Restless Legs Syndrome
As we mentioned, the most common symptom of RLS is the urge to move the legs. The feeling has been described in many ways, but a few common terms are:
- Crawling. The sensation has been described as like bugs crawling under the skin.
- Pulling. Some people feel a pulling or tugging sensation deep inside the leg.
- Aching. Others have described the feeling as achy or painful, similar to the sensation of having a charley horse.
The urge to move is often irresistible and can make it difficult to stay still for long periods, such as when trying to fall asleep. Those with RLS often toss and turn at night, leading to insomnia.
The good news is that the sensation usually goes away once you start moving. But the bad news is that it can come back as soon as you stop, making it tough to get a good night's rest.
You now know the causes behind and symptoms of restless legs syndrome. However, it's also important for you to know what it is not and whether what you're experiencing is, in fact, restless legs syndrome.
What is Not Considered RLS?
A few things can be confused with RLS but don't meet the criteria.
For example, growing pains are often confused with RLS but don't include the urge to move. Growing pains are more of an ache or pain in the legs, usually at night. Children and adolescents are more likely to experience growing pains than adults.
RLS also differs from periodic limb movement disorder (PLMD), characterized by the urge to move the legs. However, PLMD only occurs during sleep, whereas RLS can occur at any time — even when you're trying to rest.
Meanwhile, pain caused by restless legs syndrome differs from other pain types, like arthritis pain. Arthritis pain is usually described as achy, throbbing, or burning. RLS pain, on the other hand, is more often described as prickly, tingling, creepy-crawly, or like bugs are biting you.
Some mental health conditions can also cause symptoms that are similar to RLS. For example, people with anxiety may feel like they need to move their legs to release tension. People with attention deficit hyperactivity disorder (ADHD) may also feel fidgety and have difficulty sitting still.
If you're unsure whether your symptoms are caused by RLS or something else, it's important to see a doctor. They can help rule out other possible causes and make a diagnosis.
Now, let's explore further how RLS affects pregnant women.
Pregnant Women, Sleep and Restless Legs
Pregnant women experience overall restlessness, which can be compounded by the hormonal changes and physical discomforts that come with pregnancy.
- First, back pain, leg cramps, and heartburn can make it tough for pregnant women to fall asleep and stay asleep.
- Second, the hormonal changes that come with pregnancy can also disturb sleep. In particular, the hormone progesterone can make you feel drowsy during the first and second trimesters. But in the third trimester, progesterone levels drop, making it harder to sleep. RLS usually develops in the second or third trimester and goes away after delivery. In some cases, however, RLS can persist postpartum.
- And last, the increased frequency of trips to the bathroom can also disrupt sleep. As the pregnancy progresses and the baby grows, the uterus puts pressure on the bladder, leading to more frequent trips to the bathroom.
All of these factors can make it tough to get quality sleep. And when pregnant women don't get enough sleep, it can lead to many problems, including fatigue, anxiety, and depression. It can even endanger the health of both the mother and the child.
How RLS Develops in Pregnant Women
To make things more difficult, when pregnant women experience RLS, it can be even more difficult to get that much-needed zzzs. Many reports that the symptoms are worse at night, making it hard to fall asleep in the first place. Some also find that their RLS is exacerbated by lying down for long periods.
RLS usually develops in the second or third trimester and goes away after delivery. However, for women who start experiencing early onset RLS before pregnancy, the condition may worsen during pregnancy.
During the first trimester, RLS may be triggered by the iron requirements of the developing baby. As we mentioned above, low iron levels in the brain are thought to cause RLS. As pregnancy progresses and the demands on the woman's body increase, RLS may worsen.
For many women, the symptoms of RLS are mild. But for some, the condition can be more severe and interfere with daily activities. In some cases, RLS can persist postpartum.
Pregnancy-Related Conditions that are Sometimes Confused with RLS Include:
RLS is common during pregnancy, but there are other things that can cause discomfort during pregnancy. In a previous section, we discussed the possible conditions that may be considered RLS in the general population. Here, we look at pregnancy complications vis-à-vis RLS symptoms.
Round Ligament Pain
Round ligament pain is a sharp, shooting pain that's felt in the lower abdomen or groin. It's caused by the round ligaments — two strong bands of tissue that support the uterus — stretching as the baby grows.
Varicose Veins
Varicose veins are another common pregnancy-related condition. The valves cause them in the veins not to work properly, which causes the blood to pool in the veins. This can cause the veins to bulge and become twisted. Varicose veins can be painful and may feel achy, throbbing, or like your legs are heavy.
Leg Cramps
Pregnant women are prone to leg cramps. They're caused by the muscles in the leg contracting and can be pretty painful. They're often worse at night, too.
Anxiety and Stress
Your mental health is important in preventing any form of health condition. Stress may lead to muscle tension, resulting in pain and discomfort. Anxiety can also cause restless, agitated movements.
