Restless Leg Syndrome: The 7 Most Common Causes (and Which Ones You Can Fix Tonight)

Restless leg syndrome (RLS) is a common neurological condition that causes uncomfortable sensations in the legs and an urge to move them—especially in the evening or at night. People often describe the feeling as crawling, tingling, pulling, or aching deep inside the legs. While it isn’t usually dangerous, restless leg syndrome can seriously affect sleep, mood, and quality of life.

The good news? Some causes of restless leg syndrome can be improved quickly—sometimes even tonight. Others require medical support, but understanding the root cause is the first step toward relief.

Below are the seven most common causes of restless leg syndrome, based on well-established medical research and clinical guidelines, along with practical guidance on what you can do.

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1. Low Iron Levels (Iron Deficiency)

Iron deficiency is one of the most common and most treatable causes of restless leg syndrome.

Iron plays a key role in dopamine production, a brain chemical involved in movement control. When iron levels are low—especially in the brain—RLS symptoms can worsen.

Clues this may be your cause:

• Fatigue or weakness
• Pale skin
• Shortness of breath with exertion
• RLS that is worse at night

What you can fix tonight:

• Avoid caffeine and alcohol in the evening, as they can worsen iron-related symptoms.
• Pair iron-rich foods (like beans or leafy greens) with vitamin C earlier in the day.

What requires a doctor:

• A blood test for ferritin (iron storage)
• Iron supplements or infusions if levels are low

Do not start iron supplements without medical advice—too much iron can be harmful.

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2. Sleep Deprivation and Irregular Sleep Schedules

Poor sleep doesn’t just result from restless leg syndrome—it can make it worse, creating a frustrating cycle.

Disrupted sleep alters dopamine signaling and increases sensory sensitivity, both of which can intensify RLS symptoms.

What you can fix tonight:

• Go to bed and wake up at the same time.
• Reduce screen use for at least 60 minutes before sleep.
• Keep your bedroom cool, dark, and quiet.

Even small improvements in sleep routine can noticeably reduce symptoms.

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3. Certain Medications

Several common medications are known to trigger or worsen restless leg syndrome.

These include:

• Some antidepressants (especially SSRIs and SNRIs)
• Antihistamines found in many allergy and sleep medications
• Certain nausea or antipsychotic drugs

What you can fix tonight:

• Avoid over-the-counter sleep aids or allergy medications that contain antihistamines unless advised by a doctor.

What requires a doctor:

• Reviewing your medication list
• Adjusting doses or switching to alternatives

Never stop a prescribed medication without medical guidance.

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4. Caffeine, Alcohol, and Nicotine

Stimulants and depressants can both disrupt dopamine and sleep quality, worsening restless leg syndrome.

Caffeine (coffee, tea, soda, chocolate) is a frequent trigger.
Alcohol may feel relaxing at first but often worsens symptoms later in the night.
Nicotine is strongly linked to more severe RLS symptoms.

What you can fix tonight:

• Avoid caffeine after early afternoon.
• Skip alcohol in the evening.
• If you smoke, avoid nicotine close to bedtime.

Many people notice improvement within days of reducing these substances.

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5. Pregnancy

Restless leg syndrome is common during pregnancy, especially in the third trimester. Hormonal changes and iron deficiency are likely contributors.

The reassuring part: pregnancy-related RLS usually resolves after delivery.

What you can fix tonight:

• Gentle leg stretching before bed
• Warm baths or heating pads (not too hot)
• Side sleeping with a pillow between the legs

What requires a doctor:

• Checking iron levels
• Discussing safe treatment options during pregnancy

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6. Chronic Health Conditions

Several medical conditions are associated with restless leg syndrome, including:

• Kidney disease
• Diabetes (especially with nerve damage)
• Parkinson’s disease
• Peripheral neuropathy

In these cases, RLS is often a secondary condition, meaning it stems from another health issue.

What you can fix tonight:

• Keep blood sugar well-controlled if you have diabetes.
• Avoid long periods of sitting—gentle movement can help.

What requires a doctor:

• Managing the underlying condition
• Considering prescription treatments for RLS if symptoms are severe

If you have kidney disease or neurological symptoms, ongoing medical care is essential.

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7. Genetics (Family History)

If restless leg syndrome runs in your family, you may have a primary or inherited form of RLS. This type often starts earlier in life and isn’t caused by another illness.

While you can’t change your genes, symptoms can still be managed effectively.

What you can fix tonight:

• Establish consistent sleep and movement routines
• Try light leg massage or stretching before bed

What requires a doctor:

• Long-term management strategies
• Medications if lifestyle changes aren’t enough

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How to Get Clarity on Your Symptoms

Because restless leg syndrome can overlap with other conditions—such as leg cramps, nerve issues, or circulation problems—it’s important to assess your symptoms carefully.

You may find it helpful to start with a free, online symptom check for Restless Leg Syndrome. This can help you understand whether your symptoms match RLS and what next steps to consider.

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When to Speak to a Doctor

While restless leg syndrome is usually not life-threatening, you should speak to a doctor if:

• Symptoms are severe or worsening
• Sleep disruption is affecting your daily life
• You have signs of iron deficiency, nerve damage, or kidney disease
• Symptoms begin suddenly or affect only one leg
• You are pregnant or have a chronic medical condition

A doctor can rule out serious causes, run appropriate tests, and help create a treatment plan that fits your needs.

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The Bottom Line

Restless leg syndrome is common, real, and often manageable. Some causes—like caffeine use, poor sleep habits, or evening medications—can be improved as soon as tonight. Others, such as iron deficiency or chronic illness, need medical attention but are still very treatable.

You don’t have to live with constant discomfort or sleepless nights. Start with small, practical changes, consider a symptom check, and involve a healthcare professional when needed. With the right approach, most people with restless leg syndrome can find meaningful relief.