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Medically reviewed guide · Last updated: 23 July 2026 · Reading time: approx. 9 min.
Inner restlessness: check the body first, then the mind
At a glance
What is it?A feeling of tension, being driven or "not being able to switch off" — often with nervousness, fidgetiness or palpitations
Usually harmless?Often yes — temporary restlessness during stress or lack of sleep is normal. Persistent restlessness, however, often has a specific cause
Common triggersToo much caffeine, an overactive thyroid, low blood sugar, medication or withdrawal — and only after that stress and anxiety
Warning signsInner restlessness with a racing heart and chest pain, shortness of breath, or with suicidal thoughts or severe panic
Key distinctionRule out a physical cause first (e.g. thyroid, caffeine) before putting everything down to "nerves"
What to do?Check caffeine, sort out sleep and exercise, try a breathing exercise — and have physical causes checked if suspected
Understand and document inner restlessness
Note when the restlessness occurs, what you have drunk or taken and how you have slept — spotting patterns is the first step. With brite. Free of charge.
Inner restlessness is the feeling of not being able to settle — tense, driven, "wound up" or unable to switch off. Some describe it as nervousness and fidgetiness, others as a tingling or a vague tension in the stomach or chest. Physical symptoms often come with it: palpitations, sweaty hands, trembling, a queasy feeling in the stomach or difficulty sitting still.
Almost everyone knows inner restlessness from stressful phases — before an exam, in a demanding situation, after too little sleep. That is normal and passes. It becomes interesting and important when the restlessness occurs without any recognisable trigger, persistently or ever more strongly. Then it is worth searching systematically for the cause — and in a specific order.
The most important point first
Inner restlessness is quickly dismissed as "psychological" or "nervous". That is often correct — but not always. Many physical causes such as an overactive thyroid, too much caffeine or low blood sugar produce exactly this feeling. That is why it is worth checking the body first before putting everything down to stress.
2. Harmless or serious?
Most forms of inner restlessness are not dangerous, but rather an expression of being overloaded, of a stimulant such as caffeine or of a readily treatable cause. Even so, it is worth distinguishing two situations:
Temporary, situational restlessness: occurs during demanding phases, can be linked to a trigger (stress, coffee, lack of sleep) and settles again. Usually harmless.
Persistent or unexplained restlessness: lasts for weeks, occurs without a clear trigger, grows stronger or is accompanied by other symptoms (weight loss, a racing heart, sweating, sleep problems). Here a cause should be sought.
Inner restlessness should be taken seriously above all in two combinations: together with a racing heart, chest pain or shortness of breath (a physical emergency) and together with suicidal thoughts or a severe anxiety or panic crisis (a mental-health emergency). Both are described in more detail in the chapter "When to see a doctor".
3. Check physical causes first
Unlike many guides that start straight away with stress and the mind, with inner restlessness it is worth taking the opposite approach: check the physical causes first. They are common, often easy to spot and usually readily treatable.
Too much caffeine: coffee, black and green tea, cola, energy drinks and some pain or cold remedies contain caffeine. It can directly cause nervousness, palpitations and restlessness — especially in sensitive people or in the afternoon/evening.
Overactive thyroid: an overactive thyroid speeds up the metabolism and typically triggers inner restlessness, a racing heart, sweating, trembling and weight loss. A simple blood test clarifies this. More on this under overactive thyroid.
Low blood sugar (hypoglycaemia): low blood sugar — for example after going a long time without eating or with diabetes on insulin — leads to trembling, sweating, ravenous hunger and inner restlessness. This improves quickly after eating.
Medication and withdrawal: some active substances can trigger restlessness, for example certain antiepileptics such as Levetiracetam, corticosteroids, asthma inhalers or thyroid hormones. Stopping sedatives or sleeping pills such as Lorazepam, as well as alcohol or nicotine withdrawal, also typically produces inner restlessness.
Heart rhythm: a fluttering or racing heart can feel like restlessness. Conversely, restlessness can also throw the heart out of rhythm — the two are closely linked.
Others: fever, anaemia, dehydration, too little sleep or the menopause can also promote inner restlessness.
