What Is Restless Sleep & What Causes It?

By: SleepScore Labs  |  April 12th, 2022

When most people go to bed, they hope they can have an uninterrupted night of sleep and wake up feeling refreshed and energized to take on the day. But this experience is not always the case. 

Some might experience an activity-filled night’s sleep that leaves them feeling tired the next day. They may struggle to fall asleep, wake up multiple times at night, toss and turn from time to time, endlessly pull at the beddings, and wake up feeling worse than the previous night.

If you can relate to this experience, you’ve had what many describe as “restless sleep.” Although sleep experts are beginning to recognize “restless sleep disorder (RSD)” as a potential new sleep diagnosis in children and teens, generally, restless sleep isn’t a recognized medical disorder. 

Restless sleep affects people of all age groups. Here’s what you need to know about this condition, its causes, symptoms, and how to treat it. 

What Is Restless Sleep?

Restless sleep is a subjective experience, but can be objectively measured through poor sleep quality, nightly sleep disruption, frequent nightly muscle movements, and daytime impairment. Because there’s no operationally defined medical definition that describes this phenomenon, people have different ideas of what it is to have a restless sleep. 

Generally, restless sleep describes sleep characterized by experiences that disturb nighttime rest and limit restorative sleep. 

According to the Journal, Sleep Medicine Reviews, in 1979, the Association of Sleep Disorders Centers and the Association for the Psychophysiological Study of Sleep introduced “restlessness” during sleep as a symptom of sleep disorders like sleep apnea and insomnia and described it as “persistent or recurrent body movements, arousals, and brief awakenings (that occur) in the course of sleep.” 

According to emerging sleep medicine literature, restless sleep disorder is a new but still unrecognized sleep disorder in children accompanied by “large body movements and repositioning that lasts all night with at least five body movements per hour and a significant impact on daytime behaviors.” 

What Are the Symptoms of Restless Sleep?

Some signs of restless sleep include:

  • Difficulty sleeping
  • Multiple nighttime awakenings
  • Frequent movements
  • Falling off the bed
  • Feeling half asleep
  • Wake up feeling tired and groggy
  • Irritability during the day
  • Excessive daytime sleepiness
  • Poor physical and cognitive performance during the day.

What Causes Restless Sleep? 

Restless sleep may affect your sleep duration, quality, and efficiency. A variety of factors can trigger or contribute to restlessness during sleep.

  • Sleep Environment

Experts describe the ideal sleep environment as dark, quiet, and cool. However, conditions like noise, bright light, uncomfortable bedding, and heat or extreme cold may limit a person’s ability to have this ideal sleep environment and a well-rested night.

  • Underlying Medical Condition

People with certain medical conditions may struggle to sleep well at night. These conditions may be physical, mental, or emotional and may manifest symptoms that cause restlessness at night.

Restless sleep may also be a symptom of sleep disorders, including:

Other medical conditions associated with poor sleep are:

  • Pain

Pain can make it difficult for a person to fall asleep. And when they do, sleep may be fragmented and unrefreshing.

What’s more, poor sleep can also lower pain tolerance and increase chronic pain symptoms, resulting in restless and poor quality sleep. 

  • Stress

Stress is another condition that may contribute to restless sleep. Studies suggest that daily life stress and traumatic stress can limit a person’s likelihood of restful sleep. 

Stress can make it difficult to initiate sleep and make a person wake up multiple times without any external disturbance. Research shows that 43 percent of US adults report that stress has interrupted their sleep in the past month. 

  • Diet 

Your evening time consumption may also impact your nighttime rest. People who take heavy or spicy meals, caffeine, tobacco, chocolate, and alcohol in the evening time may experience difficulty winding down and getting a relaxing sleep. 

  • Exercise

Exercising is a habit that everyone can benefit from for healthy living. Research suggests that it may promote healthy aging, increase a person’s lifespan, slow down the development of up to 40 chronic illnesses, and improve quality of life. 

However, evidence suggests that engaging in vigorous exercise less than an hour before bedtime might disturb sleep. 

