An irresistible urge to move your legs, often with crawling, tingling or aching sensations, that gets worse when you lie down and eases when you move. Restless legs syndrome (RLS) can make falling asleep almost impossible.
Who gets it
RLS is about twice as common in women as in men and becomes more common with age. It’s also frequent in pregnancy. It often runs in families.
The iron connection
Iron is needed to make dopamine, a brain chemical involved in movement. Low iron in the brain is strongly linked with RLS — and brain iron can be low even when a standard blood count shows no anemia.
That’s why clinicians check ferritin, a measure of iron stores, alongside other iron studies. Sleep specialists often consider iron treatment for people with RLS when ferritin is below around 75ng/mL — higher than the threshold used to diagnose iron deficiency generally. Heavy periods in perimenopause make low iron stores more likely.
Other causes and triggers
- Kidney disease and peripheral neuropathy
- Certain medications, including some antidepressants, antihistamines and anti-nausea drugs
- Caffeine, alcohol and nicotine
- Sleep deprivation
What helps
- Iron treatment if stores are low — under medical supervision, as excess iron is harmful
- Moving — walking, stretching or massaging the legs
- Warm baths or alternating warm and cool
- Regular moderate exercise (very intense evening exercise can worsen it)
- Reviewing medications with your clinician
- Prescription treatments for persistent, severe RLS
If restless legs are disrupting your sleep, ask your clinician for ferritin and iron testing — it’s a simple first step that’s often missed.