The simplest first test
For one to two weeks, consistently cut down on caffeine (including hidden sources) and pay attention to regular meals and sleep. If the restlessness improves noticeably, you probably had a physical, everyday trigger — and not a "nervous disorder".
4. Psychological causes: stress and anxiety
Only once physical triggers are unlikely or have been ruled out do the psychological causes come to the fore — they too are very common and should be taken seriously.
Stress and overload: ongoing pressure at work, in the family or from worries keeps the body in an "alarm state". Inner restlessness is then often the first noticeable sign.
Anxiety disorders: with a generalised anxiety disorder, constant inner restlessness is one of the core symptoms — often with rumination, tension and sleep problems. More on this under anxiety disorders.
Lack of sleep and sleep disorders: too little or poor sleep intensifies restlessness — and restlessness in turn disturbs sleep. A vicious circle, which can be described in more detail under sleep disorders.
Depression: depressive illnesses can also manifest in a driven, restless form (agitated depression) instead of in listlessness.
Important: physical and psychological causes do not rule each other out. They often reinforce one another — for example when too much coffee increases nervousness and the nervousness in turn robs you of sleep. That is precisely why it helps to look at both levels.
5. Self-check: what to watch out for
Before you classify inner restlessness, gather a few simple observations. They help you and the practice to find the cause more quickly.
Timing and duration: When does the restlessness occur, how long does it last — occasionally or almost daily?
Stimulants: How much caffeine (coffee, tea, cola, energy drinks) do you drink and when? Alcohol, nicotine?
Meals: Does the restlessness occur when you are hungry or after going a long time without eating, and does it improve after eating?
Accompanying symptoms: A racing heart, sweating, trembling, weight loss, diarrhoea — signs pointing to the thyroid? Or rumination, anxiety, sleep problems?
Medication: Have you recently started or stopped a medication or changed the dose?
A simple log kept over one to two weeks often makes patterns visible surprisingly quickly — and is the best basis for a good conversation with your doctor.
Keep an eye on restlessness and its triggers
With brite you record the timing, caffeine, sleep and accompanying symptoms — the best basis for you and the practice to get to the bottom of the cause together.
Inner restlessness is often harmless, but there are situations in which you should have it checked or act immediately.
You should have it checked by a doctor promptly if the restlessness persists for weeks, occurs without a recognisable reason, keeps getting stronger or is accompanied by symptoms such as weight loss, a racing heart, sweating, trembling or sleep problems. Even if the restlessness noticeably affects your daily life or sleep, an appointment makes sense — both for a physical check (e.g. the thyroid) and for psychological relief.
Get help immediately
If inner restlessness comes together with suicidal thoughts or a severe anxiety or panic crisis, you are not alone: call the emergency number 112 or the free telephone counselling service (Telefonseelsorge) on 0800 111 0 111 or 0800 111 0 222 (round the clock, anonymous). If the restlessness occurs together with a racing heart, chest pain or shortness of breath, call the emergency number 112 immediately — this can be a physical emergency.
7. Diagnosis
To find the cause, the practice usually proceeds step by step — first the common physical causes, then the psychological ones. A good log speeds this up considerably.
Heart rate and rhythm — a racing heart or an arrhythmia?
Medication check
Checks whether preparations or a withdrawal explain the restlessness
Psychological conversation
Assesses stress, anxiety, rumination, sleep and mood
Table scrollable to the right
Because inner restlessness has so many possible causes, the order matters: first the easily measurable physical factors, then the psychological ones. That way nothing treatable is overlooked.
8. What you can do yourself
Check and reduce caffeine: less coffee, tea, cola and energy drinks — especially in the afternoon and evening. Often the most effective first step.
Sort out your sleep: fixed bedtimes, less screen time and excitement before going to bed. Good sleep noticeably dampens restlessness.
Exercise: regular exercise and endurance activity (e.g. walks, cycling) release tension and have a demonstrably calming effect.
Breathing and relaxation exercises: slow exhaling (e.g. 4 seconds in, 6 seconds out), progressive muscle relaxation or short mindfulness exercises calm the nervous system in the moment of restlessness.
