Struggling With Restless Legs at Night? Discover 4 Surprising Triggers

If you’ve ever felt an irresistible urge to move your legs at night—that tingling sensation that won’t quit—you’re not alone. Restless legs syndrome affects millions of women, and the good news? There are sneaky triggers doctors say you can address. We spoke with medical experts about what causes restless legs, including surprising risk factors you may not realize are connected and actionable solutions to help.

What is restless legs syndrome?

“Restless leg syndrome (RLS) is a neurological disorder characterized by an uncontrollable, sometimes intense, urge to move the legs,” says Brynna Connor, MD, Healthcare Ambassador at NorthWestPharmacy.com. “It is often accompanied by uncomfortable sensations (described by patients as crawling, twitching and/or tingling) that typically present in the evening or at night, especially when sitting or lying down.”

“Technically, when it happens at night instead of during the day, it is called periodic leg movement disorder of sleep (PLMD),” adds Jacob Teitelbaum, MD, author of From Fatigued to Fantastic.

“Moving the legs can provide relief; however, many find that the symptoms return shortly after,” says Dr. Connor. “Individuals suffering from RLS may also find it difficult to fall or stay asleep due to the irresistible urge to move.”

If this condition sounds like something you may have experienced occasionally in your life, you may be wondering if you have RLS, but that’s not always necessarily the case.

“Occasional restless legs are not uncommon,” says Dr. Teitelbaum. “It is the classic rhythmic pattern triggered by odd discomfort in the legs that characterizes it being RLS versus other causes. RLS worsens with rest and at nighttime and decreases with activity. If it has the classic RLS pattern, but happens less than twice a week, it is considered to be intermittent RLS.”

What causes restless legs?

Your brain may not be the first part of your body that comes to mind when thinking about your legs, but it could be playing a role.

Dr. Teitelbaum says restless legs syndrome and periodic leg movement disorder of sleep, “are both caused by a deficiency of the brain neurotransmitter called dopamine, which is the key player in movement disorders.”

4 sneaky causes of restless legs

But there are several other connections between things happening in your body and restless legs, including several that will likely come as a surprise to you.

Low Iron

“Iron deficiency (particularly low levels of iron in the brain) is actually one of the most common causes of restless legs,” says Dr. Connor. “This is because iron plays a crucial role in helping the brain make dopamine, which is a neurotransmitter that controls muscle movement. When iron levels are too low, dopamine signaling can be disrupted, which can subsequently cause the uncontrollable movements/urges and uncomfortable sensations in the legs.”

If you’re experiencing restless legs due to iron deficiency treatment, treating the deficiency itself is key. “If it’s found that you are iron-deficient, your doctor may prescribe iron supplements, as well as a diet high in iron-rich foods, such as lean red meat, beans, lentils, tofu and/or leafy greens,” says Dr. Connor. “Eating vitamin C also helps your body absorb iron better.”

Menopause hormone shifts

“It’s not usual for women to notice symptoms of restless leg syndrome or experience the worsening of existing symptoms during menopause,” says Dr. Connor. “This is because estrogen levels decrease during menopause, which can impact how the brain utilizes dopamine and regulates sleep.”

If you’re in menopause, but not quite sure if menopause is playing a role in your restless leg symptoms, Dr. Teitelbaum provides guidance. “If the restless legs began with perimenopause and were worse around the woman’s menses, low estrogen is the likely trigger,” says Dr. Teitelbaum.

If menopause is the culprit for your restless legs, utilizing hormone replacement therapy to help account for the lack of estrogen could be a good place to start. Dr. Teitelbaum says “a bioidentical hormone replacement with an estrogen patch with bioidentical progesterone” could be a good place to start.

Certain medications

“Certain medications, such as antidepressants, antihistamines and anti-nausea medications, can all trigger and/or worsen RLS symptoms by interfering with dopamine and nerve signaling,” says Dr. Connor. “If the onset of RLS symptoms starts, or if they become worse, after starting a course of these medications, talk to your doctor about potential alternatives that won’t contribute to or worsen restless legs.”

Your doctor can help identify medications that treat your original condition without triggering RLS symptoms.

Other deficiencies

Low iron is not the only deficiency that could be causing your restless legs. Dr. Teitelbaum explains that low vitamin B12 can cause nerve injury, magnesium deficiency can cause muscle and nerve irritation and low folate impacts nerve health.

This is an issue as nerve damage can interfere with brain and muscle signaling, says Dr. Connor. To address these potential deficiencies, Dr. Teitelbaum recommends opting for a high-quality multivitamin.

While restless legs syndrome may sound like a particularly scary condition, it’s nothing to worry about too much but it’s worth having a conversation with your doctor to understand what exactly is behind your case of restless legs. “It’s not dangerous, basically being a nuisance,” says Dr. Teitelbaum. “But it should cause you to ask your doctor to look for the other contributing factors discussed above.”

Understanding what’s triggering your restless legs is the first step towards better sleep and reclaiming nights of true rest.

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This story was originally published November 9, 2025 at 11:30 AM.