When you’ve got a bun in the oven, sleep can be hard to come by. Between frequent trips to the bathroom, heartburn, and midnight pizza cravings (leading to more heartburn), tossing and turning can keep you more active than prenatal fitness.
On top of that, you can’t tell who’s kicking more—you, or your baby. Sound familiar?
That uncontrollable sensation to move is called Restless Leg Syndrome and affects up to 26% of pregnant women. Keep reading for the full scoop on possible causes, signs and symptoms, and some tips on how to fight it.
Signs of Restless Legs Syndrome in Pregnancy
RLS causes an unpleasant sensation in the lower limbs that feels like throbbing, itching, pulling, tingling, or just a painful feeling. Some people describe it as a creepy-crawly feeling that they can’t help but try to shake off. The urge to move can be very powerful and may feel overwhelming at times.
Sometimes, the condition can be mistaken for nocturnal leg cramps or hypnic jerking, but unlike with RLS, moving the legs doesn’t usually improve those conditions.
If you suspect you may have the syndrome, it’s important to speak with your health care provider about your symptoms. To be diagnosed, you have to meet the following criteria:
- Urge to move limbs is accompanied by an unpleasant sensation
- Urge and/or sensation is relieved by movement
- Symptoms are worse at rest and improved by activity
- Symptoms are worse in the evening and overnight
RLS is a common sleep disorder that’s also known as Willis-Ekbom Disease (WED). It affects between 5-15% of the general US population, although women are twice as likely to be affected than men. Pregnancy appears to increase the likelihood of struggling with this condition, although the exact underlying reason isn’t fully understood.
RLS During Pregnancy
When Restless Leg Syndrome occurs in pregnant women, it is considered secondary. When it occurs outside of pregnancy, it is considered primary and is usually linked to dysfunctional pathways in the brain, depletion of iron and ferritin, or genetics.
RLS is 2-3 times higher in pregnant women than in non-expecting women. The prevalence increases with each trimester with the highest number of cases in the third trimester; it also increases with each subsequent pregnancy.
For most women, the symptoms disappear soon after delivery. But in some cases, symptoms can persist for weeks after giving birth making it even harder to rest during the early newborn days when sleep is a rare but precious commodity.
Importance of Dealing With Leg Twitching
If you’re struggling with symptoms, it’s important to seek treatment. A recent study of 1,563 women in their third trimester found that those with RLS were more likely to experience poor sleep quality, poor daytime functioning, and excessive daytime sleepiness.
Studies have also linked RLS with complications like depression, premature labor, Cesarean section, and difficult delivery.
Possible Causes of Restless Legs in Pregnancy
Scientists still have a lot to learn about this condition and the underlying causes. While more research is needed, they have identified a few possible links.
Insufficient Vitamin D
Could a little sunshine put an end to that twitchy feeling in your legs? Multiple studies have identified low vitamin D as a culprit in this syndrome. The most likely explanation has to do with dopamine signaling in the brain.
Vitamin D increases levels of the neurotransmitter dopamine and its metabolites. Impaired dopamine signaling is one of the most researched theories when it comes to the cause of RLS and vitamin D supplementation has been shown to improve symptoms.
Iron, Folate, and Ferritin Deficiency
Have you been taking your prenatal vitamins? If not, you should be! Yet another cause of dysfunctional dopamine signaling is iron deficiency, a common condition in pregnancy.
Low iron levels in the fluid around the brain have been detected in people suffering from Restless Leg Syndrome, although this doesn’t always show in ferritin—the level of iron stores in the body.
Folate is a B-vitamin that is extremely important during pregnancy to prevent neural tube defects. Some research has also identified a link between folate and RLS and folate supplementation appears to help reduce symptoms.
Other factors include family history, having the condition in a previous pregnancy, caffeine intake, smoking, and poor venous blood flow (which may be related to inactivity).
How Can Women Lower Restless Legs Risk While Pregnant
Getting rest when your limbs feel creepy-crawly can be a challenge, but sleep is essential for a healthy pregnancy and delivery. Thankfully, there are some steps that expecting women can take to lower risk and improve symptoms. If simple measures don’t improve symptoms, there are some supplements and medications your health care provider can recommend.
Avoid Common Triggers
One of the best ways to prevent the syndrome and improve symptoms is to avoid common triggers. Cigarette smoking and caffeine intake have both been linked to Restless Legs, both of which should be avoided during pregnancy. Poor sleep hygiene and medications that lower dopamine (like antihistamines) are also common culprits.
A healthy, nutrient-rich diet is important throughout life, but especially so during pregnancy when Mothers-to-be are eating for two. Adding food-based sources of iron, folate, and magnesium may help to improve symptoms. Some of the best foods to incorporate include beans and legumes, leafy greens, and meat.
Take Medications and Supplements
In some cases, your healthcare provider may recommend additional supplements such as iron, folate, or magnesium. There are some medications that can be used for treatment, but they come with higher risks during pregnancy. Always consult with your doctor before taking any supplement or medication.
Things to Do for Twitchy Legs Relief When Pregnant
If you’re dealing with unpleasant symptoms and are struggling to sleep, you may be desperate for some relief. The season of expecting can be stressful enough without the added worries that come with Restless Leg Syndrome. It’s important to manage symptoms and reduce stress so you can focus on health for Mama and baby.
Sleep on the Left Side
You’ve probably heard that sleeping on the left side is recommended for pregnant women. This position increases blood flow for both Mom and baby which may help to reduce pain and cramping. If you’re struggling to adjust to sleeping on your left side, try using a maternity pillow to keep you comfy.
Take a Walk
Movement is said to be the quickest way to get relief, so why not get outside for a walk in the sun to soak up a little vitamin D too.
Relax in a Bath
Taking a warm bath can be relaxing and improve symptoms, especially if you add in some Epsom salts for added magnesium.
Massaging the legs can increase blood flow and improve cramping. This could be a great way for your partner to lend a helping hand!
Can essential oil treatment help with RLS in pregnancy?
Some pregnancy-safe essential oils may be able to help including Lavender, Roman Chamomile, Frankincense, and Cypress. Always remember to properly dilute with a carrier oil before applying them to the legs.
RLS can literally be a pain in the leg, especially when you’re expecting! Just like nausea, heartburn, and other pregnancy woes, you may not be able to prevent it entirely but there are some steps you can take to reduce the severity of symptoms.
Avoiding triggers, reducing stress, keeping active, and getting enough rest can all be helpful. If you find yourself so uncomfortable that you can’t sleep at night, speak to your healthcare provider about treatment options. Luckily for most women, the symptoms disappear after delivery (although we can’t promise the same when it comes to sleep in those early newborn days).
Sources and References:
- Restless Legs Syndrome Fact Sheet – ninds.nih.gov
- Restless Legs Syndrome (RLS) – webmd.com
Jill Zwarensteyn is the editor for Sleep Advisor and a certified sleep science coach. She is enthusiastic about providing helpful and engaging information on all things sleep and wellness.
Based in Los Angeles, she is an experienced writer and journalist who enjoys spending her free time at the beach, hiking, reading, or exploring new places around town.
She’s also an avid traveler who has a personal goal of being able to successfully sleep on an airplane someday.