  • Loneliness

Loneliness is another condition unrecognized as a medical disorder, but it significantly impacts a person’s health and well-being.

A 2013 study suggests that loneliness may intensify vigilance, limiting how much a person can wind down and restful sleep. Another 2021 study suggests that older adults who feel lonely may experience inadequate and non-restorative sleep.

  • Napping

Napping for less than 30 minutes in the middle of the day may improve alertness, productivity, and performance. 

However, if you have longer evening naps, you may struggle to go to sleep and stay asleep. A study suggests an association between frequent napping and poor sleep duration and efficiency.

  • Poor Sleep Hygiene 

Sleep hygiene includes practices that support healthy sleep. Some of these practices, as recommended by the CDC, include:

  • Going to bed and waking up at the same time every night.
  • Limiting heavy meals, alcohol, and caffeine around evening time.
  • Being physically active.
  • Keeping your bedroom comfortable and sleep-friendly. 
  • Restricting the use of electronic devices in the room. 

However, suppose you don’t practice these habits. In that case, you’ll engage in poor sleep hygiene, which may affect your nighttime rest. 

What Is the Difference Between Insomnia and Restless Sleep? 

Insomnia is a sleep disorder that occurs when a person experiences difficulty falling and staying asleep and difficulty having adequate and quality sleep even when their circumstances support sleep. 

Symptoms of insomnia are:

  • Difficulty falling asleep
  • Difficulty maintaining sleep 
  • Frequent nighttime awakenings 
  • Early morning awakenings
  • Short sleep duration
  • Poor daytime functioning 

Before a person can be diagnosed with insomnia, they must show symptoms that:

  • Result in significant functional impairment
  • Occur for up to 3 nights a week for at least 3 months
  • Are not associated with other physical or mental disorders. 

Only a healthcare professional can diagnose a person with insomnia.

On the other hand, restless sleep is not recognized as a sleep disorder. Symptoms of restless sleep are often seen as subjective and may vary from person to person. These symptoms don’t have to meet any criteria for a person to report that slept restlessly.

A person may also experience restless sleep frequently or infrequently. And this experience may and may not be associated with an underlying sleep disorder or medical condition.

How Do You Treat Restless Sleep?

It’s normal to experience restless sleep once in a while. Maybe you had too much alcohol before bedtime or went to bed later than your usual bedtime. However, if you experience persistent restless sleep and your sleep quality affects your daytime functioning, consider seeing a doctor for potential diagnosis and treatment.

Following sleep hygiene recommendations may help reduce your chances of experiencing restless sleep and improve your sleep health. Here are a few sleep hygiene practices:

  1. Avoid alcohol, caffeine, nicotine, and heavy meals during the evening time: These substances can disturb sleep quality and duration and make you feel restless during sleep. 
  2. Engage in self-care activities: Practices that soothe your body and mind may help relieve stress, improve relaxation, and promote restful sleep. Examples of self-care practices are journaling, going for walks, yoga, mindful breathing, taking warm baths, investing time in your hobbies, e.t.c.
  3. Exercise regularly: Exercising during the day supports your body’s internal clock—the circadian rhythm—which regulates sleep-wake cycles. It also promotes your body’s ability to relax in the evening and have undisturbed sleep. 
  4. Follow a regular sleep time: Try to go to bed and wake up at the same times every day of the week, including weekends, to support proper sleep health.
  5. Make your environment a sleep-haven: Keep your bedroom quiet, cool, and comfortable and use it for only sleep and relaxation activities.
  6. Avoid long evening naps: Frequent and evening napping can make it harder for you to fall asleep at nighttime. Experts recommend avoiding them for better sleep. 
  7. Limit electronic device use: Using electronic devices close to and during bedtime may increase alertness and vigilance and cause you to struggle with falling asleep. Avoid using non-essential devices in your bedroom for a good night’s rest. You can also get blue-light blocking glasses to reduce your exposure to blue light, which increases alertness. 

How Does Restless Sleep Impact All Age Groups?

People across different age groups experience restless sleep. Their symptoms may vary according to age group, and they may be associated with underlying sleep disorders or medical conditions.

