Do children get the restless legs syndrome?

Does your child toss and turn at bedtime? Are they sleepy, irritable, aggressive or ADHD like during the day? Check if they have RLS.

The Restless Leg Syndrome (RLS) can affect children. About 2% to 4% of children have clinically significant RLS. Diagnosing RLS in children is difficult as it may be hard for a child to describe their symptoms. Sometimes RLS in children is misdiagnosed as "growing pains", bedtime resistance or attention deficit hyperactivity disorder (ADHD). Children with RLS commonly have a parent with the condition.

Restless legs syndrome symptoms in children

The RLS leg sensations described by children are similar to those reported by adults (see "Symptoms" page).

Figure 1: Child with excessive daytime sleepiness

Behavioral and sleep-related signs that may suggest that a child has RLS include:

Difficulty falling or staying asleep: The child may resist bedtime, pace around, or toss and turn in bed.
Daytime effects: Lack of sleep often leads to irritability, poor concentration, aggression, hyperactivity, ADHD, learning challenges and daytime sleepiness.
Involuntary movements: Frequent kicking or leg twitching during sleep. This could be due to Periodic Limb Movement Disorder (PLMD) which frequently accompanies RLS. A PLMD index of >5/hr is considered indicative of the RLS.

Causes of childhood restless legs syndrome

The causes of childhood RLS are very similar to the causes in adults (see The "Causes" page). Some common causes include:

Genetics: It frequently runs in families.
Iron Deficiency: Low iron levels are a common contributor, and doctors often check iron status. See "Neurobiological influences" for more information on iron and RLS.
Dopamine Imbalance: Researchers believe it may be linked to insufficient activity of the brain chemical dopamine. See "Neurobiological influences" for more information on dopamine and RLS.
Medications: Certain over-the-counter medications, particularly those containing antihistamines (like diphenhydramine/Benadryl), can trigger or worsen symptoms. For further information see the "Medications that worsen RLS" page.

Symptom management of restless legs syndrome in children

Likewise, the management of RLS symptoms is very similar as for adults (see the "Treatment" page). Management strategies usually focus on lifestyle changes and addressing deficiencies:

Iron: In children with RLS, serum ferritin concentration should always be measured and iron supplementation should be considered if the serum ferritin concentration is below 50μg/L.. Administration of iron at serum ferritin levels greater than 50 μg/L could be considered on an individual basis for older adolescents. Oral ferrous sulfate 3 mg/kg in either tablet or liquid form should be administered once daily or once every other day before bed. If oral iron therapy is not tolerated or is not accompanied by a satisfactory rise in serum ferritin concentration, consideration can be
given to IV administration of iron.
Sleep Hygiene: Maintain a consistent sleep-wake schedule and avoid screen time an hour before bed. For ages 3 to 5-years 10 to 13-hours of sleep is needed. 5 to 13-years 9 to 11-hours of sleep is required. Whilst 14 to 17-years 9 to 10-hours of sleep is needed. Keep a regular bedtime routine, this trains the brain into knowing when it is time to sleep.
Physical Activity: Regular, moderate exercise during the day is helpful, but avoid vigorous activity immediately before bedtime.
Comfort Measures: Massage, warm baths, or cool/warm compresses can help soothe the legs before bed.
Dietary Adjustments: Focus on an iron-rich diet (meat, beans, dark leafy greens, etc.) and avoid caffeine (soda, chocolate, tea).
Medications: As in adults, first-line drug therapy should be the gabapentinoids. Gabapentin (5 to 10mg/kg) and pregabalin (2 to 3 mg/kg) can be used if iron is not needed or is ineffective.

Prevalence

If symptoms are affecting your child's daily life, consult a pediatrician. They may suggest iron supplementation or, in some cases, specific medications if lifestyle changes are insufficient.

Visit the Cleveland Clinic "How To Help Children With Restless Legs Syndrome" and "Pediatric Restless Legs Syndrome: More Common (and Impactful) Than You Might Think" by Pediatrics Nationwide.

Last reviewed: 23/09/2026