Restless Legs Syndrome and Sleep: Causes and Relief

What is restless legs syndrome?

Restless legs syndrome (RLS) is a common condition that causes an overwhelming urge to move the legs, usually accompanied by an uncomfortable crawling, tingling or aching sensation. It tends to strike in the evening and at night, when you are resting or trying to sleep — which is exactly why it can be so disruptive to rest.

Because it interferes so much with falling and staying asleep, RLS is a frequent and under-recognised cause of poor sleep. Our guide to insomnia explained covers sleep problems more broadly.

What does it feel like?

People describe the sensation in many ways — crawling, creeping, pulling, throbbing or itching deep inside the legs rather than on the skin. The defining feature is that:

• The urge to move comes on or worsens at rest.
• Moving the legs brings temporary relief.
• Symptoms are worse in the evening or at night.

The sensations can range from mildly annoying to genuinely distressing.

What causes restless legs?

In many cases no specific cause is found; this is called primary RLS and may run in families. In other cases it is linked to an underlying factor, such as:

• Iron deficiency — one of the more common and treatable contributors.
• Pregnancy — particularly in the later months, often easing after birth.
• Kidney problems.
• Certain medicines — including some antidepressants, antihistamines and anti-nausea drugs.
• Caffeine, alcohol and nicotine, which can aggravate symptoms.

Because RLS involves the nervous system, our overview of nerve pain explained provides helpful related background.

Self-help measures

Many people manage milder symptoms with lifestyle changes:

• Keep a regular sleep routine and a comfortable, cool bedroom.
• Cut back on caffeine, alcohol and nicotine, especially in the evening.
• Gentle exercise during the day — but avoid intense exercise late at night.
• Stretch, massage or apply warmth or cold to the legs when symptoms strike.
• Distraction — activities that occupy the mind can ease the urge.
• Relaxation techniques to wind down before bed.

When to see a doctor

Speak to a doctor if symptoms are frequent, are significantly disrupting your sleep, or are affecting your daytime wellbeing. It is especially worth a visit because some causes — such as iron deficiency — are easily checked with a blood test and treatable. A doctor can:

• Check for and treat underlying causes like low iron.
• Review whether any of your current medicines might be contributing.
• Discuss medicines for RLS where symptoms are severe.

Always follow professional advice and read the patient information leaflet for any medicine. You can browse general sleep-support products via shop all, but persistent or severe RLS deserves proper assessment.

Red flags

See a doctor sooner rather than later if symptoms come on suddenly and severely, if there is weakness or numbness in the legs, or if you are also extremely fatigued — these may point to something that needs investigation.

The takeaway

Restless legs syndrome is a common cause of disrupted sleep, marked by an urge to move the legs that eases with movement and worsens at night. Lifestyle changes help many people, and because some causes such as iron deficiency are treatable, it is well worth speaking to a doctor if it is affecting your sleep.

General information only — not medical advice. Always read the patient information leaflet and consult a doctor or pharmacist before starting any medication.