Restless Legs Syndrome: Links to Cardiovascular Health and Helpful Nutritional Research

Educational only — not medical advice.

Restless legs syndrome (RLS) is a neurological condition characterized by an uncontrollable urge to move the legs, often disrupting sleep. While RLS is typically viewed as a quality-of-life issue, emerging research suggests it may have broader implications for cardiovascular health.

RLS and Cardiovascular Risk

A study published in Neurology (January 1, 2008) analyzed 3,433 men and women enrolled in the Sleep Heart Health Study, with an average age of 68. RLS—identified through validated questionnaires—was present in:

  • 7% of women

  • 3.3% of men

The researchers found that people with RLS were twice as likely to report cardiovascular disease or stroke compared to participants without RLS.
The association was strongest in participants who experienced RLS symptoms more than 16 times per month, suggesting that symptom severity may matter.

Nutritional Factors Linked to RLS

Iron Status

Iron deficiency is among the most researched contributors to RLS.
A study in Age and Ageing (1994;23(3):200–203) evaluated 18 elderly participants with RLS and 18 controls. Findings included:

  • Serum ferritin levels were inversely related to RLS severity

  • Supplementation with ferrous sulfate improved symptoms in 11 of 15 patients, particularly in those with the lowest ferritin

Another study in Sleep (1998;21(4):371–377) involving 27 adults found a similar pattern: lower ferritin levels correlated with more severe RLS symptoms.

Note: Iron supplementation should only be used when deficiency is confirmed, as excess iron can be harmful.

Magnesium

Magnesium may also play a supportive role. A pilot study published in Sleep (1998;21(5):501–505) gave magnesium to 10 individuals with RLS for 4–6 weeks.

Results included:

  • Reduced periodic leg movements (from 33 to 21 per hour)

  • Improved sleep efficiency

Magnesium deficiency is common, and supplementation is generally considered low-risk aside from possible loose stools with high doses.

Exercise

Physical activity may help reduce symptom severity.
A small study in the Journal of the American Board of Family Medicine (2006;19(5):487–493) assigned 23 participants to either:

  • An exercise program (aerobic + lower-body resistance training), or

  • A control group

After 12 weeks, the exercise group experienced significant symptom improvement compared to controls.

Given exercise’s broad benefits, it may be a worthwhile adjunctive strategy.

Low-Risk Options With Supportive Evidence

Although these studies are small, their findings point toward several low-risk interventions that may support individuals with RLS:

  • Iron—helpful only if ferritin is low

  • Magnesium—may reduce leg movements and improve sleep

  • Exercise—shown to reduce symptom severity

Because RLS is linked with greater cardiovascular risk in some studies, addressing nutrient status and lifestyle factors may support the body’s natural balance.