Disorders

What is restless legs syndrome?

Reviewed July 2026 by Kenneth Lee, MD

Definition: Restless legs syndrome (RLS), also called Willis-Ekbom disease, is a neurological condition that creates a strong urge to move the legs, especially during rest. It can also affect the arms. Symptoms often feel worse in the evening or at night and usually improve with movement.

RLS symptoms can be frustrating and may interfere with the ability to both fall and stay asleep, but there are treatment options and everyday strategies that can help. RLS affects about 7% to 10% of Americans at any given time, with 3% affected at least twice a week. RLS is more common in women.

What are the symptoms of restless legs syndrome?

RLS symptoms can vary from person to person, but they often include:

  • Uncomfortable sensations in the legs, such as throbbing, creeping, or aching
  • A strong, sometimes uncontrollable urge to move the legs (rarely painful)
  • Temporary relief with movement, such as walking, stretching, or rubbing the legs
  • Getting worse when you keep your legs still

Symptoms are worse at night, which can make it harder to fall asleep or stay asleep. In more severe cases, symptoms may also happen during the day and involve the arms.

What are the causes and risk factors of restless legs syndrome?

Researchers don’t know exactly what causes RLS. It may be connected to low iron levels in the brain and changes in dopamine, a brain chemical that helps control movement.

Risk factors and triggers include:

  • Low iron levels or iron deficiency
  • Pregnancy, especially in the last trimester
  • Kidney disease
  • Family history
  • Untreated sleep apnea
  • Certain medications (such as antidepressant medications, anti-allergy medications, and mood stabilizers) or substances (such as alcohol or caffeine) can worsen symptoms

How is restless legs syndrome diagnosed?

RLS is diagnosed based on your symptoms and medical history. There is no single test for RLS, but your doctor may ask questions, review medications, and check for conditions that can contribute to symptoms, such as low iron. A sleep study is not needed for a diagnosis of RLS.

What treatments are available for restless legs syndrome?

Treatment depends on how often your symptoms happen, how much they affect sleep and daily life, and whether another condition may be contributing. The goal is to reduce symptoms, improve sleep, and address factors that may worsen RLS.

The first step is to look for contributing factors.

  • Check for and treat low iron levels
  • Reduce or avoid triggers such as alcohol, caffeine, certain medications, and untreated sleep apnea

Medications with strong evidence

For some people, medication can help reduce symptoms and improve sleep and quality of life. A doctor can help you choose an option:

  • Gabapentin: Works on calcium channels to reduce nerve irritation
  • Gabapentin enacarbil: Similar to gabapentin but can provide longer-lasting effects
  • Pregabalin: Similar to gabapentin, slightly longer-lasting
  • Intravenous (IV) iron therapy, such as ferric carboxymaltose: Rapidly increases iron levels in the body

Other treatment options

These may be helpful for some people:

  • Oral iron supplements (such as ferrous sulfate) when iron is low
  • Dipyridamole, a blood-thinning medication
  • Low-dose opioids for severe or difficult-to-treat cases
  • Newer non-drug treatments such as tonic motor activation system (TOMAC) devices

Treatments used with caution

Some medications may help in the short term but are no longer recommended for routine long-term use. This is because they can cause augmentation, meaning they cause your RLS symptoms to become more aggressive over time. This includes the severity of your symptoms and how early your symptoms begin in the day. These medications include dopamine agonists (such as pramipexole, ropinirole, and rotigotine) or levodopa.

Lifestyle strategies

Some lifestyle changes can help reduce your RLS symptoms. They include:

  • Regular sleep habits
  • Avoiding triggers like caffeine and alcohol
  • Physical activity and movement when symptoms happen

Frequently asked questions

Is restless legs syndrome serious?

RLS is not life-threatening, but it can have a real impact on sleep, energy, and quality of life. In addition, studies have indicated an increased risk of cardiovascular disease and mood disorders. If symptoms are disrupting your rest or daily routine, it may help to talk with a health care professional.

What triggers or worsens restless legs syndrome symptoms?

Common triggers include low iron, alcohol, caffeine, certain medications, and untreated sleep problems. Identifying and addressing triggers can be an important first step in managing symptoms.

Is restless legs syndrome related to iron deficiency?

Yes. Low iron levels are strongly linked to RLS. For some people, treating low iron can improve symptoms, so a health care professional may recommend checking iron levels as part of evaluation and care.

Can restless legs syndrome go away?

RLS symptoms may improve when an underlying cause, such as iron deficiency, is treated. For many people, RLS is a long-term condition, but treatment and everyday strategies can help manage symptoms.