It is estimated that between 5-10% of the world population suffers from ‘Restless Legs Syndrome’ or Willis-Ekbom Disease (SPI-EWE), a disorder of neurological origin that is accompanied by discomfort in the extremities, and that Despite being little known, it generates a very negative impact on the quality of life of patients.
During pregnancy it is one of the most notorious discomforts, especially in the third trimester, reaching up to 27% of pregnant women and notably reducing their quality of sleep.
We have spoken with Dr. Óscar Larrosa Gonzalo, Clinical Neurophysiologist, an expert in Sleep Medicine and Coordinator of the MipSalud Sleep Medicine Unit, about this problem during pregnancy and how we can alleviate symptoms.
What is ‘restless leg syndrome’ and what symptoms does it have
Restless Legs Syndrome or Willis-Ekbom Disease (SPI-EWE) is a disorder that affects the central nervous system (brain and spinal cord) that causes sensory and motor symptoms in the extremities (especially in the lower ones), and in many cases also a significant alteration in the quality of sleep.
Patients experience a pressing need to move their legs, usually accompanied or caused by internal, bothersome, or unpleasant sensations. These sensations begin or worsen in situations of rest or inactivity, and especially during sleep.
Other symptoms that are described are:
- Tingle
- Crepitation
- Itchiness
- Pricks, stings, or “electric current” sensation
- Internal nervousness or restlessness
- Indescribable sensation, such as internal cold-heat, “worms or spiders”, discomfort…
Despite being a generally chronic disease with a significant incidence among the population (all the more, the older the patient is), RLS continues to be poorly understood and diagnosed.
Why is its incidence higher during pregnancy?
In general, the cause of the disease is known to be an alteration of the iron transport mechanism from the blood to the central nervous system. The greater or lesser deficit of iron availability in the central nervous system causes some alterations in the function of various neurotransmitters, which translate into the appearance of discomfort.
In addition, there is a genetic predisposition to suffer this syndrome, so that if there are affected first-degree relatives (being more frequent in the maternal branch -grandparents, parents, siblings …-) the risk of suffering the disease is between six and seven times higher.
In these cases, we speak of ‘high genetic load’, and it is responsible for the appearance of RLS during childhood and adolescence. When the genetic load is less, the SPI will appear later, although there may be triggers that cause it to appear, such as pregnancy.
In most cases, the sensations associated with RLS subside during the postpartum period or within a few months of giving birth, although there are also cases in which discomfort reappears years later. In addition, as we have just mentioned, in the event that the woman becomes pregnant again, the risk of suffering from RLS again rises to 30%.
What can we do to prevent it
Although today it is not known how to cure the disease, measures can be taken to help alleviate or minimize symptoms during pregnancy, in order to improve the pregnant woman’s night rest and, consequently, her quality of lifetime:
- Hot or cold baths, leg massage, relaxation techniques…
- Moderate physical exercise of legs in the afternoon, but without getting tired, because we could cause the opposite effect
- If the symptoms also appear at certain times of the day, it is advisable to distract the mind with exercises/games such as chess, crossword puzzles, puzzles, hobbies, painting …
- Avoid heavy dinners, especially irritating foods, very hot environments, stress or any other stimulus that may negatively affect the quality of sleep of the pregnant woman.
In addition to adopting this type of measures, Dr. Larrosa recommends consulting the problem with the doctor, since it may be necessary to control other parameters such as iron, Vitamin D, folic acid and Vitamin B12 since their alteration or lack not only It aggravates the symptoms of RLS, but it can carry other important risks for the health of the mother and the baby.
Regarding the use of drugs to alleviate symptoms, they are not usually recommended, as some could have negative consequences for the baby. However, if it were necessary to resort to them due to a profound disorder in the quality of sleep of the pregnant woman, it is preferable to do so in the third trimester and always under the supervision of an expert specialist in SPI-EWE.