Peroneal Electrical Nerve Stimulation in Pregnancy for Restless Legs Syndrome

Inclusion Criteria: * Age ≥18 years * Pregnant individuals between 21 and 26 weeks' gestation at enrollment * Singleton pregnancy without known fetal anomalies * Confirmed clinical diagnosis of Restless Legs Syndrome (RLS) according to International Restless Legs Syndrome Study Group (IRLSSG) criteria, confirmed by a sleep medicine specialist to exclude RLS mimics * Able and willing to provide informed consent * Able and willing to comply with study procedures, including device usage, questionnaires, adherence diaries, and follow-up assessments up to 3 months postpartum Exclusion Criteria: Pregnancy-related: * History of preterm labor * Known fetal anomalies identified prior to enrollment Neurological and neuromuscular disorders: * Pre-existing neuromuscular disorders affecting balance or gait * Severe peripheral neuropathy involving the lower legs * Epilepsy or history of seizures Cardiovascular and circulatory conditions: * History of deep vein thrombosis (DVT) * Circulatory conditions contraindicating peroneal nerve stimulation (PNS) device use Dermatological conditions: * Skin conditions at device application sites * Known allergy to device materials Other sleep disorders: • Inadequately treated severe primary sleep disorders other than RLS (e.g., untreated severe sleep apnea, severe insomnia unrelated to RLS) Device and treatment experience exclusions (based on RESTFUL trial criteria): * Prior use of the study device or any neurostimulation device for RLS treatment * Presence of active medical implants (e.g., pacemakers, spinal cord stimulators) Other medical conditions: * Participants undergoing dialysis treatment * Severe psychiatric conditions (e.g., bipolar disorder, psychosis, severe anxiety or depression) that may interfere with adherence or accurate symptom reporting * Any condition deemed by investigators to pose safety risks or impede participation Other exclusions: * Unable or unwilling to operate the device safely and independently * Unable to participate reliably in follow-up assessments or complete self-reported diaries