Light At The End Of The Tunnel
As weve mentioned several times, restless legs syndrome that starts during pregnancy is expected to resolve after your baby is born. We recognize that its incredibly frustrating to be unable to rest when youre tired, and in the moment, it may be hard to think about more than the present moment. But if youre able, take a breath and remind yourself that there is an end to the discomfort, and italong with your little onewill be here soon.
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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.
When To Seek Help
Of course, home remedies have their limits. If these ideas dont work for you and they dont work for everyone dont hesitate to seek out the advice of a sleep expert.
Not everyone with restless legs needs to see a doctor, but severe cases can be debilitating. Some people feel so desperate and helpless, Dr. Berkowski says, as their lack of sleep can cause depression and anxiety.
He says to consult a doctor if either of the following applies to you:
- Your difficulties falling or staying asleep lead to you feeling sleepy or unrefreshed.
- Your sleep is disrupted at least two or three times a week.
If these home remedies still fall short, your doctor can provide you with more information about the potential prescription medicines that can help.
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Pregnancy And Restless Legs Syndrome
Restless legs syndrome affects between 20% and 30% of pregnant women. A primary cause of this is, not surprisingly, iron deficiency. Iron is an essential part of nutrition while pregnant because of the higher risks of developing iron-deficiency anemia.
Between this and the previously mentioned connection between RLS and iron deficiency, its not hard to figure out that connection. Working with your doctor to make sure youre keeping your iron levels up, as well as other essential vitamins, can help alleviate these symptoms.
Also, as long as your health permits and your doctor gives you the green light, light exercise helps, too, whether its walks, aerobics or other types of lower body exercises that help keep those muscles stimulated.
The good news, says Dr. Berkowski, is that if RLS wasnt an issue for you before pregnancy, chances are itll eventually fade within a few months after your pregnancy is over.
The 11 Best Treatments For Restless Legs Syndrome
What is restless legs syndrome?
Restless legs syndrome , also known as Willis-Ekbom disease, is a condition that causes uncomfortable sensations, most often in the legs. These sensations have been described as tingly, crawling, creeping feelings, and cause the overwhelming urge to move the affected limb.
RLS symptoms typically occur when the person is sitting, resting, or sleeping, and often happen at night. The movements caused by RLS are called periodic limb movements of sleep . Because of these movements, RLS can cause serious sleep problems.
Some people have primary RLS, which has no known cause. Others have secondary RLS, which is typically associated with nerve problems, pregnancy, iron deficiency, or chronic kidney failure.
For most people with RLS, symptoms are mild. But if your symptoms are moderate to severe, RLS can have a big impact on your life. It can prevent you from sleeping enough, and thus cause problems with daytime focus and thinking, your job, and your social activities.
As a result of these problems, RLS can lead to anxiety and depression. And the longer you have the condition, the worse it can get. It can even spread to other parts of your body, such as your arms .
Here we list the best treatments for RLS. Some of these you can try on your own. Others you can discuss with your doctor, who can help you create a treatment plan to help relieve your RLS symptoms.
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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.
Tips For Coping With Restless Legs Syndrome
Learning to recognize and avoid your personal triggers can help you manage RLS over time.
Effective techniques for minimizing RLS symptoms vary from person to person. Many people find relief from keeping active throughout the day and using acupuncture, massage, stretching, or relaxation techniques at night. During the day, you may be able to ward off RLS symptoms by keeping your mind busy even when you are sitting still with activities like reading or chatting to a friend.
Though RLS is not life-threatening, the frustration of not being able to sleep well can take a toll on mental health. Cognitive behavioral therapy, support groups, or reaching out to family and friends may provide additional emotional resources for coping with RLS.
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Things To Do For Twitchy Legs Relief When Pregnant
If youre dealing with unpleasant symptoms and are struggling to sleep, you may be desperate for some relief. The season of expecting can be stressful enough without the added worries that come with Restless Leg Syndrome. Its important to manage symptoms and reduce stress so you can focus on health for Mama and baby.
Symptoms Of Restless Leg Syndrome During Pregnancy
The symptoms of restless leg syndrome typically begin to show up at night time right before sleep. The symptoms can also appear when you have been sitting for a long period of time. The symptoms of restless leg syndrome typically begin in the lower legs, but many women report feeling the symptoms in their thighs, feet, arms, and even their hands.
While moving the area that is experiencing the symptoms can make the feelings go away, the sensation often returns when you stop moving. Restless leg syndrome can cause serious discomfort and major frustration. These sensations and urge to move can make it nearly impossible to get a good nights sleep. This can lead to serious fatigue and exhaustion. Know that pregnant women who suffer from this condition are more likely to experience longer labors or even c sections.
How Long Will It Last?
Women who develop restless leg syndrome during pregnancy can rest easy knowing that this problem is not permanent. Many women experience RLS during pregnancy, but the problems only last as long as your pregnancy. The symptoms of restless leg syndrome usually peak around the third trimester, but can still be unbearable in the second trimester. By the time you are holding your bundle of joy in your arms these symptoms will no longer bother you.
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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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Repetitive Transcranial Magnetic Stimulation
A noninvasive procedure thats typically used to treat depression could be helpful in relieving RLS symptoms. So far, studies have been limited and more research is needed, but the results are promising (4, 41,
Repetitive transcranial magnetic stimulation sends magnetic impulses to certain areas of the brain.
Its not entirely clear why rTMS could help relieve RLS symptoms. One theory is that the impulses increase the release of dopamine in the brain. Another suggests that rTMS could help calm the hyperarousal in parts of the brain that are associated with RLS .
