"Restlessness" can be used to describe a variety of symptoms, including hyperactivity, anxiety, insomnia, and much more, and can be caused by a variety of factors, both internal and external. Read more below to learn 7 possible causes of restlessness, treatments, and more.
You're lying in bed, exhausted from a full day, but you can't fall asleep. Difficulty falling asleep, even when you're tired, is one way to describe restlessness. Restlessness is feeling the need to constantly move, being unable to calm your mind, or a combination of the two. People who experience motor restlessness often feel they have cramps in their arms or legs whenever they're not moving. Alternatively, some people may have difficulty sitting still while at work or relaxing at home. Other people may experience mental restlessness, and instead have difficulty accomplishing tasks, managing time, or falling asleep at night.
Common characteristics of restlessness
If you're feeling restless, it will likely present with:
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The following details may help you better understand your symptoms and if and when you need to see a physician.
Medications or supplements
Taking certain medications or supplements may result in restlessness.
- Medications: Certain medications, such as asthma medication or ADD/ADHD medications, have a potent stimulant effect and may cause restlessness. Additionally, initiating or changing the dose of some medications used to treat schizophrenia or Parkinson's disease can cause restlessness. Stopping certain sedative medications, such as benzodiazepines, will frequently cause restlessness.
- Supplements: Excessive caffeine use is one of the most common causes of restlessness, and can be due to drinking caffeinated beverages, eating caffeine-rich foods (chocolate), or using supplements that contain caffeine.
Hormonal (endocrine) imbalances may result in restlessness.
- Hyperthyroidism: The most common hormonal cause of restlessness is hyperthyroidism, which is often accompanied by weight loss, heat intolerance, and heart palpitations.
- Hypoparathyroidism: This condition is rare, but can also lead to restlessness as well as numbness around the mouth, tingling of the hands and feet, muscle cramps, and anxiety.
Neurologic and psychiatric causes
Restlessness may be due to neurologic or psychiatric causes.
- Restless legs syndrome (RLS): RLS is a common cause of restlessness. People with RLS often experience an uncomfortable urge to move the legs, especially when lying in bed. There are many causes of RLS, including low iron stores, peripheral neuropathy, and pregnancy.
- Psychiatric causes: Restlessness can be due to psychiatric disorders, including generalized anxiety disorder (GAD), attention-deficit hyperactivity disorder (ADHD), schizophrenia, and bipolar disorder. Additionally, certain medications used to treat schizophrenia (haloperidol or fluphenazine), can cause restlessness characterized by either constant pacing, arm movement, or a persistent urge to move.
- Other neurologic causes: In rare cases, restlessness can be a symptom of an underlying neurologic condition that affects motor control, such as Wilson's Disease.
7 conditions of restlessness
This list does not constitute medical advice and may not accurately represent what you have.
Restless leg syndrome (RLS) is a chronic condition characterized by uncomfortable sensations while lying down and a strong urge to move the legs. Leg movement relieves the unpleasant sensations temporarily, often resulting in poor quality sleep. RLS is co...
The thyroid is a small, bow-tie shaped gland in your neck. Its main job is to produce thyroid hormone (known as T3 or T4), which serves a wide array of functions throughout the body.
When too much thyroid hormone is released, the body’s metabolism gets ramped up, causing symptoms ...
Premenstrual dysphoric disorder
Premenstrual dysphoric disorder (PMDD) describes a set of severe, debilitating symptoms that appear seven to ten days before a woman's menstrual period begins.
It may be caused by an abnormal reaction to the natural female hormone changes, creating a deficiency in the mood-regulating brain chemical serotonin.
Risk factors include a personal or family history of PMDD, postpartum depression, and/or general depression, as well as cigarette smoking.
Physical symptoms include headaches, abdominal pain and bloating, back pain, and breast tenderness. Psychological symptoms include severe depression, anxiety, and irritability.
Because symptoms tend to get worse over time, medical help should be sought so that quality of life can be improved.
If symptoms persist for a year or more, a diagnosis of PMDD may be made.
Treatment includes improving the diet, adding vitamin and mineral supplements, and getting regular exercise.
Birth control pills to regulate the menstrual cycle may be prescribed, along with anti-inflammatory medicines such as ibuprofen. Antidepressants in the selective serotonin reuptake inhibitor class (SSRI) are helpful in some cases.
Top Symptoms: fatigue, stomach bloating, anxiety, depressed mood, abdominal cramps (stomach cramps)
Symptoms that always occur with premenstrual dysphoric disorder:impaired social or occupational functioning, symptoms of depression, anxiety and emotional lability
Symptoms that never occur with premenstrual dysphoric disorder:constant sadness, disapearance of periods for over a year
Urgency: Primary care doctor
Mild bipolar disorder i
Bipolar disorder is a common, lifelong mental health condition of variable severity that can run in families, characterized by episodes depression and mania that last for weeks or months. Symptoms often start in adolescence or young adulthood.
Mania is a state of elevated or irritable mood, with changes in behavior, such as decreased need for sleep, increased goal-directed and risky activities, and increased talkativeness. Depressive episodes in bipolar disorder are like major depression, characterized by low mood, loss of pleasure, and low energy. Mood episodes are separated by periods of remission with stable mood and minimal difficulties with daily function.
Treatment for bipolar disorder varies from person to person, depending on symptoms and other individual factors. It often consists of medications such as mood stabilizers and antipsychotics that help reduce extreme symptoms. Hospitalization may be recommended in acute episodes. Psychotherapy can also be helpful.
