What Is Restless Legs Syndrome? A Plain-Language Guide to the Urge to Move Your Legs at Night
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
TL;DR
Restless legs syndrome (RLS) is a condition that creates a very strong urge to move the legs, usually because of an aching or uncomfortable feeling deep in the legs. It strikes in the evening or at night when you are sitting or lying down, and moving — walking, stretching, or jiggling your legs — eases the feeling for a short time. RLS can begin at any age and tends to get worse as you get older, and it often goes hand in hand with a related condition called periodic limb movement of sleep, where the legs twitch or kick through the night. There is often no known cause, though doctors suspect a brain chemical called dopamine is out of balance, and the condition sometimes runs in families. Treatment starts with lifestyle changes and self-care (warm baths, massage, exercise, cutting caffeine), moves to iron supplements if iron levels are low, and then to prescription medicines and, in some cases, a small electrical stimulation device — and most people find real relief.
Quick Answer
What is RLS? Restless legs syndrome (also called Willis-Ekbom disease) is a condition that causes a strong, hard-to-resist urge to move the legs, usually from aching or uncomfortable feelings deep in the legs.
When does it strike? Mostly in the evening or at night when sitting or lying down; symptoms usually happen on both sides and feel like crawling, creeping, pulling, throbbing, aching, itching, or electric sensations.
What causes it? Often no known cause; researchers suspect an imbalance of dopamine, a brain chemical that regulates muscle movement. It can run in families and sometimes appears during pregnancy.
How is it diagnosed? By five specific criteria — irresistible urge to move, worse at rest, relieved by activity, worse at night, and not explained by another condition — plus blood tests, especially an iron level check.
How is it treated? Lifestyle changes and self-care first, iron supplements if you're low in iron, then prescription medicines (calcium-channel medicines first, dopamine medicines or opioids in specific cases) and sometimes an electrical stimulation device.
What the research says
RLS is common worldwide. A systematic review and modelling analysis of 52 articles from 23 countries estimated that 7.12% (95% CI 5.15–9.76) of adults aged 20–79 had RLS in 2019, about 356 million people. Prevalence was similar in high-income and lower-income regions. Older age (odds ratio 1.13), smoking (1.46), depression (1.71), and diabetes (1.54) were linked with higher odds of RLS. (Song et al., J Glob Health, 2024)
Treatment guidance rests on a large evidence review. The American Academy of Sleep Medicine's systematic review of RLS and periodic limb movement disorder treatments screened 3,631 studies, of which 148 had data suitable for statistical analysis. It supports the Academy's clinical practice guideline on treatment in adults and children. (Winkelman et al., J Clin Sleep Med, 2025)
What Is Restless Legs Syndrome (RLS)?
Restless legs syndrome (RLS) is a condition that causes a very strong urge to move the legs. That need to move usually comes from an aching or uncomfortable feeling in the legs itself. The symptoms typically show up in the evening or at night, when you are sitting or lying down — and moving eases the feeling for a short time.
RLS can begin at any age, even in childhood, and it tends to get worse with age. Because it makes it hard to sleep, it can affect daily activities. You may also see it called by another name: Willis-Ekbom disease.
The good news is that simple self-care steps and lifestyle changes may relieve symptoms, and medicines help many people with RLS.
What Does Restless Legs Syndrome Feel Like?
The main symptom is an urge to move the legs. People with RLS commonly describe four things that go together.
Feature | What It Looks Like |
Discomfort begins while resting | Symptoms start after you've been lying down or sitting — for example, in a car, on an airplane, or in a movie theater |
Relief with movement | Stretching, jiggling the legs, pacing, or walking may improve symptoms |
Worse in the evening | Symptoms occur mainly at night |
Nighttime leg twitching | RLS may be linked with periodic limb movement of sleep — a related condition where the legs twitch and kick during sleep, possibly all night long |
The sensations usually happen on both sides of the body, and they are described as feelings within the legs rather than on the skin. Less commonly, the condition affects the arms. People describe the feelings as crawling, creeping, pulling, throbbing, aching, itching, or electric.
Interestingly, people with RLS usually do not describe the symptoms as muscle cramps or numbness — but they strongly describe the desire to move their legs. Symptoms also tend to get better and worse over time; they sometimes disappear for periods and then come back.
