Restless legs syndrome: Symptoms and relief

July 18, 2025

Providence Health Team

[5 MIN READ]

Restless legs syndrome often feels like a “creepy-crawly” sensation in the legs, making it difficult for you to sleep.
While the cause is often unknown, underlying medical conditions can sometimes lead to restless legs syndrome.
Learn easy things you can do at home to help relieve restless legs syndrome symptoms and how our sleep specialists may be able to help you get additional relief.

Restless legs syndrome: Symptoms and relief

You’re in bed, and you can’t settle. Something with your legs doesn’t feel right. Maybe it’s a deep itch you can’t scratch. Or a tickling sensation. Or a buzzy, electric-like feeling. All you know is that you must move your legs to get these feelings to stop.

If this sounds familiar, you may have restless legs syndrome (RLS). Know this: It’s not just in your head. RLS is real and can be incredibly bothersome, affecting your quality of life. It’s also common. According to a recent study, 7.12% of adults 20 to 79 years old have RLS.

Morris B. Chang, M.D. MBA, a sleep specialist at Providence Swedish Sleep Medicine in Issaquah, Washington, shares what many of his patients experience with RLS, how it’s diagnosed and treatment options, including some simple things you can try at home.

What is restless legs syndrome?

People who have restless legs syndrome (RLS) experience an irresistible urge to move their legs. This urge is usually accompanied by or caused by uncomfortable sensations or unpleasant sensations in the legs.

RLS, also called Willis-Ekbom disease, is sometimes confused with other conditions, including periodic limb movements in sleep (PLMS) and periodic limb movement disorder (PLMD), which cause your legs to twitch or jerk uncontrollably. Many people who have RLS also have PLMS.

The cause of RLS is often unknown, although it’s common with certain health conditions. It tends to be more common in women and people who are older.

RLS isn’t serious, but the symptoms can be aggravating, affecting your quality of life and resulting in daytime sleepiness.

Symptoms of restless legs syndrome

“Many people have difficulties describing what the restlessness feels like, and RLS sufferers describe their symptoms in many various ways,” Dr. Chang says. “‘Heeby-jeeby’ and ‘creepy-crawly’ sensations are some ways RLS may be characterized. Some of my patients describe a feeling of ants crawling up their legs or under the skin, an ‘anxious’ feeling inside the legs or a vague sensation of an unpleasant feeling there. However they describe it, though, RLS uniformly means there is something uncomfortable happening in the legs, compelling the sufferer to move them.”

Common symptoms of RLS include restlessness that:

Occurs or worsens during rest or inactivity
Temporarily gets better by movement (such as kicking, walking or stretching)
Tends to happen in the evening or at night

“It’s important to note that the sensations and resulting leg movements occur while awake,” Dr. Chang says. "For some people, these symptoms occur in the arms as well, and as RLS worsens, they may start earlier and earlier in the day.”

What causes RLS?

“There is still a lot we don’t understand about how or why RLS occurs, but a problem with the brain’s regulation of dopamine (an important neurotransmitter) appears to play a major role in the development of RLS,” Dr. Chang says. “Iron deficiency is often a factor as well: Iron is an important cofactor in the production of dopamine.”

If you have primary RLS, also called idiopathic RLS, that means the cause is unknown. People who have primary RLS often have family members who also have RLS.

An underlying medical condition, such as Parkinson’s disease, can result in secondary RLS.

“People who are iron-deficient, pregnant, suffering from chronic kidney failure or taking certain medications (most notably certain antidepressants and antihistamines) are all at increased risk of developing RLS,” Dr. Chang says. “Having a family history of RLS can also increase the risk. In general, females are more likely to suffer from RLS than males. Also, RLS appears to occur more frequently in European and North American countries than in Asian countries.”

How is RLS diagnosed?

To diagnose RLS, your doctor will take a careful medical history.

“If you have the cardinal features I mentioned earlier, if those symptoms are causing you distress, sleep disturbances or other forms of impairment, and if there isn’t some kind of ‘mimic’ that could be mistaken for RLS, then you likely have RLS,” Dr. Chang says. “Fancy tests like sleep studies are not necessary to make the diagnosis.”

Things that can mimic RLS include nocturnal leg cramps (which you might call a charley horse), side effects from some types of antipsychotic medications and certain neurological conditions, such as arthritis or peripheral neuropathy (nerve damage) caused by diabetes.

How to treat and manage restless legs syndrome

“If there is evidence of iron deficiency, I recommend iron supplementation, such as iron tablets you can get over the counter at your pharmacy,” Dr. Chang says.

If your RLS is making it difficult for you to sleep, Dr. Chang says there are several easy lifestyle changes you can make at home that have been reported to help RLS symptoms. These include:

Hot baths or leg soaks before bed
Leg massages
Mild leg exercises or stretches before bed

“It’s also important to note that caffeine, nicotine and alcohol can trigger RLS, so it’s a good idea to limit these substances if there is a correlation between their use and the symptoms,” Dr. Chang says. “Stress, irregular sleep schedules, sleep deprivation and being sedentary for long periods of time can also act as triggers for some people.”

For people who have severe RLS and don’t have an iron deficiency, prescription medication may help. These include:

Alpha-2 ligand medications, such as gabapentin
Dopamine agonists, such as pramipexole and ropinirole

“Because the daily onset of RLS can be predictable for many people, taking these medications should be timed carefully to try to prevent the symptoms from starting in the first place,” Dr. Chang says.

When to talk to a Providence provider

If you’re experiencing RLS symptoms, it’s important to talk to your health care provider. They can rule out other medical conditions and offer personalized advice for symptom relief. At Providence, our sleep specialists take the time to ask you detailed questions about your sleep habits, medical history and symptoms to put you on a path to better sleep quickly.

Unless you have a reversible underlying medical condition, such as a low levels of iron or you’re pregnant, RLS tends to persist and gradually worsen over time. But talking to a Providence provider can help.

“RLS does not typically go away on its own,” Dr. Chang says. “The good news is that RLS is often managed well over the long term with proper evaluation, management and follow-up by your medical team.”

Contributing caregiver

Morris B. Chang, M.D. MBA, is a sleep specialist at Providence Swedish Sleep Medicine in Issaquah, Washington.

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