How Hypertension and Restless Legs at Night Disrupt Sleep
Feeling your legs twitch, ache, or move on their own at night can be more than just annoying—it might be a sign of a condition that needs attention. When this happens along with high blood pressure (also called hypertension), it can affect your sleep, mood, and overall health. Many people don’t realize there’s a link between restless legs and hypertension, but understanding this connection can help you manage both more effectively.
Understanding Hypertension and Restless Legs
Hypertension means your blood pressure is consistently higher than normal. Blood pressure is the force of your blood pushing against the walls of your arteries. Over time, high pressure can strain your heart and damage blood vessels, increasing the risk for heart disease, stroke, and kidney problems.
Restless legs syndrome (RLS) is a condition that causes an uncontrollable urge to move your legs, especially at night. It’s often described as tingling, crawling, or itching deep inside the legs. Moving the legs usually gives temporary relief, but the symptoms often return when you’re still, like when trying to sleep.
Both conditions are common, but when they occur together, it can be a sign that something deeper is going on in the body—especially with your nervous system, blood circulation, or sleep patterns.
How the Body Works During Rest and Circulation
Your nervous system controls everything from your heartbeat to your ability to feel pain or discomfort. At night, your body naturally winds down. Your heart rate slows, and blood pressure typically dips slightly. This is called “nocturnal dipping,” and it helps your organs rest and recover.
For people with hypertension, this dipping doesn’t always happen. Some may even have rising blood pressure at night. This abnormal pattern can affect sleep quality and may make symptoms of RLS worse.
Restless legs syndrome is tied to the nervous system, especially how the brain handles dopamine, a chemical that helps with movement control. Poor circulation or nerve signaling—common in people with hypertension—may make RLS more noticeable or uncomfortable at night.
How It All Connects
Experts believe there may be a two-way relationship between high blood pressure and restless legs. Here’s how they may influence each other:
- Disrupted Sleep: RLS symptoms make it hard to fall or stay asleep. Poor sleep is known to raise blood pressure over time.
- Overactive Nervous System: Both hypertension and RLS are linked to increased activity in the sympathetic nervous system—the part that controls “fight or flight” responses. This can keep your body from fully relaxing.
- Reduced Blood Flow: If your circulation isn’t working properly due to high blood pressure, nerves in your legs may not get enough oxygen, leading to that crawling or tingling sensation.
- Shared Risk Factors: Conditions like diabetes, kidney disease, and obesity are linked to both RLS and hypertension. Certain medications can also make symptoms worse.
Even though one condition doesn’t directly cause the other, they often overlap in people with chronic health issues, particularly those over 40.
Common Causes and Symptoms
Understanding the root causes can help you manage both hypertension and restless legs more effectively. Here are some of the most common triggers and symptoms:
Causes of Restless Legs Syndrome
- Low iron levels, even without anemia
- Chronic kidney disease
- Pregnancy (especially in the third trimester)
- Neuropathy (nerve damage)
- Certain medications (antidepressants, antihistamines)
- Genetics (family history of RLS)
Symptoms of RLS
- Unpleasant sensations in the legs (burning, creeping, itching)
- Strong urge to move the legs, especially at rest
- Symptoms that get worse in the evening or at night
- Temporary relief with movement (stretching, walking)
- Trouble falling asleep or staying asleep
Common Symptoms of Hypertension
- Often has no symptoms (“silent” condition)
- Headaches or dizziness (in some cases)
- Shortness of breath
- Fatigue or confusion (in severe cases)
- Irregular heartbeat or chest pain (urgent signs)
If you’re dealing with both sets of symptoms, it’s a good idea to talk to a healthcare provider who can look at the whole picture.
When to Seek Help
Don’t ignore signs that your body is trying to send you, especially if they’re keeping you from getting restful sleep. Ongoing sleep loss can raise your blood pressure and make other health conditions worse.
Reach out to your doctor if:
- You often feel the need to move your legs at night
- You’re having trouble sleeping or staying asleep
- Your blood pressure is high and not well controlled
- You feel tired during the day even after a full night’s sleep
- You notice leg discomfort that gets worse with rest
Your provider may suggest a sleep study, blood tests (like iron levels), or changes in medication. Sometimes lifestyle changes—like more regular sleep habits, reducing caffeine, and staying active—can make a big difference.
Managing hypertension and restless legs doesn’t have to be overwhelming. With the right support and a few changes, you can sleep better, feel better, and protect your long-term health. Start by talking to your doctor and sharing all your symptoms—even the ones that seem unrelated.
Dr. Gwenna Aazee is a board-certified Internal Medicine Physician with a special focus on hypertension management, chronic disease prevention, and patient education. With years of experience in both clinical practice and medical writing, she’s passionate about turning evidence-based medicine into accessible, actionable advice. Through her work at Healthusias.com, Dr. Aazee empowers readers to take charge of their health with confidence and clarity. Off the clock, she enjoys deep dives into nutrition research, long walks with her rescue pup, and simplifying medical jargon one article at a time.