When Should You See a Doctor About Restless Legs?
Talk with your healthcare professional if you have symptoms of RLS. The condition can interfere with your sleep, cause daytime drowsiness, and affect your quality of life. Getting it checked is worth it because treatable causes — like low iron — may be hiding behind the symptoms.
What Causes Restless Legs Syndrome?
Often, there is no known cause for RLS. Researchers suspect the condition may come from an imbalance of dopamine — a brain chemical that sends messages regulating muscle movement.
Two other things are known to play a role:
Heredity. RLS sometimes runs in families, especially when the condition starts before age 40. Researchers have found sites on the chromosomes where genes linked to RLS may be present.
Pregnancy. Pregnancy or hormonal changes may worsen RLS symptoms. Some people get RLS for the first time during pregnancy, especially during the last trimester. In that case, symptoms usually disappear after delivery.
Who Is at Risk of Restless Legs Syndrome?
RLS can develop at any age, even during childhood, and it becomes more common as people get older. It is also more common in women than in men.
RLS usually isn't related to a serious medical condition. However, it sometimes occurs together with other conditions, which is one reason doctors run blood tests.
Risk Factor | How It Connects to RLS |
Peripheral neuropathy | Damage to the nerves in the hands and feet, sometimes caused by chronic diseases such as diabetes or alcohol use disorder |
Iron deficiency | Too little iron in the body can cause or worsen RLS; it can come from heavy menstrual periods, donating blood often, or bleeding from the stomach or bowels |
Kidney failure | Kidneys that don't function properly can lower iron levels in the blood, and other body chemistry changes may cause or worsen RLS |
Spinal cord conditions | Damage or injury of the spinal cord has been linked to RLS |
Parkinson's disease | People with Parkinson's disease may have a higher risk of developing RLS |
Can Restless Legs Syndrome Cause Complications?
Yes — mostly through lost sleep. RLS symptoms range from mild to serious, and many people find it hard to fall asleep or stay asleep, which can affect their quality of life. That lost sleep can cause depression in some people and may lead to excessive daytime drowsiness. RLS can even interfere with napping.
How Is Restless Legs Syndrome Diagnosed?
To diagnose RLS, your healthcare professional takes your medical history and asks about your symptoms. The diagnosis is based on five specific criteria set by the International Restless Legs Syndrome Study Group.
Diagnostic Criterion | What It Means |
1. Strong urge to move the legs | The urge is hard to resist and usually occurs with discomfort in the legs |
2. Worse at rest | Symptoms start or get worse when you're sitting or lying down |
3. Relieved by activity | Symptoms ease with walking or stretching |
4. Worse at night | Symptoms are more intense in the evening or night |
5. Not explained by another condition | Something else must not better account for the symptoms |
Your healthcare professional also may give you a physical and a neurological exam. Blood tests — especially of your iron level — can help look for possible causes of your symptoms and guide your treatment.
You may be referred to a sleep specialist. That could involve an overnight stay at a sleep clinic for a sleep study if another condition, such as sleep apnea, is suspected. However, a diagnosis of RLS usually doesn't require a sleep study.
How Is Restless Legs Syndrome Treated?
The treatment path depends on what's behind your symptoms. Sometimes RLS symptoms go away after treating an underlying condition, such as iron deficiency. That may involve taking an iron supplement by mouth or through a vein in your arm. One important safety note: only take iron supplements after having your blood-iron level checked and while being monitored by your healthcare professional.
If your RLS is not directly caused by another condition, treatment focuses on lifestyle changes. If those aren't effective, your healthcare professional may prescribe medicines. There is also a device that delivers electrical stimulation to a nerve on the side of your knee that may help RLS symptoms. It requires a prescription and is often used alongside medicines.
What Medicines Are Used for Restless Legs Syndrome?
Several prescription medicines can reduce restlessness in the legs. Many were developed to treat other diseases but can help with RLS. Finding the right medicine — or combination — may take a number of trials.
