Background: Restless legs syndrome (RLS) with insomnia is presumed to be associated with antenatal depression. RLS without insomnia, however, has not been investigated in association with antenatal depression. We aimed to examine whether RLS without insomnia during pregnancy is associated with antenatal depressive symptoms.
Methods: This cross-sectional study used data from a randomized controlled trial (RCT) assessing antenatal depressive symptoms among Japanese pregnant women. The participants were 2,108 women who attended the RCT at 16-20 weeks of pregnancy. RLS, insomnia, and antenatal depressive symptoms were assessed using the Cambridge-Hopkins questionnaire short form, Insomnia Severity Index, and Edinburgh Postnatal Depression Scale, respectively. Associations of antenatal depressive symptoms with RLS and insomnia were examined using logistic regression analysis, adjusting for age, partner, education, children, and planned pregnancy.
Results: Of the total participants, 206 (9.8%) had antenatal depressive symptoms; 80 (3.8%) had RLS. The mean age (standard deviation) was 30.4 (4.6) years. RLS was positively associated with antenatal depressive symptoms: the odds ratio was 2.30 (95% confidence interval, 1.28-4.16). RLS without insomnia was positively associated with antenatal depressive symptoms, as well as insomnia without RLS and RLS with insomnia: the odds ratio was 2.44 (95% confidence interval, 1.09-5.46) for RLS without insomnia, 3.83 (2.78-5.28) for insomnia without RLS, and 5.80 (2.42-13.92) for RLS with insomnia, compared to neither RLS nor insomnia.
Conclusions: We observed the positive association between RLS without insomnia and antenatal depressive symptoms, suggesting the importance of assessing and treating RLS without insomnia during pregnancy for the reduction of antenatal depressive symptoms.
Keywords: Antenatal depressive symptoms; Edinburgh postnatal depression scale; Insomnia; Restless legs syndrome.
© 2025. The Author(s).