Here’s what restless sleep looks like in these age groups:

Infants

CDC recommends that infants from 0 to 12 months have 12 to 17 hours of sleep a day. Studies suggest that from 6 months, an infant may start experiencing interrupted sleep at night as 27.9 percent to 57 percent of infants between 6 and 12 months from the study didn’t sleep all through the night (six or eight hours at night). 

However, the study found that having interrupted sleep during infancy doesn’t impact mental or psychomotor development. These sleep interruptions also didn’t affect the mother’s mood. Therefore interrupted sleep during infancy may doesn’t necessarily mean restless sleep. 

Plus, experts also state that infants can have five hours of uninterrupted sleep until the third month, when they may start having a fragmented sleep, especially when they’re ill. 

Infants may show symptoms of sleep disturbances associated with restless sleep9oow like:

  • Nighttime awakening
  • Difficulty falling asleep
  • Need to co-sleep with parents

Toddlers

Parents may also notice restlessness in the way their toddlers sleep. Researchers mention three factors that influence an infant’s sleep: temperament, soothability, and fear. 

Toddlers with active temperaments and high fear levels may have less sleep. Toddlers with high soothability, the ability to be comforted easily after being upset, have longer sleep time. These factors may also impact how restful or restless a toddler’s sleep is. 

Toddlers may also experience restless sleep due to fear of sleeping alone or staying up late. 

Children

Restless sleep is a common sleep complaint in children. Studies suggest that restless sleep in children may be a symptom of medical or sleep conditions like 

  • Sleep-disordered breathing (SDB)
  • Pain
  • Asthma
  • Teeth grinding
  • Restless legs syndrome (RLS)
  • Autism spectrum disorders (ASDs)
  • Periodic leg movements
  • Attention-deficit/hyperactivity disorder (ADHD).
  • Sleep terrors
  • Sleepwalking
  • Sleep talking

Interestingly, experts are beginning to recognize restless sleep as a new and separate disorder in children. Children with restless sleep disorder may show symptoms like:

  • Fragmented sleep
  • Frequent body movements during sleep that occur almost every night
  • Daytime impairment
  • Irritability and hyperactivity

A small study shows that restless sleep disorder occurs in 7.7 percent of children.

Teens

The CDC recommends that teens get 8 to 10 hours of sleep. However, research suggests that 72.7% of students get less than 8 hours of sleep on weekdays. 

Teens may go to bed late, struggle to fall asleep, and experience sleep disturbances because of habits like excessive social media use, alcohol and drug use, partying, and engaging in other nighttime social activities, e.t.c.

Adults 

The prevalence of sleep disturbances and problems in adulthood is widely studied. 

According to the CDC, adults should have more than 7 hours of sleep. However, more than 1 in 3 US adults don’t get enough sleep. Restless sleep may contribute to poor sleep duration and sleep quality. 

Research also suggests that 50 to 70 million adults have sleep disorders. Some sleep disorders may manifest as restlessness during sleep, among other signs. Plus, evidence indicates that 60 percent of adults experience sleep disturbances like restless sleep. 

Older Adults 

Although sleep disturbances are not a normal part of aging, they’re common in older adults. Some sleep changes people may experience as they grow older that may also be associated with restless sleep include:

  • Short sleep duration 
  • Frequent daytime naps
  • Increased nighttime awakenings
  • Difficulty falling asleep
  • Decreased slow-wave sleep.

Several conditions prevalent in older adults are associated with poor sleep and may impact a person’s ability to have well-rested nights. Some of them are:

  1. Nocturia
  2. Loneliness
  3. Chronic pain
  4. Chronic illnesses
  5. Cognitive decline
  6. Sleep apnea

Restless sleep may impact a person’s ability to have a refreshing and restorative night’s rest. Signs of restless sleep are different from person to person. Generally, if you wake up feeling like you barely slept or need more sleep, you may have had a restless night’s sleep. Sleep hygiene practices may help you have consistent well-rested nights. However, if you have frequent restless sleep, consider seeing a doctor to get needed treatment.