Medicine Type | Examples | Key Points |
Calcium-channel medicines (first-line) | Gabapentin (Neurontin, Gralise, Gabarone), gabapentin enacarbil (Horizant), pregabalin (Lyrica) | First-line treatment for most people; possible side effects include dizziness, trouble with balance, mental fog, and weight gain |
Dopamine-increasing medicines | Rotigotine (Neupro), pramipexole (Mirapex ER), ropinirole | Work for a short time; RLS may worsen over time, symptoms can return earlier in the day or spread to the arms, and they can cause impulse-control issues such as compulsive gambling — so they're used only if calcium-channel medicines fail or cause side effects |
Medicine for occasional symptoms | Carbidopa-levodopa (Sinemet, Rytary, others) | Taken as needed only; daily or near-daily use can cause symptoms to worsen |
Opioids (low dose) | Oxycodone (Oxycontin, Roxicodone), hydrocodone (Hysingla ER), buprenorphine (Belbuca, Butrans) | Used when other medicines haven't worked; in low doses most people have no major side effects and misuse is rare |
Be aware that some other medicines can worsen RLS symptoms, including some antidepressants, some antipsychotic medicines, some anti-nausea medicines, and some cold and allergy medicines. Your healthcare professional may recommend avoiding these if possible.
And one special case: most medicines prescribed for RLS aren't recommended during pregnancy. Instead, self-care techniques and iron supplements may be suggested — though if symptoms really bother you during the last trimester, certain RLS medicines may be recommended.
What Home Remedies and Lifestyle Changes Help Restless Legs?
Lifestyle changes are the first step in treatment, and they are simple to try.
Self-Care Step | How It Helps |
Warm baths and massage | Soaking in a warm bath and massaging the legs can relax the muscles |
Warm or cool packs | Heat, cold, or alternating the two may lessen the uncomfortable feelings |
Good sleep hygiene | Fatigue tends to worsen RLS; keep a cool, quiet, comfortable sleep environment, go to bed and rise at the same time daily, and get at least seven hours of sleep |
Moderate exercise | Regular moderate exercise may relieve symptoms, but overdoing it or working out too late in the day may make symptoms worse |
Avoid caffeine | Cutting back for a few weeks may help — that includes chocolate, coffee, tea, and soda |
Foot wrap or vibrating pad | A foot wrap designed for RLS puts pressure under the foot; a vibrating pad on the back of the legs may also bring relief |
How Can You Cope with a Lifelong Condition?
RLS is most often a lifelong condition, so coping strategies matter. Telling others about your condition helps family, friends, and co-workers understand what you're going through — including why you might pace the halls or stand at the back of the theater. Don't resist your need for movement: trying to ignore the urge to move may actually make symptoms worse. Keep a diary of your sleep, the medicines and strategies that help, and what makes symptoms worse, and share it with your healthcare professional. Begin and end your day with stretching exercises or gentle massage. And consider a support group — it brings together family members and people with RLS, and your insights can help others too.
How Should You Prepare for Your Appointment?
If you have RLS symptoms, make an appointment with your healthcare professional. You may be referred to a neurologist — a doctor who specializes in conditions affecting the nervous system — or to a sleep specialist.
Before you go, write down your symptoms, including when they started and when they tend to occur. Write down key medical information: other conditions you have, all medicines you take (prescriptions, over-the-counter medicines, vitamins, and supplements), and whether RLS runs in your family. Take a family member or friend along so you don't miss or forget details, and write down your questions.
You Ask | Your Healthcare Professional Asks |
What is the most likely cause of my symptoms? | Do you get a strong urge to move your legs? |
Are there other possible causes? | What words describe your symptoms? |
What tests do I need? | Do symptoms start while sitting or lying down, and are they worse at night? |
What treatment options are available? | Does movement make you feel better? |
How can I manage my other health conditions together? | Have you been told you kick, shake, or move your legs while sleeping? |
What self-care steps might improve my symptoms? | Do you often have trouble falling or staying asleep, or feel tired during the day? |
What educational materials or websites do you recommend? | Does anyone else in your family have restless legs? How much caffeine do you have daily? What is your typical exercise program? |
Where can I find a support group for people with RLS? | Are you at risk of low iron (limiting meat, donating blood often, or blood loss from recent surgery)? What RLS medicines have you used, and were they effective? |
In the meantime, cut back on or eliminate caffeine, alcohol, and tobacco, and massage your legs while soaking in a warm bath.