Managing Pregnancy-Related RLS
If you're dealing with restless legs syndrome during pregnancy, there are a few things you can do to find relief:
Get Moving
The best way to relieve the symptoms of RLS is to keep moving. Walking, stretching, or other gentle exercises can help ease the sensation. If this sounds too much, even moving your legs while sitting down can help.
Keep in mind that the relief is only temporary. As soon as you stop moving, the symptoms will likely come back. But keeping your legs in motion can help you get through periods of restlessness.
Light workouts during the day can also help reduce symptoms at night. Regular exercise is helpful for people with RLS. But it's important to avoid overdoing it. Exercising too close to bedtime can also make symptoms worse.
Try to Stay Cool
Another way to ease the symptoms of RLS is to keep your legs cool. Applying a cold compress to your legs can help relieve the sensation. Taking a cool bath or shower may also help.
Cooling your legs in a pool or lake can be especially helpful in summer. Just be sure to dry off afterward.
Wear Comfortable Clothes
Wearing tight, constrictive clothing can make the symptoms of RLS worse. So it's important to wear comfortable, loose-fitting clothes. This will help you stay cool and give your legs the freedom to move.
Some fabrics can also irritate the skin, so choosing gentle clothing is important. Natural fibers like cotton are usually a good choice. Others, like wool, can be irritating. You might need to experiment to see what works best for you.
Wear compression stockings
For some people, compression stockings can help relieve the symptoms of RLS. These special stockings apply gentle pressure to the legs. This can help reduce the sensation of restless legs.
Compression stockings are available without a prescription. But it's important to choose the right size. Stockings that are too tight can make symptoms worse.
Avoid Caffeine and Alcohol
You're pregnant, so you're probably steering clear of alcohol. But it's also important to limit caffeine during pregnancy. That's because caffeine can trigger RLS and worsen if you overdo it. Caffeine is a stimulant that can make you feel more alert and increase your body's natural movements.
If you can't give up caffeine entirely, try limiting your intake to 200 milligrams or less daily. That's about the amount in one 12-ounce cup of coffee.
Get a Massage
A soothing massage can help relieve the symptoms of RLS. Ask your partner to give you a gentle massage or see if there's a prenatal massage therapist in your area.
Acupuncture and other complementary therapies may also help ease the symptoms of RLS. But be sure to talk to your healthcare provider before trying any new treatment, especially during pregnancy.
Take Care of Your Iron and Folic Acid Levels
Anemia is a common cause of RLS. So it's important to ensure your iron levels are where they should be during pregnancy.
You can help prevent anemia by eating iron-rich foods, such as leafy green vegetables, lean red meat, beans, and fortified cereals. You should also take a daily prenatal vitamin that contains iron, or you can talk to your healthcare provider about taking iron supplements.
Folic acid is another nutrient that's important for preventing RLS. Folic acid helps your body produce new cells, including red blood cells. Like iron, this nutrient comes from various foods: leafy green vegetables like Brussel sprouts and spinach, eggs, liver, and supplements. You can also get it from folic acid-fortified foods like orange juice and bread.
Iron and folate deficiency anemia during pregnancy can lead to serious health problems for you and your baby. These problems include premature birth, low birth weight, and neural tube defects.
Adjust Your Sleep Habits
If you're dealing with RLS, getting enough sleep is key. But that can be easier said than done when dealing with pregnancy-related fatigue and frequent trips to the bathroom.
To help yourself get the rest you need, try to stick to a regular sleep schedule as much as possible. Go to bed and get up at the same time every day. And try to limit naps to 30 minutes or less.
If you can't fall asleep, get out of bed and do something else until you feel tired. Lying in bed, tossing, and turning will only make it harder to fall asleep when you finally do drift off.
How to Treat RLS in Pregnancy
If lifestyle changes and home remedies don't relieve your symptoms, your healthcare provider may prescribe RLS medications.
Dopamine agonists are a type of medication that can help ease the symptoms of RLS. These drugs act on the nervous system to help reduce the sensations in your legs.
Some dopamine agonists, such as ropinirole (Requip) and pramipexole (Mirapex), are available in generic form. These drugs have been studied extensively and are considered safe during pregnancy.
Other dopamine agonists, such as rotigotine (Neupro) and cabergoline (Dostinex), are not available in generic form. These drugs have not been studied much, so their safety during pregnancy is not as well-established.
If you're pregnant and have RLS, talk to your healthcare provider about the best treatment options.
Women who have RLS during pregnancy are also more likely to have the condition after they give birth. For some women, the symptoms disappear within a few weeks or months. But for others, the symptoms may persist or even get worse. Talk to your healthcare provider about treatment options if your symptoms don't go away after you give birth.
The Power of Meditation for RLS Symptoms
In addition to the remedies and options above, some women find that meditation can help ease the symptoms of many pregnancy-related conditions, including RLS.
