What constitutes restless sleep in children?

Parents commonly report in sleep questionnaires and in person to clinicians that their child is restless in sleep. There is little agreement on what constitutes restless sleep and so the significance of this observation is uncertain and its relationship to parental concerns about daytime tiredness, learning difficulties or problematic behaviours is unclear. Restless sleep may be secondary to other sleep problems such as obstructive sleep apnoea or periodic limb movement disorder. However, there may be some evidence to support the concept of restless sleep as a primary sleep problem. Certainly, more evaluation of restless sleep with validated tools and agreed definitions should be the starting point in clarifying the significance of restless sleep in childhood.