Top Symptoms: fatigue, irritability, depressed mood, difficulty concentrating, trouble sleeping
Symptoms that always occur with mild bipolar disorder i: periods of feeling very energetic and needing little sleep
Urgency: Primary care doctor
Borderline personality disorder is a personality disorder, or a persistent abnormal behavior pattern manifesting during childhood or adolescence, involving unstable mood and relationships, unstable self-image, and recurrent self-harm or suicida...
A cluster headache is a type of recurring headache that is moderate to severe in intensity. It is often one-sided head pain that may involve tearing of the eyes and a stuffy nose. Attacks can occur regularly for 1 week and up to 1 year. Each period of attacks (i.e. each cluster) is separated by pain-free periods that last at least 1 month or longer. Other common headaches may also occur during these cluster-free periods.
Top Symptoms: severe headache, nausea, throbbing headache, history of headaches, sensitivity to light
Symptoms that always occur with cluster headache: severe headache
Urgency: Hospital emergency room
Depression is a mental disorder in which a person feels constantly sad, hopeless, discouraged, and loses interest in activities and life on more days than not. These symptoms interfere with daily life, work, and friendships.
Top Symptoms: fatigue, depressed mood, headache, anxiety, irritability
Symptoms that always occur with depression: depressed mood
Urgency: Primary care doctor
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Restlessness treatments and relief
When it is an emergency
You should head to the emergency room if:
- You feel like your heart is racing or beating irregularly
- You experience persistent numbness or loss of sensation:Lasting longer than a few minutes
- You're having difficulty catching your breath
- You're confused or having difficulty seeing: Or you are experiencing any auditory or visual hallucinations
When to see a doctor
Schedule an appointment with your doctor if:
- You notice a marked inability to focus on tasks for a long time
- You experience any limb tremors
- Your restlessness interferes with your ability to sleep or work
- You think a change in your medications may be causing difficulty focusing, sitting still, or falling asleep at night
You can try a few things at home before seeking medical attention for restlessness.
- Try reducing caffeine: Consider backing off on the number of cups of coffee, tea, or soda you consume per day. Alternatively, if you have difficulty falling asleep, try abstaining from caffeine after a certain time of day.
- Exercise: Exercise helps prevent many common conditions, but it also improves cognition while reducing stress and anxiety. Try incorporating regular exercise into your routine to see if it improves your symptoms.
- Never stop taking or adjust medication doses without asking your doctor. It is possible that a side effect of your medication could be causing your restlessness, but make sure to call your doctor and ask for their advice before making any changes.
FAQs about restlessness
Here are some frequently asked questions about restlessness.
Why do I feel restless at night?
Restlessness at night is due to poor sleep hygiene, and anxiety is often caused by life events. Sleep hygiene is a set of behaviors that involves abstaining from substances like nicotine, alcohol, and caffeine before sleeping as well as avoiding using blue-light emitting screens like phones, laptops, or tablets. It is also useful to exercise more than two hours before sleep and to sleep and wake at the same time every day.
Can anxiety cause restlessness?
Yes, anxiety can cause restlessness. It is common when you're anxious about life events to feel unsettled. It often helps to find an activity that allows you to release your anxiety safely. Speak with a trusted medical, religious, or psychiatric counselor.
How do I stop tossing and turning in my sleep?
The first step to preventing tossing and turning during sleep is to determine the cause of poor sleep quality. There are many different techniques to improve sleep quality. One of the most common and most effective is altering one's behavior to improve "sleep hygiene." This change involves creating a regular sleep and wake time, avoiding caffeine, smoking, and alcohol within a few hours of sleep, keeping a cool sleep environment, and restricting the use of screens before rest.
Why do I feel restless all the time?
Constant restlessness can be a sign of many different conditions. Many psychological conditions, including post-traumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD), depression, generalized anxiety disorder (GAD), and bipolar disorder can result in frequent or constant restlessness. It can also occur following life events, new medications, or even changes in diet or consumption of caffeine or sugar.
What causes restlessness during sleep?
Commonly, life events or being particularly worried about events occurring soon can cause restlessness during sleep. If you are experiencing restlessness and find yourself preoccupied with a particular thought, this event may be causing your restlessness. Alternatively, attention deficit hyperactivity disorder (ADHD) can also cause increased restlessness. Finally, lack of sleep can also cause restlessness.
Questions your doctor may ask about restlessness
- Is one of your eyelids drooping like in this picture? This is called ptosis.
- Are you experiencing a headache?
- Have you ever forced yourself to vomit after eating?
- Are you sleepy during the day?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
- Lutz EG. Restless Legs, Anxiety and Caffeinism. Journal of Clinical Psychiatry. 1978;39(9):693-698. NCBI Link.
- Pereira JC, Pradella-Hallinan M, Lins Pessoa Hd. Imbalance Between Thyroid Hormones and the Dopaminergic System Might Be Central to the Pathophysiology of Restless Legs Syndrome: A Hypothesis. Clinics (Sao Paulo). 2010;65(5):548-554. NCBI Link.
- Kallweit U, Werth E, Seiz A, et al. Psychiatric Comorbidities in Restless Legs Syndrome. The Journal of Neuropsychiatry and Clinical Neurosciences. 2016;28(3):239-242. Psychiatry Online Link.
- Wilson Disease. National Organization for Rare Disorders. Updated 2018. NORD Link.
- Jayakody K, Gunadasa S, Hosker C. Exercise for Anxiety Disorders: Systematic Review. British Journal of Sports Medicine (BJSM). 2014;48(3):187-196. NCBI Link.
- Irish LA, Kline CE, Gunn HE, Buysse DJ, Hall MH. The Role of Sleep Hygiene in Promoting Public Health: A Review of Empirical Evidence. Sleep Medicine Reviews. 2014;22:23-36. NCBI Link.