Is RLS Misdiagnosed as ADHD?

PostedSeptember 10, 2025

UpdatedSeptember 12, 2025

ByMy Patient Advice

Author: Victoria Rowe, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Yes, RLS misdiagnosis ADHD can happen, as restless legs syndrome (RLS) and attention deficit hyperactivity disorder share overlapping symptoms such as restlessness, difficulty concentrating, and irritability. A lack of proper assessment can cause diagnostic confusion, where sleep disruption from RLS is treated as ADHD.

Why RLS Can Look Like ADHD

RLS is a neurological condition that causes an uncontrollable urge to move the legs, often accompanied by uncomfortable sensations, particularly in the evening or at night. The resulting poor sleep can cause daytime fatigue, inattention, and irritability behaviours that mimic ADHD symptoms.

In children especially, hyperactive behaviour during the day may be a response to tiredness rather than a sign of ADHD. Without recognising the connection to nighttime leg discomfort, healthcare providers may overlook RLS as a possible cause.

The Importance of ADHD Differential Diagnosis

A thorough ADHD differential diagnosis should consider other conditions that can produce similar symptoms. In the case of suspected RLS, sleep history, reports of nighttime leg movements, and iron level testing can be valuable. Sleep studies may also help confirm an RLS diagnosis.

Avoiding Misdiagnosis

It is vital to correctly identify RLS, as its treatment, such as improving iron levels or prescribing dopamine-based medication, differs greatly from the way ADHD is managed. Treating the wrong condition could leave symptoms unresolved and quality of life diminished.

Understanding the risk of RLS misdiagnosis ADHD ensures that both patients and clinicians approach diagnosis with a wider perspective, reducing errors and improving outcomes. For more on diagnostic confusion and effective ADHD differential diagnosis, consider reaching out to providers like ADHD Certify.

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to Sleep disorders.

Victoria Rowe, MSc

Author

Victoria Rowe is a health psychologist with a Master’s in Health Psychology and a BS in Applied Psychology. She has experience as a school psychologist, conducting behavioural assessments, developing individualized education plans (IEPs), and supporting children’s mental health. Dr. Rowe has contributed to peer-reviewed research on mental health, including studies on anxiety disorders and the impact of COVID-19 on healthcare systems. Skilled in SPSS, Minitab, and academic writing, she is committed to advancing psychological knowledge and promoting well-being through evidence-based practice.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.