Causes Of Restless Legs Syndrome In Pregnancy
Scientists don’t know exactly what causes the sensations in the legs at night. But some believe it may stem from an imbalance of the brain chemical dopamine. That chemical normally helps keep muscle movements smooth and even.
RLS in pregnancy might be triggered by a lack of enough folic acid or iron. There’s also some evidence that rising estrogen levels during pregnancy may contribute to RLS.
Trying to calm your restless legs all night can make you sleepy and irritable during the day.
Having restless legs syndrome can also make you more likely to have a longer labor and to need a C-section.
What Causes Rls In Pregnancy
There are many unanswered questions for why restless legs syndrome crops up in pregnant women and not others. It may be caused by low iron levels or a vitamin deficiency. Other suggestions for RLS during pregnancy include genetic predisposition, high estrogen levels, compressed nerves, or changes in dopamine levels in the brain.2,3
Importance Of Dealing With Leg Twitching
If youre struggling with symptoms, its 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.
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Ethical Aspect Of The Study
Before data collection began, we obtained ethics approval from the General Secretariat of the Association of Public Hospitals in Karabük and Gazi University Ethics Committee , and written consent from the pregnant women participating in the study. The pregnant women who were identified as having RLS were referred to a neurologist.
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 cant 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 doesnt usually improve those conditions.
If you suspect you may have the syndrome, its important to speak with your health care provider about your symptoms. To be diagnosed, you have to meet the following criteria:
RLS is a common sleep disorder thats also known as Willis-Ekbom Disease . 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 isnt fully understood.
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Avoid These Before Bed
When it comes to what not to consume, Dr. Berkowski lists the four things you should avoid to help ease your RLS symptoms:
- Nicotine.
- Caffeine.
These products are all known to trigger RLS symptoms, Dr. Berkowski says.
Additionally, if you have wheat or dairy allergies but still consume those products, that could also be a source of trouble. What and dairy allergies can cause inflammation which, in turn, cause issues with iron absorption, says Dr. Berkowski, so its something to keep in mind.
How To Treat Restless Leg Syndrome During Pregnancy
The treatment for the Restless Legs Syndrome during pregnancy caused by the hormonal changes can be aided or relieved via the following ways:
- Take sufficient rest
Irrespective of the fact that this leg syndrome affects the womens good nights sleep, you must make sure to get enough rest as possible. This is because the fatigue due to the lack of sleep could end up making things worse. Therefore, this does not mean for you to force yourself to sleep by taking a sleep medicine when experiencing an RLS episode. In fact what you could do to ease the cramps out is to get up and slowly walk down the hallway a few times, as this gentle movement of the legs helps aid the discomfort making it good enough for the women to go to bed.
- Always distract yourself
When experiencing restless legs syndrome during pregnancy, quickly distract yourself by solving a crossword puzzle, watching your favorite movie or an episode of a series, listen to music, or even take a hot bath.
- Maintain a food journal
- Consult your doctor
- Apply heat
At times taking a hot bath or even applying a heating pad or ice pack could help you get relief from the restless leg syndrome.
- Acupuncture
Only with the help of the doctor, try to book a session of acupuncture, exercise, meditation, or any other relaxation technique.
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History Examination And Laboratory Results
A 33-year-old gravida 2 para 1 medical professional was referred to Sleep Medicine from Psychiatry at 29 weeks gestation for an evaluation of her restless legs syndrome . She was taking escitalopram at 20 mg in the morning for a long-standing major depressive disorder. She endorsed severe, daily, typical symptoms of RLS that began in the early second trimester. There was also a history of RLS in the previous pregnancy. Her obstetric team had tried trazodone at 50 to 100 mg at bedtime due to significant sleep onset and maintenance difficulty but this was ineffective and therefore discontinued by her psychiatrist. Clonazepam was substituted at 0.5 mg at bedtime for severe RLS resulting in insomnia, worsening mood and anxiety symptoms. Due to concerns with long-term daily use of clonazepam in pregnancy, she was referred to Sleep Medicine for further management.
There was no history of smoking, alcohol, or recreational drug use before or during pregnancy. She drank one soft drink per day. There was no family history of sleep disorders. Past medical history was significant for generalized anxiety disorder, major depressive disorder, irritable bowel syndrome, and preterm labor at 35 weeks gestation 2.5 years ago. She had been taking oral ferrous sulfate 325 mg daily since the beginning of the pregnancy in addition to a prenatal vitamin. She was not taking any other over-the-counter medications or supplements.
