Restless legs syndrome (also referred to as RLS) is very common in pregnancy and can vary from simply being a nuisance to severely disrupting sleep for some women.

In some cases it may be associated with high blood pressure during pregnancy, pre-eclampsia, delivery by Caesarean section or depressed mood.

15-25% of pregnant women will experience restless legs syndrome during pregnancy, mostly starting during the pregnancy.  Risk factors include pre-existing RLS, family history of RLS, RLS during a previous pregnancy and low ferritin.

RLS is described by women as the urge to move the legs that is only relieved by continued movement of the legs.  It can also be described as aching or itching deep in the muscles.  Symptoms are usually worse in the evening, when resting or trying to sleep. Symptoms generally worsen as the pregnancy progresses and usually resolve completely after delivery.  They are often associated with difficulty sleeping.  There is sometimes an association between restless legs and depression or anxiety.

RLS should not be confused with nocturnal leg cramps which are also common in pregnancy.  Leg cramps are characterised by sudden painful tightening and hardening of muscles which are not relieved by movement, at least initially.

What can help with restless legs?

Moderate intensity exercise is thought to reduce the incidence of RLS.  Examples of this include brisk walking, water aerobics, dancing or gardening.  Yoga, massage or compression stockings may help.  Avoidance of exacerbating factors such as insufficient sleep, caffeine and nicotine is important.  Assessment of iron/ferritin levels may be of benefit as iron supplementation may improve your symptoms of RLS.  Some medications are thought to increase the incidence of RLS – you may need to discuss this with your doctor.  Occasionally if symptoms of RLS are persistent, medications may be considered as a treatment option – again you will need to discuss this with your doctor. Management of other associated conditions such as depression is also important.

You can be reassured that restless legs syndrome experienced during pregnancy will improve after delivery, even if breast feeding.

 

This post was written by Obstetrician Dr Meredith Tassone.