Restless Legs Syndrome, ADHD, and Sleep
Why this matters
Sleep difficulties are very common for ADHD women.
Sometimes the difficulty is about sleep timing.
Sometimes it is about anxiety or stress.
Sometimes it is about an overlapping sleep condition.
One common and often overlooked overlap is Restless Legs Syndrome (RLS).
When RLS is present, sleep can feel impossible to settle into, no matter how tired you are or how carefully you follow sleep routines.
What is Restless Legs Syndrome
Restless Legs Syndrome is a neurological sleep-related condition that affects the body’s ability to remain still at rest.
It is defined by a strong urge to move the legs, often paired with uncomfortable sensations. These symptoms:
- begin or worsen during rest
- improve with movement
- are worse in the evening or at night
RLS is not about anxiety, willpower, or an inability to relax.
It is a nervous system pattern.
How RLS can feel
People describe RLS in many ways. The common feature is that the sensation is hard to ignore.
You might notice:
- an urge to move your legs when sitting or lying down
- discomfort that builds the longer you stay still
- temporary relief when you move, stretch, or walk
- symptoms that worsen as the day goes on
Sensations are often described as:
- crawling
- buzzing
- pulling
- tingling
- aching
- inner restlessness
Some people experience symptoms occasionally. Others notice them most nights.
How RLS affects sleep
RLS can interfere with sleep in several ways.
You may notice:
- difficulty falling asleep because your legs will not settle
- frequent repositioning in bed
- getting up to walk around at night
- sleep that feels light or fragmented
- waking up tired even after enough time in bed
Some people also experience periodic limb movements during sleep, which can further fragment rest without fully waking them.
Why RLS overlaps with ADHD
Research shows that RLS occurs more often in people with ADHD than in the general population.
Several factors help explain this overlap:
- both conditions involve dopamine-related brain systems
- iron status plays a role in nervous system signaling
- sleep disruption worsens attention, emotional regulation, and stress tolerance
Because ADHD already places strain on executive functioning, the added impact of disrupted sleep can make symptoms feel much harder to manage.
This does not mean ADHD is getting worse.
It means sleep is adding load.
Why RLS is often missed in ADHD women
RLS can be overlooked because it is often described as:
- restlessness
- anxiety
- sensory discomfort
- trouble relaxing
For ADHD women, symptoms may be attributed to mental hyperactivity rather than a physical urge to move.
Hormonal changes, pregnancy, postpartum shifts, and perimenopause can also influence RLS symptoms, which means it may appear or worsen at certain life stages.
Overlap matters
RLS rarely exists alone.
It can overlap with:
- delayed sleep timing
- insomnia
- sleep apnea
- chronic pain
- stress and trauma-related sleep disruption
When overlap is missed, people are often given advice that never had a chance to help.
What helps
Treatment depends on symptom severity and what is contributing to the pattern.
Common treatment directions include:
- evaluating iron status and treating deficiency when present
- reviewing medications or substances that may worsen symptoms
- targeted medical treatments for frequent or severe symptoms
- addressing overlapping sleep conditions
If RLS is part of your sleep picture, support that addresses the nervous system directly is often more effective than behavioral strategies alone.
If you feel exhausted, restless at night, and frustrated by sleep advice that does not work, you are not failing.
Your body may be asking for a different kind of support.
References (APA, clickable)
Cortese, S. (2005). Restless legs syndrome and attention-deficit/hyperactivity disorder. PubMed. https://pubmed.ncbi.nlm.nih.gov/16218085/
Ghayad, T. (2025). Prevalence and clinical impact of restless legs syndrome in pediatric ADHD subjects. PubMed. https://pubmed.ncbi.nlm.nih.gov/40981213/
Liu, H., Xiao, G. (2024). Association between ADHD and restless legs syndrome. Frontiers in Psychiatry. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1310259/full
Restless leg disorders in kids with ADHD. (n.d.). Nationwide Children’s Hospital Health Library. https://www.nationwidechildrens.org/conditions/health-library/restless-leg-disorders-in-kids-with-adhd
Restless legs syndrome. (n.d.). Wikipedia. https://en.wikipedia.org/wiki/Restless_legs_syndrome
Trenkwalder, C. (2024). Restless legs syndrome: Pathophysiology and diagnostic criteria. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC11539677/
Periodic limb movement disorder. (n.d.). Wikipedia. https://en.wikipedia.org/wiki/Periodic_limb_movement_disorder
Roy, M. (2018). Association between RLS and adult ADHD symptoms. PubMed. https://pubmed.ncbi.nlm.nih.gov/25555628/