Study Highlights High Prevalence and Severity of Restless Legs Syndrome in Pregnant Women

Mauro Manconi, MD, PhD

(Credit: Insel Gruppe)

Findings from the Life-ON Cohort Study newly presented at the 2025 SLEEP Annual Meeting, held June 8 to 11, in Seattle, Washington, showed that restless legs syndrome (RLS) was a common condition during pregnancy in women, affecting more than one-fourth of available patients.¹

In this study, researchers tracked the prevalence, severity, and risk factors for RLS from early pregnancy through 1 year postpartum. Among 439 pregnant women enrolled between 10 to 15 gestational weeks and followed after delivery, 26.03% (n = 113; 95% CI, 22.0%–30.4%) met the International RLS Study Group’s 5 essential diagnostic criteria for RLS. The study also reported a cumulative incidence of 34.7% across the full follow-up period of 12 months.

Women with a prior history of RLS were at notably increased risk (HR, 7.86; 95% CI, 4.09–15.07; P <.0001), whereas those with a personal history of depression (HR, 2.03; 95% CI, 1.003–4.09; P = .049) or a positive family history of RLS (HR, 2.00; 95% CI, 0.92–4.35; P = .08) also faced elevated risk.

Presented by lead author Mauro Manconi, MD, PhD, head of the service at the Sleep and Epilepsy Centre of the Neurocenter of Southern Switzerland, the study used data from the Life-ON Cohort, which conducted 11 scheduled visits per participant and included a full polysomnography during the second trimester. Of the women who developed RLS during pregnancy, authors noted that 50.68% had a prior history of RLS outside of pregnancy (OR, 2.717; 95% CI, 1.791–3.782), and 18.7% reported a positive family history of RLS.

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All told, symptom severity of RLS remained relatively stable across pregnancy. Researchers reported that approximately 20% of women with RLS experienced severe to very severe symptoms, defined as an International RLS Study Group Rating Scale score greater than 20 points. Additionally, authors observed that periodic limb movements with a sleep index greater than 15 were found in 26% of the pregnant women.

Investigators noted that women with personal or family histories of RLS were especially predisposed to develop symptoms during pregnancy. Given that a substantial proportion of women experienced severe RLS symptoms, researchers suggested that screening and treating eligible women could improve quality of life as well as reduce comorbidity during pregnancy.

A previously published 2024 study further clarified the trajectory of RLS, with results revealing that symptoms peaked late in pregnancy and typically subsided in the postpartum period.² In this study, 260 pregnant women were followed during the third trimester, and at 2 and 6 months postpartum, alongside a control group of 130 students. Researchers reported that RLS prevalence was highest in the third trimester, affecting 26.5% of pregnant women. Notably, prevalence declined to 18.1% at 2 months postpartum and further to 7.3% 6 months after delivery, closely aligning with the control group prevalence of 6.2%.

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REFERENCES
1. Manconi M, Estevens AM, Hackethal S, et al. Restless Legs Syndrome During Pregnancy and Puerperium: Data From the Life-ON Cohort. Presented at: 2025 SLEEP Annual Meeting; June 8-11; Seattle, WA. ABSTRACT 0909.
2. Lepuzanovic M, Sinanovic O, Aziraj-Smajic V, Kapic D, Basagic E, Muftic M. Prevalence of restless legs syndrome during pregnancy and postpartum period. J Perinat Med. 2024;52(8):852-857. Published 2024 Aug 5. doi:10.1515/jpm-2024-0208