Does Restless Legs Syndrome Make Your Pregnancy More Dangerous?

by Martin Reed Patient Advocate

Sleep disorders such as insomnia can make it difficult to become pregnant in the first place, but new research suggests that one specific type of sleep disorder may influence pregnancy outcomes and delivery complications.

Restless legs syndrome (also known as Willis-Ekbom disease) is characterized by a persistent urge to move the legs, usually due to unpleasant sensations. Symptoms typically occur at rest and are most common at night.

Pregnant women are two to three times more likely to suffer from restless legs syndrome (RLS) compared to the general population.

Predictors for restless legs syndrome during pregnancy include:

  • History of RLS (in previous pregnancies or prior to pregnancy)

  • Family history of RLS

  • Anemia

  • Low iron level

  • Low folate level

  • High estrogen level

The negative effects of RLS during pregnancy

A Chinese study published in Sleep Medicine set out to determine the relationship between restless legs syndrome in pregnancy and any associated complications during delivery.

Close to 4,000 pregnant women aged between 18 and 40 who delivered babies in a single Chinese hospital over a three-year period were enrolled in the study.

The women were interviewed about their experience with RLS during pregnancy, and any difficulties during pregnancy or complications during delivery were investigated.

Pregnancy and delivery complications associated with restless legs syndrome

Researchers found that older women were more likely to suffer from RLS and that, compared to those without RLS, those with daily and frequent RLS reported a higher incidence of:

  • Hypertension

  • Preeclampsia

  • Heart disease

Pregnancy and delivery complications not associated with restless legs syndromeEncouragingly, researchers found no link between RLS and other complications such as:

  • Eclampsia

  • Diabetes

  • Postpartum hemorrhage

Why is RLS associated with pregnancy and delivery complications?

There's still no scientific consensus as to why there may be a link between RLS and complications during pregnancy and delivery.

Still, researchers in this study did find that those who experienced RLS symptoms at least once per week had lower overall rates of folic acid and iron supplement consumption compared to those without RLS symptoms.

Excessive daytime sleepiness was also more common in women with RLS, suggesting that making adequate sleep a priority could be beneficial.

Women with RLS were also found to have higher BMI levels before delivery (but not before pregnancy). Other studies have suggested a hormonal link to RLS in pregnancy, in particular estrogen, progesterone, prolactin, and thyroid hormone.

The psychological issues associated with pregnancy (such as anxiety, stress, insomnia, and fatigue) may also play a part.

The physical changes the body undergoes during pregnancy need to be considered, too. In particular, as the fetus grows it can push up against nerves that can produce RLS symptoms.

How to manage the symptoms of RLS during pregnancy

Mental distractions such as crossword puzzles can help manage RLS symptoms. Reducing or eliminating caffeine consumption may also help.

If you're currently taking drugs with a known link to RLS symptoms (such as antidepressants and antihistamines), you may want to speak with your doctor to see if you can safely stop taking these medications (or take alternatives) during your pregnancy.

Iron supplements and some dopaminergic medications, benzodiazepines and anti-epileptic drugs may also help treat RLS during pregnancy, but these options should always be discussed with your doctor. Opioids are not recommended for treating RLS in pregnant women.

Martin is the creator of Insomnia Land’s free sleep training for insomnia. His online course uses cognitive behavioral therapy for insomnia__ to help participants fall asleep and stay asleep. More than 4,000 insomniacs have completed his course and 97 percent of graduates say they would recommend it to a friend.

Martin Reed
Meet Our Writer
Martin Reed

Martin is the creator of Insomnia Coach, an eight-week course that combines online sleep education with individual sleep coaching. His course helps clients improve their sleep so they can enjoy a better life with more energy and start each day feeling happy, healthy, rested, and refreshed. Martin also runs a free sleep training course that has helped over 5,000 insomniacs. He holds a master’s degree in health and wellness education and studied clinical sleep health at the University of Delaware.