Take A Prenatal Supplement
A folate-rich prenatal vitamin is necessary for preventing certain birth defects in baby, but it may also help RLS symptoms. Folate and iron help the body produce the hormone dopamine, which then helps muscles and nerves function right.
To make sure baby gets the nutrition they need, take a vitamin with folate, not folic acid. Heres a list of my favorite prenatal vitamins.
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Who Gets Rls During Pregnancy
About 1 in 4 pregnant women develop RLS, most often in the third trimester. Only 1 in 7 women have RLS in the first trimester. The severity of symptoms varies widely from one woman to the next. It often disappears in the weeks after birth, often in the first month.1-3
Rates of RLS during pregnancy are different around the world. About 1 in 5 women in Europe and the Americas develop RLS in pregnancy. This compares to 1 in 3 women in the Eastern Mediterranean region, and 1 in 7 in the Western Pacific Rim. One study in Nigeria found no RLS in 310 pregnant women.3
Women who develop RLS during pregnancy are more likely to report symptoms of RLS within 8 years of delivery, compared to women who did not have gestational RLS. The thought is that pregnancy reveals a genetic predisposition to restless legs syndrome that would have developed later in life anyway.4
What Does Restless Legs Syndrome Mean For My Pregnancy And Baby
There is no need to worry about RLS harming your baby or causing problems for your pregnancy. Your doctor or midwife will likely want to check your iron and folate levels. If either of those are found to be low, they may suggest that you take a supplement. If your restless legs arent caused by a deficiency, theyre simply an irritation to you and not a danger to your baby.
Thats not to say that there are no effects from having to deal with restless legs syndrome. Your general mood and emotional state may be affected during the times that your body feels uncomfortable and agitated. RLS may make it hard to sleep, which can leave you even more exhausted than pregnancy typically does. A lack of sleep at night may make your daytime self less efficient, feel like youre in a fog, or can lead to general irritability.
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When All Else Fails
If RLS symptoms are severe and majorly disrupt quality of life, some providers recommend dopamine antagonist drugs and opiates. But proceed with caution. Dopamine and opiate drugs are classified as Pregnancy Category C, and according to the FDA:
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well controlled studies in humans.
If youve exhausted the other options and your day-to-day is severely affected, it may be worth talking with your doctor about other options.
What Does Restless Legs Syndrome Feel Like
First, lets start with what its like to have restless legs syndrome, whether its during pregnancy or not. If youve never felt it, it may be hard to understand what a sufferer is describing. And if you do experience it, you may find it hard to come up with words to make others understand what it feels like.
People describe the feeling that RLS causes in their legs in various ways: restless, twitchy, tingling, itchy, creeping, crawling, pulling, throbbing, electric. What everyone seems to agree on is that they have an irresistible urge to move their legs. Whether their legs feel physically uncomfortable, or they experience it as just a strong mental urge, they cant feel comfortable unless theyre moving their legs. This urge occurs most often in the evening while relaxing or trying to sleep . Sufferers of RLS may toss and turn, jiggle their legs, change positions frequently, or feel the need to get up and walkmotion seems to be the only thing that makes the urge go away.
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Foods To Avoid With Restless Leg Syndrome
These foods arent great for any pregnant mama, but they can also worsen RLS symptoms.
- Caffeine: This stimulant can worsen restless leg syndrome symptoms.
- Refined sugar: Sugar depletes minerals in the body, especially magnesium. Without adequate nutrients, muscles and nerves cant function properly which can contribute to RLS.
If symptoms are severe, strategically consuming calcium can also help. Too much calcium can block iron absorption , so its best to avoid eating calcium and iron rich foods together.
Warm Compresses Can Be Soothing
Heated or cooled pads, often used to relieve swelling caused by injuries and other conditions, have a long history as a home remedy. Dr. Berkowski says they can be effective by creating a new sensation for the brain to process, reducing the uncomfortable sensation produced by restless legs syndrome.
You can buy an inexpensive cold or warm compress at a store, but the simplest way to make one is to soak fabric in cold or warm water and place it against your skin.
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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 doesnt always show in ferritinthe 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.
How Do You Test For Restless Leg Syndrome
There is no test for restless leg syndrome.
That said, your healthcare provider may want to do tests to rule out other conditions. RLS can also be caused by things like kidney or brain disorders, so tests to measure the function of other organs may be suggested.
If youre pregnant, though, its generally assumed pregnancy is the cause.
