By Arabella Peterson Wellness 11.03.2025

Tossing, Turning, and Tingling at Night? You Could Have This Overlooked Sleep Condition

Restless Leg Syndrome could be the reason behind your sleepless nights.

Do you ever lie in bed with a tingling, crawling, itching or throbbing feeling deep within your legs? There’s an irresistible urge to relieve the discomfort by walking, stretching or shaking. Falling asleep is a battle as you struggle to focus on anything else but these frustrating sensations.

If this sounds familiar, you might be experiencing the lesser-known (but surprisingly common) condition, Restless Leg Syndrome.

Psychologist and CEO of the Sleep Health Foundation, Dr Moira Junge estimates that around 10-15% of the population is diagnosed with the condition, but many more likely have it without knowing what it is.

She describes the symptoms as deeply unsettling, explaining, “It’s usually at night, pre-sleep when we're really tired and still, there's this intense need to move your limbs. It's mostly legs, but sometimes it's upper limbs as well. Sometimes it’s a creepy crawly feeling and that agitating sense of needing to move your legs, but sometimes it can be full blown pain. It can be excruciating in its extreme form.”

Like many others, Perth-based artist Carla Adams didn’t realise what was happening when she started experiencing symptoms about a year ago. “I was coming into Peri-menopause. It was such a weird feeling and I had no idea what it was at first. It was a feeling of extreme discomfort. A bit like an itch but deep under the skin,” she says.

“It's interesting that it's classified as a sleep disorder,” notes Dr Junge, “It's technically a neurological disorder, but sleep disorder specialists deal with Restless Leg Syndrome (RLS) as well as neurologists because mostly it manifests when someone's trying to rest or sleep.”

While the condition is neurological in nature, the physical sensations experienced are by no means imagined or exaggerated. The underlying cause is believed to involve dopamine dysfunction in the brain, which plays a key role in motor control. RLS impacts more women than men, and research shows that people with neurodevelopmental disorders like ADHD are far more likely to experience it. Though we’re learning more about the underlying causes and triggers of RLS, there’s still much to uncover about why it affects some people more severely than others.

For Carla, the combination of ADHD and peri-menopause contributed to a nightly struggle to relax. “I feel like the perfect storm of those two conditions causes so much havoc!” She says. “One of my sensory nightmares is itchiness and while RSL doesn’t itch as such, it’s a similar pervasive, constant feeling so I find it really hard to wind down after I have an episode.”

According to Dr Junge, some other conditions and factors that RLS is commonly linked to is iron deficiency, certain medications, obstructive sleep apnea, menopause or most frequently – pregnancy.

“Pregnancy is a classic time for it because you've usually got low iron and you're really sleep deprived, so it's sort of a cruel irony that it emerges in sleep deprived people.”

She continues, “It’s important to note that while RLS is quite common, it’s relatively unknown. Insomnia and obstructive sleep apnea are the two most common disorders, followed by RLS, but they usually coexist. It's very rare to find someone with just sleep apnea without insomnia or RLS. Nearly everyone has all three things.”

For those suffering from RLS, another level of frustration can be trying to explain the condition to others, and seek a diagnosis. Many people with RLS don’t recognise their symptoms as part of a medical condition, and instead attribute them to stress, muscle cramps, or simply restlessness. Common misdiagnoses include anxiety, insomnia or arthritis. As Carla says, “It’s a feeling that is so different to anything else I’ve experienced before so it can be really difficult to explain the sensations and you end up sounding a bit crazy – especially to someone who has never heard of RLS before.”

Unsurprisingly, discomfort in the legs is a major warning sign of RLS, but there are other symptoms to look out for. According to Dr Junge, “one of the biggest factors is what we call EDS – excessive daytime sleepiness. It’s one thing to be tired – we're all tired sometimes – but if you're getting to sleep at a reasonable time, eating well, exercising but still have the urge to nap during the day, that's a telltale sign for either Obstructive Sleep Apnea or Restless Leg Syndrome.”

If restless legs are stopping you from falling asleep, your first step should be lifestyle adjustments. This might mean taking warm, relaxing baths, using heat packs (or ice packs), getting leg massages, stretching before bed, reducing your caffeine and alcohol intake, exercising regularly and implementing healthy sleep habits. For Carla, keeping her mind occupied is a crucial coping mechanism, “Distraction is the only thing that helps me fall asleep,” she says. “If I am suffering from RSL, I usually read until I drift off.”

However, it’s not just getting to sleep that’s the problem, it’s your sleep quality. RLS affects people when they’re awake, but during sleep, it manifests as Periodic Limb Movements During Sleep (PLMS). Dr Junge explains, “As you sleep, you’ll be periodically jerking your legs. It's almost like a metronome. If you have a bed partner, they’ll probably notice, but if not, you’ll just feel absolutely wretched the next day because overnight it’s been like having your brain flicked with an elastic band all night.”

“If you were to look at their sleep architecture, someone with this condition will probably be heading into deep sleep, but then be jolted back up to light sleep. They don't have a lovely transition into the normal sleep stages which supports a high quality of rest. On a sleep study, it would show that they've had a micro arousal maybe 20 times an hour, a lot of sleep disturbance, a lot of micro waking.”

Carla eventually discovered that skipping her ADHD medication contributed to worsening restless legs, usually starting early evening and lasting into the night. If you’re unsure about what might be triggering your RLS, she suggests tracking your experiences and physical sensations. “Keep notes about what you have done on the days you experience RLS so you can identify a possible trigger. It can often be something you wouldn’t even think about.”

If you think you’re living with Restless Leg Syndrome, keep a record of your symptoms and lifestyle changes and book an appointment with your GP. From here, they might recommend you take magnesium, folate or iron supplements (Dr Junge recommends Ferrograd C), or refer you to a specialist where further evaluation, a sleep study or Cognitive Behavioural Therapy for Insomnia (CBT-I) will potentially be the next step. If RLS is interfering with your sleep and daily life, seek professional advice – better rest could be closer than you think.