Diagnostic Criteria for Newly Defined Pediatric Restless Sleep

child sleeping
child sleeping
A committee of 10 sleep clinicians developed a set of 16 consensus questions, conducted a comprehensive literature search, and extensively discussed potential diagnostic criteria.

Consensus diagnostic criteria for pediatric restless sleep disorder (RSD) have been established, as outlined in Sleep Medicine.

Though restless sleep has been a frequent complaint since the 1970s and is increasingly characterized as the core feature of a unique disorder, no clinical disorder has been established.

To determine if there is sufficient evidence to propose criteria for the diagnosis of RSD, a task force of 10 sleep experts was formed to review the data and clinical experience on RSD and to reach a consensus on diagnostic criteria.

The task force agreed on 16 consensus questions to guide the establishment of a new disorder and the development of diagnostic criteria. Based on the early results of the review of existing literature, the task force unanimously agreed there was sufficient evidence for a clinical entity characterized by restless sleep that did not meet criteria for other sleep disorders but that did significantly disrupt sleep and impact daytime function. Most existing evidence and experience related to children aged 6-18 years and was insufficient in younger children and adults. Therefore, this age group was the focus of the task force’s efforts.

Clinical diagnosis of RSD is based both on subjective patient reporting as well as data from a single night of video-polysomnography. There are 8 diagnostic criteria that this data must meet to support a diagnosis of RSD. The patient or a close companion must present with a complaint of “restless sleep,” involving gross, clearly visible, movements of major muscle groups lasting for ≥1 second during sleep and are not related to other disorders (such as seizures, sleep-related rhythmic movements, etc). Restless sleep must occur ≥3 times per week for ≥3 months, result in clinically significant impairment on daytime functioning, and not be better explained by another disorder or environmental factor.

The efforts of this task force resulted in the establishment of diagnostic criteria for RSD for use in both clinical and research settings. Though the requirement of video-polysomnography may make it more difficult to diagnose RSD, the authors explained that “this more conservative approach is considered warranted until other methods of objective measurement” may be verified.


DelRosso LM, Ferri R, Allen RP, et al. Consensus diagnostic criteria for a newly defined pediatric sleep disorder: restless sleep disorder (RSD). Sleep Medicine. 2020;75:335-400.