Diagnosing Restless Legs Syndrome

Updated August 27, 2025

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Table of Contents

Symptom Review and Physical Exam
Potential Additional Testing
Frequently Asked Questions

Key Takeaways

Though there’s no test for restless legs syndrome, doctors diagnose this movement disorder by asking about symptoms and ruling out other conditions.
Conditions that produce symptoms similar to RLS include kidney disease, diabetes, iron deficiency, pulmonary fibrosis, ADHD, pregnancy, and irritable bowel syndrome.
Additional testing for RLS includes a blood draw that checks iron, blood sugar, and thyroid hormone levels and nerve conduction studies that can identify problems in the muscles or nerves.

Restless legs syndrome (RLS), a sleep-related movement disorder that causes a crawling sensation in the legs and an uncontrollable need to move them, can be tricky to diagnose. Its symptoms often overlap with other conditions, and there’s no medical test that can diagnose it Trusted Source National Institute of Neurological Disorders and Stroke (NINDS) NINDS aims to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. View Source . Instead, doctors assess your symptoms against diagnostic criteria.

Symptom Review and Physical Exam

To diagnose restless legs syndrome, first, your doctor will do a physical exam and ask about your symptoms, medical history, medications you take, and your family history. They may also ask if you use caffeine, alcohol, or tobacco, since those substances can worsen symptoms Trusted Source American Family Physician View Source .

You may be diagnosed with RLS based on whether you experience these criteria:

An unpleasant crawling, pulling, or creeping sensation in the legs and an uncontrollable urge to move them
Progressive worsening of symptoms during rest, in the evening, and at night
Symptoms improved or resolved by moving the legs
Disrupted sleep from frequent leg movements and fatigue during the day
Restlessness that also involves the arms
No other medical conditions present to explain symptoms

Leg movement can look like kicking, stretching, pacing, or rubbing against deep sensations in the lower limbs. These are voluntary movements. If these movements are involuntary, they are likely not restless legs syndrome Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. View Source .

Conditions With Symptoms Similar to RLS

Other health conditions can cause RLS or similar symptoms, so these need to be ruled out before you can receive an RLS diagnosis:

Kidney disease: Almost 70% of people with end-stage renal disease have RLS Trusted Source Experimental and Therapeutic Medicine View Source . Some studies suggest low iron levels from kidney disease and dialysis can contribute to the condition Trusted Source Arquivos de Neuro-Psiquiatria View Source .
Diabetes: Diabetes can cause neuropathy, or damage to nerves throughout the body, including your legs. This can cause RLS-like symptoms. Diabetes itself can also increase your risk for RLS, but managing day-to-day blood sugar levels can help with RLS Trusted Source National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) NIDDK research creates knowledge about and treatments for diseases that are among the most chronic, costly, and consequential for patients, their families, and the Nation. View Source .
Iron deficiency: Experts believe low iron levels can affect how your neurotransmitters function, and iron deficiency is common among people with RLS. Thus, ideal iron levels when treating RLS are usually on the high side of normal Trusted Source International Journal of General Medicine View Source .
Pulmonary fibrosis: This chronic lung disease can cause low oxygen levels in your bloodstream. When your legs don’t get enough oxygen, RLS symptoms can develop Trusted Source Neurology Neurology is the medical journal of the American Academy of Neurology. View Source .
Irritable bowel syndrome (IBS): People with IBS have a higher chance of developing restless legs syndrome, and those with RLS also develop IBS more often Trusted Source Sleep Medicine View Source .
Attention-deficit hyperactivity disorder (ADHD): This neurological disorder and RLS both stem from the same brain areas, and up to 43% of people with ADHD experience RLS symptoms Trusted Source Sleep Medicine Reviews View Source .
Pregnancy: Pregnancy can increase your probability of developing RLS by decreasing iron and vitamin D levels. Gestational diabetes can further increase the risk Trusted Source Annals of Thoracic Medicine View Source .

Some medication side effects can also mimic restless legs syndrome, including those for nausea, depression, allergies, and some antipsychotics. If you have one of the conditions above, that doesn’t mean you can’t treat RLS, but knowing about them can help your provider decide which treatment options might work best.

Potential Additional Testing

To rule out the presence of other health conditions that can cause RLS symptoms, your doctor may recommend a few different tests.

Blood Tests

No laboratory test can diagnose restless legs syndrome, but blood tests can identify potential causes of RLS symptoms, like low iron levels, kidney failure, and pregnancy. Sleep apnea can also exacerbate restless legs syndrome. Providers typically start with a ferritin (iron) level and a basic metabolic panel to check for kidney function and blood glucose.

Nerve Conduction Studies

Your nerves serve as a high-speed road system for messages to travel from your brain to every area of your body and back, and nerve conduction studies test how well your nerves can do their job. While these studies can’t diagnose RLS, they can help your doctor identify nerve damage and rule out other diagnoses Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. View Source . You may need one or both types of nerve conduction studies:

EMG test (electromyography): This test checks the electrical signals in your muscles while you rest. Healthy muscles should have no electrical activity at rest, so the presence of activity can signal a problem.
Nerve conduction study: This test can reveal how fast electrical signals move along your nerves, and a slower or weaker signal can point to nerve damage.

Sleep Study

A sleep study (polysomnography) can’t diagnose RLS, but it can offer helpful information about other sleep disorders that could be worsening restless legs syndrome Trusted Source Neurotherapeutics View Source Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source . It can also help your doctor diagnose other sleep disorders, which could be affecting your sleep and making RLS symptoms worse Trusted Source National Heart, Lung, and Blood Institute (NHLBI) The NHLBI is the nation's leader in the prevention and treatment of heart, lung, blood and sleep disorders. View Source .

Frequently Asked Questions

Who is most at risk for developing RLS?

Between 5 and 15% of people in North America and Europe have restless legs syndrome (RLS), and it occurs more often as age increases. Women experience RLS more than men, and pregnant people are two to three times more likely to have it than those who aren’t pregnant.

Should I see a sleep specialist for RLS symptoms?

Yes, if you’re experiencing symptoms of restless legs syndrome—especially if they’re interfering with your sleep or daily life—it’s a good idea to consult a sleep specialist or your primary care provider. Sleep specialists are trained to recognize the signs of RLS, rule out other possible conditions, and recommend appropriate treatment.

Is there a test for restless leg syndrome?

No specific test exists to diagnose restless legs syndrome, but your doctor can offer a diagnosis based on your symptoms, health history, medications, family history, and by ruling out other conditions through examinations, blood work, and other diagnostic testing.

Is restless legs syndrome hard to diagnose in children?

Yes, restless legs syndrome can be hard to diagnose in children because this age group has a more difficult time describing their symptoms, often leading to a misdiagnosis. Restless legs may also present differently than it does in an adult Trusted Source Mayo Clinic Proceedings View Source .

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Written By

Abby McCoy, RN, Contributing Writer

Abby McCoy is an experienced RN who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She holds a Bachelor’s of Science in Nursing from St. Louis Univeristy and has practiced nursing all over the world from San Francisco, CA, to Tharaka, Kenya. She now writes health content for trusted health outlets like Everyday Health and Next Avenue.

Medically Reviewed by

Lulu Guo, MD, Sleep Medicine Physician

Dr. Lulu Guo is a graduate of the prestigious Medical Scholars program at Michigan State University and was admitted into medical school at the age of seventeen after completing undergraduate studies in two years. She is double board-certified in Family and Sleep Medicine.

Learn more about our Editorial Team

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