• Adela

Does Low Iron Levels Affect Sleep?

Updated: Jun 25

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Iron Supplementation and Restless Sleep

Once in a while, I will meet a family whose baby seem like they’re just more restless than usual and beyond the standard sleep prop dependency. These babies tend to flail around more and have a hard time getting into a deep sleep. There is a new theory that iron supplementation may help remedy this restlessness.

Full disclosure, I typically write these posts using peer-reviewed studies that have been evaluated, replicated and evidence based. But today I’m focusing on something that’s a little on the speculative side because I find this interesting for anyone with a seemingly “restless” baby. Check-in with your medical doctor to discuss your specific situation.

Iron Deficiency

So we’re all familiar with iron, right? Everybody knows about iron, the essential mineral that helps red blood cells carry oxygen around the body. That function right there makes iron a downright essential component of our circulatory system and therefore our overall health.

Iron deficiency, commonly known as anemia, also happens to be the single most common nutritional deficiency worldwide. The vast majority of those cases are in developing countries, but the numbers in North America and Europe are still alarmingly high. In the US alone, there are around 2.8 million visits to physicians annually where anemia is the primary diagnosis.

So, in short, a LOT of people aren’t getting enough iron.

Now, if you follow health news at all, you’ve also probably heard about Restless Leg Syndrome (RLS) lately. It is also known as Willis-Ekbom Disease, a condition that makes your legs feel restless. People with RLS describe the sensation as an irresistible urge to move accompanied by uncomfortable sensations in their lower limbs. Standing up and moving their legs typically remedies the feeling almost instantly, but only temporarily. Symptoms occur more frequently when individuals are sleeping or lying down.

RLS is also a bit of a mystery when it comes to its cause. According to the National Institute of Health, “In most cases, the cause of RLS is unknown. However, RLS has a genetic component and can be found in families where the onset of symptoms is before age 40. Specific gene variants have been associated with RLS. Evidence indicates that low levels of iron in the brain also may be responsible for RLS.”

So now comes the big question… could those restless babies that I was talking about earlier possibly be suffering from some variety of Restless Leg Syndrome due to an iron deficiency?

In a 2008 joint study from the Southern Illinois University and Carle Clinic Association, 1.9% and 2% of children and adolescents respectively were shown to have Restless Leg Syndrome. A 2020 study from the BC Children's Hospital Research Institute entitled Iron deficiency and sleep - A scoping review, found that iron supplementation was tremendously effective in treating a number of sleep disorders, including RLS. Sample sizes were small and the data collection process leaves a little to be desired, but it’s still a good indication that iron plays a big role in the quality of sleep.

Restless Leg Syndrome Diagnosis

Unfortunately, diagnosing RLS isn’t an exact science. There are no markers or proteins to test for. It’s done by a doctor’s evaluation of the patient’s description of their symptoms, and for that reason, the only people who have been diagnosed are individuals who are capable of explaining what they’re experiencing.

And guess who that leaves out…

You guessed it; Babies, toddlers, and as theorized in a 2005 study, a significant number of children.

A 2005 Mayo Clinic study established rates of restless legs syndrome in children, finding that, “almost 6 percent of children seen in Mayo's sleep clinic have the disease. The study also notes that the most common risk factors for the disease in kids are family history of restless legs syndrome and iron deficiency.”

Restless Sleep Disorder

Restless Sleep Disorder, as researchers have described it, hasn’t been thoroughly researched yet, but evidence suggests that it could be an early variant of restless leg syndrome which in some cases could be caused by insufficient iron levels. Or, as they more eloquently put it in their conclusion, “We have characterized clinically and polysomnographically children with RSD and attempted a new diagnostic category. We also have identified an association between RDS and iron deficiency. Future larger studies are needed to confirm these findings and evaluate the natural progression of restless sleepers.”


So again, I’m not trying to offer medical advice here. I just found this fascinating and wanted to share it with all of you. If your little one is one of those overly animated sleepers, it might be worth asking your pediatrician to check their iron levels. Even if it’s not the cause of their sleepless nights, anemia is something you’ll want to remedy.

And remember, if your baby fits into the other category, the much more prominent category who have trouble falling asleep because of their dependency on a “prop,” I’m here to help you solve that problem. It may not be as simple as taking an iron supplement, but I can say unreservedly that it’s worth the effort to get your baby sleeping through the night.

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