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Does pregnancy cause the restless legs syndrome?

Up to one in four of pregnant women experience the restless legs syndrome (RLS).

Yes, pregnancy can be associated with the onset of RLS.  Approximately 15% – 26% of pregnant women experience RLS which may be new onset RLS or worsening of existing RLS symptoms. Typically the RLS symptoms peak in the third trimester before usually resolving after delivery.  About 90% of pregnancy onset cases resolve within a month after delivery.  The number of pregnancies a woman has is also a predictor of having RLS.  Some women will experience a recurrence of RLS later in life.  The symptoms of pregnancy related RLS are the same as in the general RLS population (see the "Symptoms" page).  Similarly the criteria for the diagnosis of pregnancy related RLS are the same as for nonpregnant persons (see the "Diagnosis" page).

Why pregnancy increases the risk of restless legs syndrome

Several factors may contribute to RLS in pregnancy, these are:

  • Falling iron stores, even without anaemia

  • Increased iron and folate requirements

  • Hormonal changes, particularly rising oestrogen

  • Changes in dopamine signalling

  • Sleep disruption and genetic susceptibility

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As for the general population certain medications (e.g. Sedating antihistamines, dopamine-blocking anti-nausea medicines and some antidepressants) can aggravate RLS (see the "Medications that worsen RLS" page for more information). 

 

Do not stop or change the dose of a prescribed medicine without medical advice.

Treatments for restless legs syndrome during pregnancy

Nonpharmacological treatments for RLS in pregnancy

The primary treatment approach for RLS in pregnancy focuses on conservative, non-drug lifestyle changes (e.g. cut down on caffeine, do moderate exercise daily, good sleep habits) under the guidance of a healthcare provider.  Nonpharmacological strategies to treat the acute leg discomfort in RLS (e.g. leg stretches, hot or cold packs, leg massages, leg exercises, warm baths etc.)  are discussed in the "Getting relief" page.  Consider taking vitamin D if it is low and your health professional approves its use.

A pregnant woman lying on a sofa

Iron therapy in pregnancy

Addressing any iron deficiency is as important in pregnancy as it is in nonpregnant persons.  Criteria for oral or IV iron administration is the same in pregnancy as it is in nonpregnant individuals.  IV iron has been shown to be safe in the second and third trimesters.  There isn't enough safety data for the administration of iron in the first trimester.

Do not start, change or stop iron therapy until you have discussed options with a healthcare professional.

Medications for RLS in pregnancy

 Medication is usually avoided unless symptoms are severe and are causing substantial insomnia or distress.  Evidence for most RLS medicines during pregnancy is limited.  If the RLS is unresponsive to the nonpharmacologic approaches and iron supplements the use of medications in the second and third trimesters for severe RLS should be discussed with the patient outlining the risks and benefits of treatment.  Collaboration between an obstetrician and sleep or neurology specialist is preferable.  Medication doses should be kept low and intermittent therapy considered.  Gabapentinoids, oxycodone, methadone, buprenorphine, and intermittent carbidopa/levodopa (not used > 3 times a week) can be considered.

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Do not start, stop or change the dose of a prescribed medicine without medical advice.

Last reviewed: 21/09/2026

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