Restless Legs at Bedtime: The Hidden Role of Sleep Position

Do you find yourself settling down for a peaceful evening, only to be met with an irresistible urge to move your legs? That creeping, crawling, or tingling sensation is a frustrating reality for millions. According to the Journal of Sleep Research, restless legs sleep affects approximately 5-10% of adults in Western countries, often turning what should be recovery time into a nightly battle for comfort.

While internal factors like iron deficiency and genetics are well-documented triggers, one of the most overlooked contributors is the physical environment of your bed, specifically, how your body is aligned. At Putnams, we have spent over 40 years designing comfort solutions in Devon to help people sleep better. We understand that while the urge to move feels neurological, the trigger is often mechanical.

If you struggle with leg discomfort sleeping, the solution might not just be in medication or diet, but in changing the geometry of your rest.

Why Legs Become Unsettled at Night

For many sufferers, symptoms occur almost exclusively when sitting or lying down.

Night time leg restlessness isn’t just a neurological quirk; it is often a physical response to inactivity and a lack of proper postural support.

When we lie flat, our musculoskeletal system finally begins to decompress from the day's gravity.

However, if your mattress doesn't offer the right resistance, or if your limbs are left at awkward angles, the muscles and tendons remain under subtle tension. 

Does sleep position affect restless legs? The biomechanics suggest it does. If your spine is misaligned or your hips are twisted, it creates a "pull" through the lower back that radiates down into the legs.

Dr. Andy Berkowski of the Cleveland Clinic notes that restless legs sleep symptoms are triggered by "a combination of inactivity and rest without movement," and that "the sensation is relieved with movement." By optimising your resting posture, you can reduce the mechanical irritation that often sparks this desperate urge to move.

See also - The Science of Sleep: How Understanding Your Sleep Cycle Can Improve Your Health

Circulation and Nerve Sensitivity During Sleep

To understand how to calm restless legs at night, we must look at the two primary physiological systems affected by your sleep posture: your blood flow and your nervous system.

1. The Circulation Factor

When you are walking or standing, your calf muscles act as a pump, helping to move blood back up to the heart against gravity. When lying flat, this "second heart" stops working. If your legs are positioned flat or crossed, blood flow can become sluggish, exacerbating poor circulation sleep legs issues.

Research indicates a strong link between vein health and restless legs at night. Studies published regarding venous insufficiency, where blood pools in the lower limbs rather than returning efficiently to the heart, have shown it is significantly correlated with RLS severity. In fact, clinical findings have reported an 85.9% resolution of restless legs sleep symptoms in patients after they received treatment for underlying venous reflux. While not everyone needs medical intervention, this data highlights how critical efficient circulation is to keeping legs calm.

2. Nerve Irritation

Nerves travelling from your spine to your feet pass through distinct "bottlenecks" at the hips and knees. This is particularly relevant for side sleepers. If you sleep on your side and your top leg falls forward onto the mattress, it rotates your pelvis and creates a twist in the lower back.

This rotation can stretch the sciatic nerve, creating a subtle but persistent irritation. This nerve irritation sleep factor keeps the nervous system "awake" and hyper-sensitive. The brain interprets this tension as discomfort, forcing you to shift positions constantly to find relief.

Supporting the Lower Body for Calm Rest

The key to reducing restless legs sleep disruptions is pressure redistribution. By neutralising the spine and elevating the limbs, you can lower the "neurological noise" sent to your brain.

The Power of Elevation

Lifting the legs slightly helps the veins return blood to the heart, reducing the "heaviness" and throbbing often associated with Restless Leg Syndrome (RLS). However, creating a makeshift pile of standard pillows often fails because they are unstable and compress too easily, creating uneven pressure points.

Using a dedicated foam support, like a Putnams Leg Rest or Bed Wedge, is far more effective. These are designed to elevate the legs by roughly 6–10 inches, which is the optimal height to aid venous return without straining the hips. Our contoured foam supports the best leg position for sleep comfort, allowing the calf muscles to fully switch off rather than fighting to stay on a wobbly stack of pillows.

Side-Sleepers: Alignment is Key

If you prefer sleeping on your side, the "knee-knock" effect is a primary trigger for discomfort. When knees touch or the top leg drags the hip forward, the alignment of the spine is compromised.

Placing a Memory Foam Knee Pillow between your legs instantly aligns the hips and pelvis. This simple addition prevents the lower back from twisting and takes the strain off the sciatic nerve. By keeping the legs parallel, you remove the tension that often makes legs feel jumpy or restless.

Lifestyle Adjustments to Support Posture

While correcting your sleep position is a powerful tool, it works best when paired with other healthy habits.

• Check Your Iron Levels: As noted by health experts, iron deficiency is a leading cause of RLS. If you are positioning your legs perfectly but still suffering, it is worth consulting your GP to check your ferritin levels.
• Temperature Therapy: A warm bath before bed can relax stiff muscles, while some find cool compresses help distract the nerves.
• Moderate Movement: While rigorous exercise late at night can be stimulating, gentle stretching or a short walk in the evening can help dissipate built-up energy in the limbs before you get into bed.

Frequently Asked Questions About Restless Legs Syndrome (RLS)

What are the main causes of Restless Legs Syndrome?

The most common causes of restless legs sleep include iron deficiency, which impacts dopamine levels in the brain, and genetic predisposition. Studies have shown that individuals with a family history of Restless Leg Syndrome (RLS) are more likely to experience symptoms (NINDS, 2021). Other secondary causes include chronic conditions like diabetes or neuropathy (Johns Hopkins Medicine, 2023).

Does sleep position affect restless legs?

Yes, sleep position can impact RLS symptoms. Poor spinal alignment or improper positioning can create nerve irritation sleep, making symptoms worse.

How to calm restless legs at night?

Ensure proper sleep posture with leg elevation or a knee pillow, maintain healthy iron levels, and try gentle stretching before bed.

Summary: Your Checklist for Calmer Nights

You don’t have to accept restless nights as the norm.

By addressing posture and supporting your legs properly, you can finally find relief.

• Use a knee pillow for side sleeping to prevent nerve irritation sleep.
• Elevate your legs for better circulation and reduce poor circulation sleep legs issues.
• Prioritise high-quality support for the best leg position for sleep comfort.

At Putnams, we believe comfort is a necessity, not a luxury. Support your legs and enjoy peaceful nights. Enjoy our full comfort supporting collection here.