You’ve finally settled into bed after a long day, ready to rest—but as soon as you get comfortable, your legs start to tingle, twitch, or ache. The urge to move them is impossible to ignore, and sleep slips farther away. If this sounds familiar, you may be experiencing restless legs syndrome (RLS), a surprisingly common sleep disruption during pregnancy.

RLS can make it difficult to fall asleep, stay asleep, or feel rested in the morning. Fortunately, understanding why it happens and learning simple behavioral and lifestyle strategies can bring meaningful relief.

What Exactly Is Restless Legs Syndrome?

Restless legs syndrome—also called Willis-Ekbom disease—is a neurological condition that creates an overwhelming urge to move the legs, often accompanied by unpleasant sensations like:

• Tingling

• Crawling or itching feelings under the skin

• Aching, throbbing, or pulling sensations

These symptoms typically worsen at night or when you’re resting and often improve temporarily with movement. During pregnancy, RLS can occur for the first time or worsen if you’ve had it before.

Why Pregnancy Increases RLS Symptoms

While anyone can experience RLS, pregnancy is a key trigger—especially during the third trimester. Up to 25% of pregnant women report symptoms. Several physiological and hormonal factors play a role:

1. Iron and Ferritin Deficiency

Your body’s iron stores naturally decrease during pregnancy because you’re supplying both your own needs and your baby’s. Low iron or ferritin (the protein that stores iron) can disrupt dopamine signaling in the brain—a neurotransmitter essential for muscle control and movement. This is considered one of the strongest biological links to RLS.

2. Hormonal Fluctuations

Pregnancy dramatically increases levels of estrogen and progesterone, which may alter how dopamine works in the nervous system. While these hormones are critical for supporting pregnancy, their changes can unintentionally intensify leg sensations and restlessness at night.

3. Circulatory and Physical Changes

Swelling, increased blood volume, and pressure from the growing uterus can affect circulation in the legs. As a result, the legs may feel heavy or achy, especially later in the day—making RLS symptoms more noticeable when you finally lie down.

4. Sleep Deprivation and Stress

Ironically, lack of sleep and stress can worsen RLS, creating a frustrating cycle: your legs keep you awake, and being awake makes your symptoms worse.

What RLS Feels Like During Pregnancy

Every person describes RLS differently, but many say it feels like something is “crawling” or “buzzing” inside their legs. The discomfort peaks during stillness—often in the evening or at bedtime—so you might find yourself constantly shifting or stretching just to relieve the sensations.

Symptoms often improve right after giving birth, though for some, it can take a few weeks postpartum for sleep to fully normalize.

Simple Lifestyle Changes That Can Help

While RLS can be challenging, most cases during pregnancy respond well to lifestyle and behavioral adjustments. Here are some evidence-based strategies to try:

1. Get Your Iron Levels Checked

Ask your healthcare provider to test your iron and ferritin levels. If they’re low, an iron supplement may significantly reduce symptoms. Don’t start supplements on your own—too much iron can be harmful—so always follow medical guidance.

2. Stretch and Move Daily

Gentle activity improves circulation and reduces muscle tension. Try:

• Prenatal yoga

• Light walking, especially after dinner

• Leg stretches before bedtime

Movement helps discharge the urge to move and reduces nighttime restlessness.

3. Massage or Warm Compresses

Massage can help relax muscles and increase blood flow. Warm (or sometimes cool) compresses can also soothe tingling or aching sensations before bed.

4. Prioritize Sleep Hygiene

Establishing a consistent, calming bedtime routine can reduce stress and improve sleep quality. Aim for:

• A cool, quiet, dark sleeping environment

• Regular sleep and wake times

• Avoiding screens and bright light an hour before bed

Even small improvements in overall sleep can lessen RLS symptoms.

5. Limit Caffeine and Sugar

Caffeine (in coffee, tea, chocolate, and some sodas) can stimulate the nervous system and intensify restlessness. Try reducing or eliminating caffeine, especially in the afternoon and evening. High-sugar snacks can also lead to blood sugar swings that exacerbate symptoms.

6. Elevate Your Legs

If your legs swell during the day, elevate them in the evening for 30–60 minutes. This helps fluids redistribute before you lie down, easing nighttime leg discomfort.

7. Practice Relaxation Techniques

Deep breathing, meditation, or gentle prenatal stretching before bed can calm both body and mind. Many people with RLS find symptoms improve when overall anxiety levels decrease.

When to Talk to Your Healthcare Provider

If symptoms are persistent, painful, or severely disrupting your sleep, mention them at your next prenatal appointment. Your provider can:

• Check iron, folate, and magnesium levels

• Review medications or supplements that could worsen RLS

• Suggest safe treatment options, such as iron therapy or specific pregnancy-approved interventions

In rare cases, RLS can be linked to other medical conditions like thyroid disorders or kidney issues—so professional evaluation is always a good idea.

Looking Ahead: Relief Is on the Horizon

The good news? Restless legs syndrome related to pregnancy almost always improves or disappears completely after childbirth. In the meantime, lifestyle adjustments, attention to nutrient levels, and relaxation strategies can help you get the rest you need.

Sleep is vital for both you and your baby’s health. Addressing restless legs early—before they become a nightly frustration—can make pregnancy far more comfortable and restorative.