Restless Leg Syndrome During Pregnancy

Restless Leg Syndrome

When they become pregnant, most women anticipate the usual symptoms: morning sickness, backache, and a constant need to pee. But what you might not know is you could also develop a condition called restless leg syndrome (RLS), which can severely affect your ability to sleep.

Restless leg syndrome occurs in about 26% of pregnant women and is characterised by a crawling, tingling, itchy feeling in their legs, particularly when they are resting.

To relieve the sensation, they often have an overwhelming urge to move their legs. The feeling can subside after the movement but comes back again.

What Causes Restless Leg Syndrome?

Science really doesn’t understand completely what causes RLS. There are several theories about the cause, such as vitamin and mineral deficiencies, or hormonal changes.

Iron levels naturally drop during pregnancy and it is thought to be this deficiency that can trigger some cases of RLS. Iron deficiency can disrupt the levels of dopamine – a brain neurotransmitter that controls muscle activity and movement. If too much dopamine is released, your brain causes your body to make unnecessary movements.

Folate is recommended as a supplement during pregnancy, taken to lower the risk of your baby developing spina bifida. But folate has another important role: your brain needs this B vitamin to make dopamine. Research from 2007 showed only 9% of women who took iron and folate supplements during pregnancy suffered RLS symptoms, compared with 80% of women who didn’t take them.

A small study showed women with higher levels of estradiol (a type of estrogen) during pregnancy could develop RLS. The researchers found pregnant women with RLS had higher estradiol levels than women without the condition.

Women who have RLS before pregnancy might find the condition worsens, particularly in the third trimester, and becomes progressively worse with each subsequent pregnancy.

What Can I Do About Restless Leg Syndrome?

While RLS isn’t considered a serious medical condition, women who experience it know how detrimental a lack of proper sleep can be. Drugs used to treat RLS have not been researched for use during pregnancy, so we don’t know what effects they might have on your developing baby.

In most cases, women need to utilise any number of non-medical treatments to relieve their symptoms:

• Women need 3-4 times more iron and 8-10 times more folate when pregnant. Talk to your care provider about having your levels tested, and try to include natural forms of iron and folate in your diet.
• Avoid medications which block dopamine levels and increase RLS symptoms, such as antihistamines, most antidepressants, anti-nausea drugs, cold and flu drugs, and allergy medications.
• Exercise every day to improve circulation, boost pain relieving endorphins, and increase blood flow to muscles. Just don’t overdo it and definitely avoid exercise too close to bedtime.
• If your symptoms are keeping you awake all night, try going to bed at midnight and waking at 9am. Dopamine and iron levels usually drop at night and rise during the day, and this might help you to avoid the peak time for symptoms.
• Avoid drinking coffee or other caffeinated beverages. Being well hydrated improves circulation, so reach for the water or herbal teas instead.
• Have weekly massages (as if you need an excuse!) to alleviate the symptoms of RLS.
• Avoid lying or sitting still too long before sleep, as the longer you are inactive the more likely the symptoms of RLS will appear.

If you wake up with RLS, you might like to try the following to alleviate the symptoms and hopefully get back to sleep:

• Massage your legs
• Use warm or cold compresses on your leg muscles
• Have a warm bath
• Stretch your legs, and walk around
• Try distracting yourself with a book or activity

For most women who develop Restless Leg Syndrome during pregnancy, it is only temporary. Unfortunately it might be one of those things you have to live with, but usually it peaks in the last month of pregnancy and disappears not long after the birth of your baby. If RLS is causing you to struggle, due to lack of sleep, speak to your care provider.