Your provider will likely go over the following questions with you to confirm an RLS diagnosis:
- Do you have a strong urge to move your legs along with uncomfortable sensations?
- Are symptoms worse at rest and at night?
- Are symptoms relieved by movement?
- Do you have any known medical conditions that could cause these symptoms?
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What Are The Symptoms Of Restless Legs Syndrome
The main symptom is the overwhelming urge to move your legs. But you may also have uncomfortable and unpleasant sensations in your legs. Some people describe these as:
- tingling
- a creepy-crawly sensation, like ants moving up and down the legs
- like fizzy water in the veins.
These sensations are often worse just below the knee and can sometimes be painful.
Your symptoms may be worse when youre resting and may feel better when you move. They may be worse in the evening or at night.
Restless legs syndrome can be very frustrating, but it should not affect your health or pregnancy. However, it can make it more difficult to get a good nights sleep. A lack of sleep wont hurt your baby, but it can make your day-to-day life a bit more difficult. We have some tips that may help you sleep better.
Restless legs syndrome caused by pregnancy usually develops during the third trimester . At this point, sleeping on your side is the safest thing to do for your baby because research shows it can reduce the risk of stillbirth.
Do Hot Baths Help Restless Leg Syndrome
Try taking a warm bath or shower, one of the more useful home remedies to help reduce restless leg syndrome. Warmth relaxes muscles and helps prevent spasms and twitching. Adding Epsom salts can reduce aches and pains. A warm bath can also help you wind down and set the stage for a restful night.
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What Is Restless Leg Syndrome
Restless leg syndrome affects the nerves in the leg and causes sensations like itching, burning, or a creepy crawly feeling. The symptoms can be difficult to describe, since they stem from the nerves, not the muscles.
Unlike leg cramps that are generally sharp and seize the muscle, restless leg syndrome causes an allover uncomfortable feeling that gives you a strong urge to move the legs, especially at night.
Restless Legs During Your Pregnancy
Many women suffer from restless or tired legs during their pregnancy. Not very surprising, because there is a lot of extra pressure on your legs, since you are a little heavier. In addition, your bloodcirculation becomes weaker due to the increase of hormones. Your veins can expand because of the increasing pressure and work less efficiently. Even varicose veins can evolve. When you feel that your legs tickle or tingle a little, you can move them a little and then it will stop. But not long after that the feeling will come back just as hard. In order to really solve the feeling, compression stockings are regularly recommended. Not very sexy, beige stockings on your legs while you carry your baby.
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Symptoms Of Restless Leg Syndrome
RLS may cause strange and unpleasant sensations in your legs. Some people describe it as a pulling, throbbing, irritating, or painful feeling. It also causes a powerful, sometimes uncontrollable, urge to move your legs.
Symptoms occur during long periods of inactivity. For example, you may notice them while youre traveling, sitting in a movie theater, or trying to sleep.
They can also make it almost impossible to get a good nights rest. This can leave you feeling fatigued, adding to the other discomforts of your third trimester of pregnancy.
How Common Is Restless Leg Syndrome
RLS affects approximately 1 in 10 people , but is much more common in pregnant women.
Restless leg syndrome during pregnancy affects nearly one-third of women by their third trimester.
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What Causes Restless Legs Syndrome
In the majority of cases, there’s no obvious cause of restless legs syndrome.
This is known as idiopathic or primary restless legs syndrome, and it can run in families.
Some neurologists believe the symptoms of restless legs syndrome may have something to do with how the body handles a chemical called dopamine.
Dopamine is involved in controlling muscle movement and may be responsible for the involuntary leg movements associated with restless legs syndrome.
In some cases, restless legs syndrome is caused by an underlying health condition, such as iron deficiency anaemia or kidney failure. This is known as secondary restless legs syndrome.
There’s also a link between restless legs syndrome and pregnancy. About 1 in 5 pregnant women will experience symptoms in the last 3 months of their pregnancy, although it’s not clear exactly why this is.
In such cases, restless legs syndrome usually disappears after the woman has given birth.
Is Restless Leg Syndrome During Pregnancy Dangerous
RLS doesnt directly put baby in jeopardy, but can indirectly make for a more complicated labor and uncomfortable pregnancy.
If your RLS is caused by nutrient deficiencies, this can lead to issues like anemia, mood disorders, and low energy. And sleeping can be difficult with RLS, which can lead to a whole host of health problems for you and baby. Some studies have found that pregnant women who get less than 8 hours of sleep are at greater risk of having a longer labor and Caesarean section.
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