Restless legs at night: why it happens, what helps and when to see your GP

You finally get into bed, and your legs won't settle. There's a crawly, tingly, can't-keep-still feeling, and the only thing that helps is moving them. Then it starts again as soon as you lie still. If that sounds familiar, you're far from alone.

The short answer: this is often restless legs syndrome (RLS). The Sleep Health Foundation says it affects 2% to 5% of people, men and women, and the odds go up as you get older. It's usually worse in the evening, it can make it hard to fall and stay asleep, and there are simple things that can ease it. Here's what's going on, how it differs from a leg cramp, what helps, when to see your GP, and how the Thrive Health Band and the Thrive by Optihealth app can show you how your nights are going.

What restless legs feel like

The Sleep Health Foundation describes RLS as real discomfort in your limbs, mostly the legs, with a very strong urge to move them. People describe it in lots of ways:

pulling or drawing
crawling or tingling
itchy, prickly or pins and needles
aching or painful

Moving your legs makes it feel better, at least for a while. It tends to show up when you've been still for a long time, such as sitting at a desk, in the car, at the movies, on a plane, or lying down to sleep. And it's always worse in the evening.

myDr adds that tossing and turning in bed is common. Healthdirect says symptoms are usually worse when you're trying to fall asleep and can stop you getting enough sleep. A run of broken nights can then leave you tired, irritable or flat the next day.

Restless legs or leg cramps?

They're easy to mix up, but they feel different.

Restless legs is an uncomfortable feeling plus an urge to move. Moving eases it.
A leg cramp is a muscle suddenly tightening, usually in the calf. Healthdirect says it normally goes away quite quickly by itself, and that gently stretching the muscle should help.

If your leg pain doesn't go away, see your doctor.

What causes restless legs?

Often there's no single cause. The Sleep Health Foundation and myDr list a few things linked with RLS:

Family history. If your parents had RLS, your own chance is higher.
Low iron. Not getting enough iron, and iron-deficiency anaemia, are both linked with RLS.
Pregnancy. RLS is more likely later in pregnancy and usually goes away after giving birth. If you're pregnant, talk to your doctor or midwife before trying any medicine or supplement.
Caffeine, smoking and alcohol. All three have been linked with RLS.
Some medicines. myDr notes certain medicines can bring on symptoms or make them worse.
Other health conditions, such as kidney problems or diabetes.

That might sound like a long list, but often it comes down to a few everyday habits, plus a chat with the GP.

What helps restless legs at night

The Sleep Health Foundation and myDr suggest a handful of things to try:

Move. Walking, rubbing your legs, or a few knee bends can ease the feeling.
Stretch and massage. myDr suggests gently stretching and massaging your legs at least twice a day.
Have a warm bath before bed.
Try heat or cold. A heat pad, an ice pad wrapped in a tea towel, or switching between the two can help.
Cut back on caffeine. Especially later in the day. See how long caffeine lasts.
Go easy on alcohol and smoking. See does alcohol affect sleep.
Keep active, but not too late. myDr notes intense exercise, or exercising late in the day, can sometimes make symptoms worse.
Keep a regular bedtime. A dark, comfortable room and a relaxing wind-down help. Our sleep hygiene basics cover the rest.

On long days at a desk or in the car, getting up for a short walk can help too. See movement breaks at work. And if your legs are keeping your partner awake as well, our piece on sleep divorce may be worth a read.

When to see your GP

Restless legs are uncomfortable, but they're common and there's plenty you can do. myDr suggests making an appointment with your GP if you have symptoms of RLS. Your GP will ask about your symptoms, when you notice them and how they affect your sleep, and check whether anything, including medicines you take, could be playing a part.

There's no lab test for RLS itself. Your GP may do a blood test to check your iron and other levels. If your iron is low, your doctor can talk to you about iron supplements, but they're not suitable for everyone, so always check with your doctor before taking one. If your symptoms are severe, your GP can talk you through other options.

It's also worth seeing your GP if leg cramps keep coming back.

You can show your Thrive trends to your GP too. They can help you describe how often your nights are broken and what was going on around them.

See how your nights are going with Thrive

What Thrive can and can't see. The Thrive Health Band is worn on your wrist. It doesn't measure your leg movements and it can't tell you whether you have RLS. What it can show you is how your nights are going, and what you logged around them.

Your sleep. The Band has no screen and up to 14 days of battery, so you can wear it to bed. Thrive shows your hours slept along with Quality, Quantity, Regularity and Timing, so you can see whether your sleep is more broken on some nights than others.

Log what you notice. You can log Leg cramps or Insomnia as symptoms, with a note. In your Daily Check-In, tag your day with things like Coffee, Alcohol, Long sitting, Stretching or Massage. You can also add your own factor, such as "Restless legs", with the + Add chip.

Keep your results together. If your GP checks your iron, you can add your blood test results to Thrive. See blood test results in one place.

Over time, Thrive builds a picture of what's usual for you right across your health, from sleep, heart and activity to mood, stress, meals, medications and symptoms. Your Health Fingerprint is ready after about 30 days of wear. Then you can ask Ask Thrive questions like:

"Is my sleep Quality lower on nights I tagged Restless legs?"
"Do I log Leg cramps more often after Long sitting days?"
"Did my sleep change in the weeks I tagged Stretching?"

Before you buy

Thrive Health Band: A$589 for the band including 12 months of the Thrive plan, paid upfront. Prices are in AUD and include GST.

Free shipping. Your 12 months start when you activate your Band, and there's no automatic renewal.

One size, IP68, up to 14 days battery, 12-month warranty, not a medical device, no Apple Health sync. The app is Thrive by Optihealth on iPhone and Android.

See today's price on the Thrive store

At renewal: a new band plus 12 more months for A$589.

Or keep your band and renew the plan for A$240 a year.

Or A$29 a month with no lock-in.

Consumer guarantees under Australian Consumer Law always apply. See Returns if something is wrong with your purchase.

Common questions

Why are restless legs worse at night?

The Sleep Health Foundation says RLS is always worse in the evening. It also tends to show up when you've been still for a while, which is exactly what happens when you lie down to sleep.

Can low iron cause restless legs?

Low iron is linked with RLS. Your GP can check your iron with a blood test. Don't start iron supplements without checking with your doctor first.

Is it restless legs or a cramp?

Restless legs is an uncomfortable feeling with an urge to move, eased by moving. A cramp is a muscle suddenly tightening, usually in the calf, and gentle stretching helps.

For more answers, see Questions.