Pregnancy is a time of many changes, both physically and emotionally. And meditation can help you cope with these changes by promoting relaxation and reducing stress. Pregnant women who meditate regularly report feeling calmer and more in control during pregnancy and labor.
Meditation has been around for centuries, and there are many different ways to do it. Pregnant women can learn meditation through books, audio recordings, or classes. Once you know how to meditate, you can do it anywhere.
To get started, you can try guided meditation, which involves following along with a recording of someone else's voice. A session usually lasts for 20 to 30 minutes and will guide you through the process of focusing on your breath and letting go of intrusive thoughts.
Or you can try mindfulness meditation. Mindfulness is a moment-to-moment awareness of your thoughts, feelings, and surroundings. It's about being present in the here and now, without judgment.
Here are some ways you can practice mindfulness meditation before going to sleep:
- Pay attention to your breath and the sensations in your body.
- Focus on one thing at a time, such as a mantra or your breath.
- Accept your thoughts and feelings. Do not judge them or try to change them.
- Let go of any preconceived notions about what meditation should be.
If you're new to meditation, many resources are available to help you get started. You can find guided and mindfulness meditations online or on apps like BetterSleep. BetterSleep features a wide array of sounds, music, and meditations to help you sleep better.
Frequently Asked Questions (FAQs)
Why Do I Experience Restless Legs During Pregnancy?
Pregnancy brings a variety of discomforts you may not have experienced yet. RLS during pregnancy is one of them. When you're pregnant, you may put on weight that can put pressure on your legs and cause them to feel restless. Another reason may be due to changes in hormone levels. These changes can cause your muscles to feel tighter and lead to restless legs.
How Can I Prevent RLS During Pregnancy?
It's difficult to know if you will experience RLS during pregnancy, as the causes vary between women. What you can do to reduce your risk by getting enough nutrients and vitamins, developing good sleeping habits, and working out regularly.
Can RLS Be Harmful to My Baby?
There's no evidence that RLS is harmful to your baby. However, RLS is known to cause sleep problems, which can negatively affect your overall health and well-being, affecting your baby's health and well-being.
How Long Does RLS Last During Pregnancy?
For some women, RLS goes away on its own after they give birth. But for others, the symptoms may persist or even get worse. Talk to your healthcare provider about treatment options if your symptoms don't go away after you give birth.
What Other Pregnancy-Related Conditions Can Cause Symptoms Similar to RLS?
There are several other conditions that can cause symptoms similar to RLS, including leg cramps, carpal tunnel syndrome, and sciatica. Talk to your healthcare provider if you're unsure what's causing your symptoms. They can help you get a proper diagnosis.
What are the Treatments for RLS During Pregnancy?
Treating RLS includes lifestyle changes, home remedies, and medication. If your symptoms are severe, you may need to consult with your doctor or even ask to be hospitalized.
How Can I Sleep Better with RLS?
There are many ways to relieve RLS symptoms and even get good sleep. Follow these steps to minimize the discomforts associated with RLS:
- Taking regular breaks during the day to move around and stretch your legs
- Exercising regularly
- Taking medications prescribed by your doctor to help relieve RLS symptoms
- Adjusting your bedtime routine to include relaxation techniques such as yoga or meditation
- Creating a comfortable sleeping environment in your bedroom
Is There a Cure for RLS?
Unfortunately, there is no cure for RLS. If it's secondary RLS, the underlying cause may be treated. Your doctor will need to understand your full experience with RLS before coming up with a management plan. You should not wait to seek medical help if your symptoms are severe.
What are the Long-Term Effects of RLS?
RLS is a lifelong condition that you may experience from time to time, even worsening with age.
If You Have RLS, Can You Still Breastfeed?
There isn't an established answer to this question. However, RLS can interfere with your sleep, making it difficult to breastfeed, especially at night. If you're having difficulty breastfeeding, talk to your OB-GYN. They can offer guidance and support.
Is RLS Contagious?
No, RLS is not contagious because viruses or bacteria do not cause it. It's caused by hormones, iron deficiency, and other underlying health conditions.
Can RLS be Passed Down in Families?
Studies have found that RLS may have a genetic component and may be more common in certain families. If you have RLS, it's important to ask your family members about their experience and whether other extended family members have it too. This can help you better understand your risk and give your doctor an idea about managing it.
Final Thoughts
Pregnancy should be a time of joy and excitement. It's a time when you're growing a new life and preparing for the arrival of your baby. But it can also be a time of stress and anxiety.
If you're pregnant and have RLS, there are things you can do to ease your symptoms. Try simple lifestyle changes like getting regular exercise and wearing comfortable clothes. You can also try home remedies like a warm bath or a heating pad on your legs. If these things don't help, talk to your healthcare provider about other treatment options.
In addition to the remedies and options above, some women find that meditation can help ease the symptoms of many pregnancy-related conditions, including RLS.
If you haven't tried meditation before, it's important to find a method that works for you. Once you know how to meditate, you can do it anywhere.