Leg restless at night

Overview

Restless legs syndrome (RLS) is a condition that causes an uncontrollable urge to move your legs, usually because of uncomfortable sensations like tingling, crawling, or aching. These feelings are worse when you are resting or sitting still, especially at night, and they can make it hard to fall asleep or stay asleep.

Yes, restless legs syndrome is a common condition. About 5–10% of adults experience symptoms that are frequent or severe enough to need treatment.

RLS can affect anyone at any age, but it becomes more common as you get older. It is also more common in women than in men. Some people first notice symptoms during pregnancy.

Symptoms

Common symptoms

• A strong, often overwhelming urge to move your legs, especially when you are resting or lying down.
• Uncomfortable sensations in the legs, such as tingling, crawling, pulling, aching, or itching.
• Symptoms that get worse in the evening or at night.
• Temporary relief from moving, stretching, or walking.
• Difficulty falling asleep or staying asleep because of leg discomfort.

Symptoms in children

• Children may have trouble describing the sensation – they might say their legs 'feel funny' or 'need to move'.
• RLS in children is sometimes mistaken for 'growing pains' or hyperactivity.
• It can cause problems with falling asleep, leading to daytime tiredness and difficulty concentrating at school.

Symptoms in older adults

• Symptoms may be more frequent and more intense.
• Sleep disruption can be more severe, increasing the risk of daytime drowsiness and falls.
• Older adults are more likely to have other health conditions or take medications that can make RLS worse.

Causes

Main causes

• In many cases, the exact cause is unknown – this is called primary RLS and often runs in families.
• RLS can be linked to low iron levels in the brain, even if your blood iron is normal.
• Other medical conditions can cause or worsen RLS, such as kidney failure, diabetes, or peripheral neuropathy (nerve damage).
• Some medications, including certain antidepressants and antihistamines, can trigger or worsen symptoms.

Risk factors

• Family history – having a close relative with RLS increases your chance of having it.
• Pregnancy – especially in the third trimester, though symptoms often go away after giving birth.
• Iron deficiency or anaemia.
• Being middle-aged or older.
• Long-term health conditions like Parkinson’s disease or kidney disease.

When to see a doctor

See a doctor urgently if:

• If your symptoms come on very suddenly and are severe.
• If you have leg pain, swelling, or redness along with the urge to move – this could be a blood clot.

Book a routine appointment if:

• If RLS symptoms disturb your sleep regularly or make you feel very tired during the day.
• If self-help measures like leg stretches, massage, or avoiding caffeine do not help.
• If you think your symptoms might be caused by an underlying health problem or medication.
• If you are pregnant and RLS is affecting your rest.

Diagnosis

There is no single test for RLS. Your doctor will ask about your symptoms, when they happen, and what makes them better or worse. They will also check for underlying causes like iron deficiency.

Tests that may be done

• A blood test to check your iron levels, kidney function, and other possible causes.
• Sometimes a sleep study (polysomnography) is done if your doctor suspects another sleep disorder.

What to expect at your appointment

Your doctor will likely ask you to describe the feelings in your legs and when they occur. They may also ask about your sleep habits, activity level, and any medicines you take. The appointment typically takes 15–30 minutes. Based on the information, they can often diagnose RLS and suggest treatment options.

Treatment

Treatment for RLS focuses on relieving symptoms and improving sleep. For mild symptoms, lifestyle changes are often enough. If symptoms are more troublesome, medications can help. The right approach depends on what is causing your RLS and how much it affects your life.

Self-care at home

• Move your legs – walking, stretching, or massaging the legs can provide instant relief.
• Apply heat or cold – a warm bath or a heating pad can relax the muscles.
• Avoid things that trigger symptoms, such as caffeine, alcohol, and nicotine, especially in the evening.
• Establish a regular sleep schedule – go to bed and wake up at the same time each day.
• Try relaxation techniques like deep breathing or meditation before bed.

Medical treatments

If self-care is not enough, your doctor may recommend medications. Common types include drugs that increase dopamine in the brain, medications that affect calcium channels (often used for nerve pain), or iron supplements if your iron levels are low. These treatments are prescribed based on your symptoms and health profile. Your doctor will explain the benefits and possible side effects.

When is surgery considered?

Surgery is not used to treat restless legs syndrome.

Living with this condition

Living with RLS means finding ways to manage symptoms so they do not take over your nights. Many people learn to move or walk when the urge strikes, and they plan activities that keep them from sitting still for too long. It can help to talk to your family about what you are experiencing so they understand.

Lifestyle tips

• Exercise regularly, but not too close to bedtime – moderate activity like walking or swimming can reduce symptoms.
• Avoid caffeine after lunchtime and limit alcohol intake.
• Create a relaxing bedtime routine – dim lights, quiet activities, and a cool bedroom.
• If you work at a desk, take short breaks to stand and stretch your legs.

Diet and exercise

Eating a balanced diet with enough iron, magnesium, and folate may help. Good sources include leafy greens, beans, nuts, and lean meats. Regular, moderate exercise like walking, cycling, or yoga can ease symptoms, but it is best not to exercise vigorously late in the day.

Mental health and emotional wellbeing

RLS can cause frustration, anxiety, or low mood because it disrupts sleep and can be hard to control. Poor sleep also affects concentration and patience. It is normal to feel this way. Talking to a healthcare provider about your feelings can be helpful, and many people find that treating the RLS greatly improves their mood.

Prevention

There is no guaranteed way to prevent RLS, especially if it runs in your family. However, you can reduce your risk by keeping your iron levels healthy, staying active, and avoiding known triggers like caffeine and alcohol. If you have a condition like kidney disease, managing it well can help.

Screening programmes

Screening for RLS is not recommended for the general population. If you have a family history or conditions that increase risk, let your doctor know so they can watch for symptoms.

Complications

If left untreated

• Severe sleep problems – difficulty falling asleep and staying asleep, leading to daytime fatigue.
• Reduced ability to concentrate, remember things, or perform daily tasks.
• Increased risk of depression and anxiety due to poor sleep and chronic discomfort.
• In rare cases, severe RLS can cause people to have trouble sitting through meetings, travel, or other quiet situations.

Long-term outlook

For most people, RLS is a long-term condition, but it can be managed well with the right combination of lifestyle changes and medical treatment. Symptoms often come and go, and they can improve with treatment. Many people lead full, active lives with good sleep once they find what works for them. The outlook is hopeful, especially when you work closely with your healthcare team.

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