Pregnancy and RLS

Nearly a third of pregnant women have a condition called restless legs syndrome (RLS). People who have restless legs syndrome describe it as an "itchy," "pulling," "burning," "creepy-crawly" feeling that gives them an overwhelming urge to move their legs.

Once they do move their legs, the feeling often subsides. But by then the movement has already woken them up.

Causes of Restless Legs Syndrome in Pregnancy

Scientists don't know exactly what causes the sensations in the legs at night. But some believe it may stem from an imbalance of the brain chemical dopamine. That chemical normally helps keep muscle movements smooth and even.

RLS in pregnancy might be triggered by a lack of enough folic acid or iron. There's also some evidence that rising estrogen levels during pregnancy may contribute to RLS.

Trying to calm your restless legs all night can make you sleepy and irritable during the day.

Having restless legs syndrome can also make you more likely to have a longer labor and to need a C-section.

Treating RLS While Pregnant

If your symptoms are severe enough to interrupt your sleep night after night, you'll probably want to see your doctor to get RLS treated. That can be challenging during pregnancy.

Most drugs typically used to treat restless legs syndrome, such as Requip (ropinirole) and Mirapex (pramipexole), have not been studied extensively in pregnant women. So there is not enough data to determine all potential risks for a developing fetus.

Before you take any medicine for restless legs syndrome, your doctor should check your iron levels. If you're low, you can take an iron supplement. In many cases where the supply of iron in the body is low a supplement will be enough to correct RLS.

If your RLS symptoms still don't go away after an iron deficiency has been found and treated, some doctors prescribe opioid (narcotic) medication. Because of a risk of withdrawal symptoms in a newborn, opioids are typically given for a short period of time.

Also, the FDA has approved a device for treating RLS. Relaxis is the name of the vibrating pad placed under the legs while you're in bed. It is available only by prescription.

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Lifestyle Changes

If your RLS isn't that severe, try making some simple changes to your routine. These lifestyle changes have been shown to not only reduce the symptoms of restless legs syndrome, but they're also good for your pregnancy in general:

  • Avoid drinking coffee, soda, and other caffeinated beverages.
  • Exercise every day, but stop within a couple of hours of bedtime so you don't get too wound up to sleep.
  • Get into a regular sleep routine. Go to bed and wake up at the same time every day, if you can. Before bed, relax with a warm bath or by snuggling up in bed with a good book.

Whenever you wake up with RLS, try these tips to make the gnawing feeling go away so you can get back to sleep:

  • Massage your legs.
  • Apply a warm or cold compress to your leg muscles.
  • Get up and walk or stretch your legs.
  • Read or watch TV to distract yourself.

Restless legs syndrome can resolve after giving birth. Within a few days after your baby is born it in many cases will disappear. That's good news, because new moms will soon have much more pressing things to attend to in the middle of the night.

WebMD Medical Reference Reviewed by Kecia Gaither, MD, MPH on October 03, 2014

Sources

SOURCES:

UpToDate: "Restless Legs Syndrome."

National Institute of Neurological Disorders and Stroke: "Restless Legs Syndrome Fact Sheet."

Hensley, J. J Midwifery & Women's Health, May 2009.

Uglane, M. Acta Obstetricia et Gynecologica Scandinavica, September 2011.

Manconi, M. Sleep Medicine Reviews, August 2012.

Djokanovic, N. Journal of Obstetrics and Gynaecology Canada, June 2008.

NHS: "Restless Legs Syndrome - Treatment."

Manconi, M. Neurology, Dec. 7, 2010; pp 2117-2120.

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