The Bottom Line
Restless legs syndrome turns ordinary evenings into an uncomfortable battle against the urge to move — but it is a manageable, treatable condition. Simple steps like warm baths, regular exercise, better sleep habits, and less caffeine help many people, and low iron — one of the most common underlying causes — is easy to check and easy to treat. If lifestyle changes aren't enough, several medicine groups and even an electrical stimulation device are available. If your legs are keeping you (and your sleep) restless at night, a conversation with your healthcare professional is the right first step.
Take the Next Step. If your legs ache and twitch at night, don't just brush it off as "one of those things." Track your symptoms for a few weeks — when they hit, what helps, and what makes them worse — and bring that record to your healthcare professional. A simple iron blood test could reveal the cause, and a tailored plan can give you your evenings and your sleep back.
Frequently Asked Questions
Is restless legs syndrome the same as leg cramps?
No. People with RLS usually don't describe their symptoms as muscle cramps or numbness. The hallmark of RLS is a strong, hard-to-resist urge to move the legs, caused by feelings deep within the legs (crawling, creeping, pulling, throbbing, aching, itching, or electric).
Does restless legs syndrome go away on its own?
Sometimes. If RLS is caused by another condition, such as iron deficiency, symptoms may go away after the underlying condition is treated. Pregnancy-related RLS usually disappears after delivery. But RLS is most often a lifelong condition that gets worse with age, so treatment and self-care are important.
Why do my symptoms only happen at night?
RLS symptoms are typically triggered by rest — sitting or lying down — and they follow a daily pattern, occurring mainly in the evening or at night. Movement temporarily eases the feeling, which is why getting up and walking often helps.
Can children get restless legs syndrome?
Yes. RLS can develop at any age, even during childhood, though it becomes more common as people get older.
Can low iron really cause restless legs?
Yes. Too little iron in the body (iron deficiency) can cause or worsen RLS. It can result from heavy menstrual periods, frequent blood donation, or bleeding from the stomach or bowels. That's why an iron blood test is a standard part of RLS evaluation — but only take iron supplements after your iron level is checked and under medical supervision.
Do I need a sleep study to be diagnosed with RLS?
Usually not. A diagnosis of RLS is based on your symptoms matching five specific criteria, plus blood tests and a physical and neurological exam. A sleep study is only considered if another condition, such as sleep apnea, is suspected.
What is the first-line medicine for restless legs syndrome?
Medicines affecting calcium channels — gabapentin, gabapentin enacarbil, and pregabalin — are the first-line treatment for most people with RLS. Possible side effects include dizziness, trouble with balance, mental fog, and weight gain.
Can I just stop taking my other medicines if they worsen RLS?
Don't stop anything on your own. Some antidepressants, antipsychotic medicines, anti-nausea medicines, and cold and allergy medicines can worsen RLS. Talk with your healthcare professional about whether you can safely avoid them or about treatments to manage RLS if you need them.
Related Reading
References
Mayo Clinic Staff. Restless legs syndrome: Symptoms and causes. Mayo Clinic. Last updated June 30, 2026. Accessed October 14, 2026. https://www.mayoclinic.org/diseases-conditions/restless-legs-syndrome/symptoms-causes/syc-20377168
Mayo Clinic Staff. Restless legs syndrome: Diagnosis and treatment. Mayo Clinic. Last updated June 30, 2026. Accessed October 14, 2026. https://www.mayoclinic.org/diseases-conditions/restless-legs-syndrome/diagnosis-treatment/drc-20377174
Song P, Wu J, Cao J, et al. The global and regional prevalence of restless legs syndrome among adults: a systematic review and modelling analysis. J Glob Health. 2024;14:04113. PMID: 38843039. DOI: 10.7189/jogh.14.04113
Winkelman JW, Berkowski JA, DelRosso LM, et al. Treatment of restless legs syndrome and periodic limb movement disorder: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2025;21(1):153-199. PMID: 39324664. DOI: 10.5664/jcsm.11392
Medical Disclaimer: This content is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have about a medical condition.
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