Restless legs syndrome in pregnancy: Frequency, sleep quality, and questionnaire-defined risk of obstructive sleep apnea syndrome.

AIM: This study aimed to investigate the frequency of Restless Legs Syndrome (RLS) in pregnant women and its relationship with sleep quality and the questionnaire-defined risk of obstructive sleep apnea syndrome (OSAS).

METHODS

This cross-sectional study included 208 pregnant women, and RLS was diagnosed according to the International Restless Legs Syndrome Study Group criteria. RLS severity and disease-specific quality of life were evaluated using the International Restless Legs Syndrome Rating Scale (IRLS) and the Restless Legs Syndrome Quality of Life (RLS-QoL) questionnaire. Sleep quality and daytime sleepiness were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS), while the risk of OSAS was evaluated using the STOP-Bang and Berlin questionnaires.

RESULTS

RLS was identified in 69 women (33.2%) and was more common in the third trimester than in the earlier trimesters (39.0% vs. 23.8%). Women with RLS had lower serum iron and hemoglobin levels, and higher ESS, PSQI, and STOP-Bang scores; poor sleep quality and a high questionnaire-defined OSAS risk were also significantly more frequent in this group. Even after adjusting for trimester, hemoglobin, and weight gain, women with RLS were approximately 6.6 times more likely to have poor sleep quality (OR: 6.56, 95% CI: 3.45-15.77, p=0.001); RLS presence also significantly increased the STOP-Bang score (β=0.320, p<0.001).

CONCLUSIONS

RLS is a common condition during pregnancy, particularly in the third trimester, and is independently associated with poorer sleep quality and a higher questionnaire-defined OSAS risk after adjusting for trimester, hemoglobin, and gestational weight gain. These findings suggest that pregnant women with RLS may benefit from routine assessment for sleep-related problems to support timely diagnosis and appropriate management.