varicose veins at night

Overview

Varicose veins are swollen, twisted veins that you can see just under the surface of the skin, most often in the legs. At night, they can become more uncomfortable because lying down or staying still for long periods may increase pressure and reduce blood flow.

Yes, varicose veins affect up to 3 in 10 adults. Many people experience worse symptoms at night.

They are more common in women, older adults, people who stand or sit for long periods, and those who are overweight or have a family history of varicose veins.

Symptoms

Common symptoms

• Aching, heavy, or tired legs, especially at night
• Swelling in the lower legs or ankles
• Throbbing or cramping in the legs during the night
• Restless legs or a urge to move your legs when trying to sleep
• Itching or a burning sensation around the veins
• Visible bulging, dark blue or purple veins

Symptoms in children

• Varicose veins are very rare in children. If they appear, it may be due to an underlying condition, so it is important to see a doctor for assessment.

Symptoms in older adults

• As you age, the valves in your veins naturally weaken. Older adults are more likely to develop varicose veins and may have more severe nighttime symptoms like persistent aching or cramping.

Causes

Main causes

• Weak or damaged valves inside the veins that allow blood to flow backward and pool
• Increased pressure in the leg veins from standing or sitting for long periods
• Weakening of the vein walls with age

Risk factors

• Family history of varicose veins
• Being female (hormonal changes during pregnancy or menopause can weaken vein walls)
• Pregnancy (the growing womb puts pressure on leg veins)
• Being overweight or obese
• Getting older
• Jobs that require long periods of standing or sitting

When to see a doctor

See a doctor urgently if:

• If you have sudden swelling, redness, or warmth in one leg – these could be signs of a blood clot (deep vein thrombosis). Call your local emergency number or go to A&E immediately.
• If a varicose vein bursts and you cannot stop the bleeding.

Book a routine appointment if:

• If your nighttime symptoms (aching, swelling, cramps) are getting worse or affecting your sleep
• If you have skin changes like sores, rashes, or discoloration near the veins
• If you want to explore treatment options for comfort or appearance

Diagnosis

A doctor can usually diagnose varicose veins by looking at your legs and asking about your symptoms. They may feel the veins and check for swelling or tenderness.

Tests that may be done

• A focused physical exam of your legs while you are standing and lying down
• A duplex ultrasound – a painless test that uses sound waves to check blood flow and see if the valves are working properly

What to expect at your appointment

The diagnosis is straightforward and often done in your doctor's office. The ultrasound takes about 30 minutes. Your doctor will explain the results and discuss treatment options if needed.

Treatment

Treatment for varicose veins ranges from simple self-care to medical procedures. The goal is to ease symptoms, prevent complications, and improve appearance. Your doctor will help choose the best approach for you.

Self-care at home

• Elevate your legs above heart level for 15-30 minutes several times a day, especially before bed
• Wear graduated compression stockings (you can buy them at pharmacies – ask your pharmacist for the right fit and strength)
• Avoid standing or sitting for long periods – take short walks or do leg exercises if you have to stay still
• Maintain a healthy weight
• Exercise regularly, like walking or swimming, to improve blood flow
• Sleep with extra pillows under your legs to raise them slightly

Medical treatments

If self-care is not enough, your doctor may suggest treatments such as sclerotherapy (injecting a foam or solution into the vein to close it), laser or radiofrequency ablation (using heat to seal the vein from inside), or endovenous laser treatment. These are done as outpatient procedures. Your doctor will explain the options and what to expect.

When is surgery considered?

Surgery (such as vein stripping or phlebectomy) is rarely needed now, but it may be considered for very large or severely symptomatic veins that do not respond to other treatments. Your specialist can discuss if this is an option for you.

Living with this condition

Living with varicose veins at night can be managed with simple habits. Keep your legs elevated during the day and before bed, wear compression stockings if recommended, and move regularly during long periods of sitting or standing.

Lifestyle tips

• Walk or do gentle leg stretches every hour if you have a desk job or are on a long journey
• Avoid standing for hours without movement
• Wear comfortable, non-restrictive clothing and shoes
• Avoid crossing your legs when sitting

Diet and exercise

A high-fibre, low-salt diet can help prevent constipation and reduce swelling. Regular exercise, especially walking, swimming, or cycling, strengthens your calf muscles and helps push blood upward. Aim for at least 30 minutes of moderate activity most days.

Mental health and emotional wellbeing

Varicose veins can sometimes affect how you feel about your legs, causing anxiety or frustration especially if symptoms disturb sleep. It is normal to feel this way. Talk to your doctor about your concerns – they can offer support and treatment options to help.

Prevention

You may not be able to fully prevent varicose veins, especially if you have a family history. However, a healthy weight, regular exercise, avoiding long periods of standing or sitting, and elevating your legs can lower your risk and keep existing veins from getting worse.

Screening programmes

Routine screening for varicose veins is not recommended for the general public. If you have a strong family history or symptoms, talk to your doctor.

Complications

If left untreated

• Skin changes such as darkening, thickening, or hardening around the veins
• Open sores (ulcers) near the ankle that can be slow to heal
• Bleeding from a varicose vein that may be hard to stop
• Blood clots (superficial thrombophlebitis) in the affected vein, causing redness and pain
• Deep vein thrombosis (DVT) – a clot in a deeper vein – which can be serious

Long-term outlook

For most people, varicose veins are a manageable condition. With simple self-care and, if needed, treatment, symptoms can be controlled and complications avoided. The outlook is good, and many people live comfortably with varicose veins for years.

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