Pregnant women with restless legs syndrome (RLS) may face a higher risk of perinatal depression, according to a study published in the Journal of Clinical Sleep Medicine. The findings suggest that screening for RLS during the third trimester could help healthcare providers identify women who may need additional mental health support.
The research found that pregnant women with restless legs syndrome were approximately three times more likely to develop perinatal depression and twice as likely to experience depressive symptoms compared with women without the condition. The association was strongest when RLS occurred during the third trimester and remained significant after researchers accounted for factors including age, education, partner status, occupation, number of children and whether the pregnancy was planned.
“We found that pregnant women with restless legs syndrome had about three times the risk of developing perinatal depression,” said first author Dr. Kazuhide Tezuka, a visiting researcher in the department of mental health at the University of Tokyo Graduate School of Medicine. “This association was seen for restless legs syndrome identified in the third trimester, but not in the second.”
Published on August 31, the study examined the relationship between RLS and perinatal depression, which includes major depressive episodes during pregnancy or in the months following childbirth.
What Is Restless Legs Syndrome?
Restless legs syndrome is a sleep-related movement disorder characterised by a strong, often irresistible urge to move the legs, sometimes accompanied by uncomfortable sensations. Symptoms typically begin or worsen during rest or inactivity, improve temporarily with movement and occur predominantly in the evening or at night. These symptoms can make falling asleep difficult.
According to a recent survey by the American Academy of Sleep Medicine (AASM), 13% of Americans report having been diagnosed with RLS. Previous research has also found that people with the condition experience depression and anxiety at four times the rate of the general US population. RLS is also known to occur during pregnancy.
Because the condition can interfere with sleep, identifying its symptoms during pregnancy may provide healthcare professionals with an additional indicator when assessing maternal mental health.
Researchers Analysed Data From 2,435 Pregnant Women
The study included 2,435 pregnant women in Japan with an average age of 30.5 years. Participants completed screening questionnaires for restless legs syndrome during their second and third trimesters. Researchers identified RLS in 40 women, or 1.6%, during the second trimester and in 60 women, or 3.5%, during the third trimester.
The team tracked major depressive episodes and depressive symptoms through three months after childbirth. During this period, 69 participants developed perinatal depression.
The association between RLS and depression remained statistically significant after accounting for several demographic and pregnancy-related factors. However, the researchers noted that the number of depression cases among participants with RLS was small, limiting the strength of conclusions that can be drawn from the findings.
Third-Trimester Screening May Help Identify At-Risk Women
The researchers suggest that screening for restless legs syndrome later in pregnancy could help healthcare providers identify women who may be at elevated risk of perinatal depression. Since RLS can develop or become more noticeable as pregnancy progresses, relying solely on assessments conducted during early prenatal visits may overlook some cases.
“Because restless legs syndrome often develops later in pregnancy, asking about its symptoms again in the third trimester, not just at early prenatal visits, may help healthcare providers identify women at higher risk of perinatal depression,” said Tezuka.
The authors also highlighted several limitations. The prevalence of RLS in the study was lower than expected, participants were self-selected volunteers, and all measurements were based on self-reported information. Further research is needed to confirm the association and determine whether treating RLS can reduce the risk of perinatal depression.
The findings point to a potential role for third-trimester RLS screening in maternal mental health assessments, but they do not establish that RLS directly causes depression. Future studies will be needed to determine whether addressing the sleep disorder can improve mental health outcomes during pregnancy and after childbirth.
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