In one 2015 study, 14 people with RLS were given 14 sessions of rTMS over 18 days. The sessions significantly improved their RLS symptoms and improved their sleep. The results lasted for at least two months after the treatment ended .
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Is Rls Bad For Pregnancy
While RLS can be uncomfortable and may hamper sleep, it does not cause any adverse effects on the fetus or the mother during pregnancy. However, pregnant women with RLS may also experience periodic limb movements of sleep , nocturnal leg cramps, and sleepiness during the day.
Some women may have insomnia due to RLS. Sleep duration and sleep quality could influence maternal mental health, the type of delivery, length of labor, the neonates APGAR scores, and birth weight.
In rare cases, women with RLS may be at a higher risk of developing pregnancy complications such as abortion, premature labor, difficult delivery, preeclampsia, and intrauterine growth retardation .
What Causes Restless Legs When Pregnant
The main reason for the itching, burning and insatiable urge to move feet is the backward flow of blood. Improper circulation makes the feet feel numb and sends sharp pain through them. When you move the feet the circulation gets better and you feel better.
Upon an episode of restless leg syndrome, pregnant women might take hours for getting comfort.
Some people relate restless legs in pregnancy to either a baby boy or a baby girl. However, theres is no scientific logic to relate the two things.
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Pregnancy Problems: Restless Leg Syndrome
Restless leg syndrome and pregnancy
About 26 percent of pregnant women have restless leg syndrome , according to a report published in the Journal of Midwifery and Womens Health .
RLS can cause unpleasant sensations in your legs and an uncontrollable urge to move them. And it can interfere with your sleep.
Doctors arent sure why pregnant women are prone to RLS. It may be related to a dopamine imbalance, mineral deficiencies, or hormonal changes. If you develop RLS during pregnancy, your symptoms will likely go away within weeks of delivery.
In the meantime, home remedies may help you relieve your symptoms and get some quality sleep.
The Criteria For Selection And Assessment Of Papers
The Persian and English papers adapted from cross-sectional studies on RLS during the third trimester of pregnancy met the inclusion criteria to be included in the paper. On the other hand, other review studies, observational, and interventional studies were excluded from the list of the papers. Thereafter, the included studies were investigated based on PRISMA 2009 . In order to examine the studies, STROBE checklist was employed. Accordingly, the maximum quality check score was considered as 32.
Fig. 1
The flowchart on the stages of including the studies in the systematic review and meta-analysis
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How To Prevent The Restless Legs Syndrome During Pregnancy
Unfortunately, there are no ways to prevent the prevalence of the RLS syndrome according to the health care providers. However, what you could do instead to aid or at the most ease out the temporary cramps is follow the steps above to prevent it from getting worse and get the condition reviewed.
Also, the occurrence of the restless legs syndrome RLS tends to go away within four weeks post-delivery. However, there are studies that have also found that in a few pregnant women, that is about on the 97 percentile, the restless legs syndrome during pregnancy RLS fades away in just a few days after giving birth.
Cause Of Restless Legs Syndrome During Pregnancy
The cause of restless legs syndrome during pregnancy is due to genetics as a common factor. The other possible reasons for this syndrome in pregnancy could include pregnancy hormones like estradiol and progesterone that surge during the last or third trimester of pregnancy until after birth that follow the same pattern.
On the other hand, environmental and dietary factors such as iron deficiency and/or sensitivity to various kinds of foods could also be a possible risk or cause of RLS in pregnancy. Adding on, the common symptoms during pregnancy like lack of sleep, anxiety, depression, and stress could cause the legs syndrome RLS. This is why it is recommended to take proper rest and move your legs and be active throughout the day.
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Drugs To Boost Dopamine
Some common drugs used in this instance are pramipexole , rotigotine , and ropinirole .
Since lack of dopamine is generally responsible for RLS, this seems like a no brainer. But, there is a serious problem with taking these.
You build up a dependance, and your body stops producing its own dopamine. This can lead to even bigger issues down the road, especially as it pertains to mental health.
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.
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Medical Devices For Restless Legs Syndrome
New attention is being given to the possibility of using medical devices to improve RLS symptoms. Similar to the way that moving the legs gives temporary relief, these medical devices aim to reduce discomfort of RLS symptoms by providing external stimulation.
So far, the Food and Drug Administration has approved two medical devices as RLS treatments: a compression foot wrap and a vibrating pad. Both are available by prescription and designed for people with moderate to severe RLS.
The foot wrap works by applying targeted pressure to the affected area, usually the lower leg or foot. By contrast, the vibrating pad uses counter-stimulation to mask RLS symptoms and improve sleep quality. Both devices are considered fairly safe, though they may not be suitable for people with certain underlying health conditions.
Some physicians also recommend using a pneumatic compression device to ease RLS symptoms. Its thought that compression of the veins helps boost circulation and reduce the uncomfortable sensations caused by RLS.
How Is Restless Leg Syndrome Diagnosed
RLS is diagnosed based on a persons description of symptoms. Your doctor will ask you questions about your symptoms, the location, and how they impact your sleep. The questions will also help the doctor rule out other conditions with similar symptoms.
There are no tests to determine whether or not a person has the condition. One exception is a sleep study which can identify periodic leg movements of sleep since it is often present with RLS.
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Causes Of Restless Legs Syndrome
In many cases, the exact cause of restless legs syndrome is unknown.
When no cause can be found, itâs known as âidiopathicâ or primary restless legs syndrome.
Research has identified specific genes related to restless legs syndrome, and it can run in families. In these cases, symptoms usually occur before the age of 40.
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