Authored by Dr. Laurel Charlesworth and reviewed by the First Exposure Medical Review Team.
Dr. Laurel Charlesworth MD FRCPC is a neurologist and sleep medicine physician at The Ottawa Hospital, and an assistant professor of medicine at the University of Ottawa.
This health topic is an expert opinion about Restless Leg Syndrome in pregnancy.
* The information provided is the expert opinion of the First Exposure Medical Advisors. It is for informational purposes only and does not replace medical care and advice from a healthcare provider. Please contact your healthcare provider if you have any concerns or to discuss any questions that you believe may be relevant to you or your baby. In case of emergency, please go to the emergency room or call 911.
If you do not have a healthcare provider, please go to: Finding a Healthcare Provider
Clinical Scenario
I have restless leg syndrome and now that I am pregnant my symptoms have gotten worse.
What can I do to manage my symptoms?
Q. What is Restless Legs Syndrome?
A. Restless Leg Syndrome (RLS) is a condition where one has an uncontrollable need to move their legs because of uncomfortable feelings in their legs. The condition is generally not painful, but can range from being mildly bothersome to severe, keeping someone up from sleep for several hours.
Q. How is it Diagnosed?
A. A diagnosis of RLS is based on symptoms and a clinical assessment. The diagnosis does not require any tests. Sometimes a sleep test will be done to look for other sleep disorders such as Obstructive Sleep Apnea that can worsen RLS. Talk with your healthcare provider if you have symptoms.
Q. Who is at risk of getting RLS in pregnancy?
A. RLS is common in pregnancy. It can have a genetic component but can also occur when there is no family history. Factors that can increase one’s risk for RLS in pregnancy are:
- age – risk of RLS increases with age
- nutritional deficiencies – especially iron, as well as folate and vitamin D
- having had RLS in a previous pregnancy
Q. What is the effect of pregnancy on RLS?
A. RLS can become more frequent and severe as pregnancy progresses. This is mostly due to low iron stores but may also be worsened by changes in hormone levels, particularly estrogen. It often improves within the first few weeks postpartum.
Q. Does RLS increase the risk of any harmful effects in pregnancy?
A. RLS itself does not have a direct negative effect on pregnancy, although having enough restful sleep is important in pregnancy. RLS interferes with sleep duration and quality. Poor sleep has been shown to be associated with a higher risk of adverse effects on the pregnancy. Please see the Sleep during Pregnancy health topic for an overview.
Q. How can RLS be managed during pregnancy?
A. RLS can often be managed with iron supplementation; sometimes the iron in prenatal vitamins is enough, while some people may require a specific iron supplement. Less commonly, an iron infusion may be required. To read more about iron supplementation in pregnancy please click here. There is some evidence that vitamin D supplements may reduce the severity of RLS, although this is not as well established.
Some other ways to help reduce RLS symptoms include:
- calf / leg massage
- warm bath before bed
- compression stockings during the day
- gentle physical activity during the day
Key References
Cederberg KLJ, Silvestri R, Walters AS. Vitamin D and Restless Legs Syndrome: A Review of Current Literature. Tremor Other Hyperkinet Mov (N Y). 2023;13:12. [PMID: 37034443]. [PMC10077981].
Gupta R, Dhyani M, Kendzerska T, Pandi-Perumal SR, BaHammam AS, Srivanitchapoom P, et al. Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment. Acta Neurol Scand. 2016;133(5):320-9. [PMID: 26482928]. [PMC5562408].
Winkelman JW, Berkowski JA, DelRosso LM, Koo BB, Scharf MT, Sharon D, et al. Treatment of restless legs syndrome and periodic limb movement disorder: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2025;21(1):137-52. [PMID: 39324694]. [PMC11701286].
Disclaimer
First Exposure does not offer health care treatment. If you have an urgent question about your pregnancy or your baby’s health, you should contact your health care provider directly. If you don’t have a health care provider and you live in Ontario, you have a variety of health care options. In the case of an emergency, visit a hospital emergency room or call 911.