Pediatric Restless Legs Syndrome

Restless legs syndrome (RLS) is characterized by an uncomfortable urge to move the legs at night, often with other unpleasant sensations. These sensations might be described by children as "creepy-crawly" or tingling.


These uncomfortable feelings are often partially or completely relieved by movement, such as stretching or jiggling the legs, getting up and walking or running around, or simply tossing and turning. For some children, rubbing the legs may make them feel better. These feelings are typically worse in the evening and at bedtime. They can also occur during periods of inactivity such as sitting still for a long time. Because of the leg discomfort and increased leg movements, it often takes a long time for a child or adolescent with RLS to fall asleep at bedtime. This results in not getting enough sleep. Studies have shown that "growing pains" for some children may actually be RLS.


RLS may run in families, and is often related to low iron. Caffeine and certain medications may worsen RLS. In addition, some children with a chronic illness, such as diabetes, cancer and kidney disease, are at an increased risk for developing RLS.


There is no definitive test for RLS. The diagnosis is made based on the description of symptoms. A medical history and physical examination will also be done to make sure there are no other problems. An overnight sleep study may be recommended to evaluate for other sleep disorders.


How are periodic limb movement disorders and restless legs syndrome treated?

  • Good sleep hygiene: It is especially important that children and adolescents with RLS maintain good sleep hygiene. This includes keeping a regular sleep schedule and having a consistent bedtime routine. An earlier bedtime may also help children with RLS, especially if the symptoms are worse when your child is overtired.
  • Avoid caffeine: Caffeine can make PLMD and RLS symptoms worse, so all caffeine should be avoided. Caffeine can be found in many sodas, tea and coffee. Some antihistamines and cold or sinus preparations can also make symptoms worse.
  • Treat iron deficiency: If a blood test shows low iron, then iron supplements are usually recommended. The amount of iron in these supplements is typically more than what is in a regular multivitamin.
  • Change bedtime habits: Given that the leg discomfort gets worse the longer a child or adolescent with RLS lies in bed, it is usually better for your child to wait to get into bed until they are ready to turn out the light. Therefore, the bedtime routine, such as reading stories, should all occur before getting into bed.
  • Exercise: Exercising at least a few hours before bedtime can be beneficial for treating RLS symptoms.
  • Reduce the discomfort: Massage, cold compresses or a heating pad may provide temporary relief of RLS symptoms.