Eat regularly: balanced meals keep blood sugar stable and prevent the low-blood-sugar phases that cause restlessness.
Keep a log: When does the restlessness occur, with which trigger? This helps you to spot patterns and discuss them with the practice.
Spot the triggers, regain your calm
brite helps you document inner restlessness, caffeine, sleep and possible triggers over time — free of charge and ad-free.
Inner restlessness comes and goes — and often has more than one cause. Anyone who records the timing, caffeine, sleep and accompanying symptoms over time finds patterns faster and gives the practice the decisive clues. brite makes that easy.
Health history — document episodes of restlessness, caffeine, sleep and accompanying symptoms over time and bring an overview to your appointment. Track your history
Intake reminder — if medication is prescribed, brite reliably reminds you to take it and helps you not to forget any preparation. Set up a reminder
Interaction check — checks whether the medication you take promotes inner restlessness or combines unfavourably. Check now
Digital medication plan — all medications clearly in one place, so that your GP and specialists have the full overview. To the medication plan
Usually not. Temporary inner restlessness during stress, coffee or lack of sleep is normal. Persistent or unexplained restlessness, however, often has a specific, readily treatable cause and should be checked. It becomes serious with restlessness accompanied by a racing heart, chest pain or shortness of breath, or by suicidal thoughts or severe panic — then get help immediately.
Because many physical causes such as an overactive thyroid, too much caffeine, low blood sugar or medication produce exactly this feeling — and are usually easy to spot and treat. If the restlessness is prematurely attributed only to the mind, a treatable physical cause can be overlooked.
Yes, very often. Coffee, black and green tea, cola, energy drinks and some painkillers contain caffeine, which can directly cause nervousness, palpitations and restlessness. A simple test is to consistently cut down on caffeine for one to two weeks and observe whether the restlessness eases.
Yes. An overactive thyroid speeds up the metabolism and typically triggers inner restlessness, a racing heart, sweating, trembling and weight loss. That is why, with newly occurring, persistent restlessness, a blood test of the thyroid values is often part of the work-up.
Yes. Some active substances such as certain antiepileptics, corticosteroids, asthma inhalers or thyroid hormones can trigger restlessness. Stopping sedatives or sleeping pills, as well as alcohol or nicotine withdrawal, also typically produces inner restlessness. Never stop medication on your own; discuss any changes with the practice.
If physical causes are unlikely and the restlessness is accompanied by persistent rumination, worries, tension and sleep problems, an anxiety disorder may be behind it. It is readily treatable. A conversation with your GP practice or a psychotherapy practice helps to make sense of it.
In the moment of restlessness, slow breathing exercises (about 4 seconds in, 6 seconds out), progressive muscle relaxation, a short walk or fresh air help. In the longer term, less caffeine, well-ordered sleep, regular exercise and fixed meals work. If the restlessness persists, it is worth searching for the cause.
Have it checked if the restlessness persists for weeks, occurs without a reason, grows stronger or is accompanied by weight loss, a racing heart, sweating or sleep problems. With restlessness accompanied by suicidal thoughts or severe panic, get help immediately (emergency number 112 or telephone counselling 0800 111 0 111 / 0800 111 0 222). With restlessness accompanied by a racing heart, chest pain or shortness of breath, call the emergency number 112.
Yes, very closely. Too little or poor sleep intensifies inner restlessness, and restlessness in turn makes falling asleep harder — a vicious circle. Fixed bedtimes, less caffeine in the evening and relaxation before going to bed can improve both. With persistent sleep problems, a medical check is worthwhile.
gesundheitsinformation.de (IQWiG): Inner restlessness, anxiety and overactive thyroid. gesundheitsinformation.de
German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN): Anxiety disorders. dgppn.de
S3 guideline on the treatment of anxiety disorders. AWMF. awmf.org
This article is for general information and does not replace medical advice, diagnosis or treatment. If inner restlessness comes together with suicidal thoughts or severe panic, please get help immediately: emergency number 112 or telephone counselling (Telefonseelsorge) 0800 111 0 111 or 0800 111 0 222. With restlessness accompanied by a racing heart, chest pain or shortness of breath, call the emergency number 112 immediately.
