About 10 percent of the adult population in the United States suffers from restless leg syndrome (RLS) according to the National Sleep Foundation but that number is significantly higher when talking about people with ADHD. In those with ADHD, about 44 percent suffer from RLS according to a review of previous studies published in the European Neurological Review in 2008.
What is Restless Leg Syndrome?
RLS is a neurological condition that is characterized by an overwhelming need to move your legs. It can also cause other unpleasant sensations in the legs, including pain, throbbing, pulling, creeping. Because symptoms mostly occur at night, it can cause difficulty when falling asleep or the sensations can wake you up. While RLS does not directly cause symptoms of daytime sleepiness, inattention or hyperactivity, these are sometimes indirect symptoms - caused by the constant disruption of sleep.
The Relationships Between ADHD and Restless Leg Syndrome
A number of studies have reported there is a link between ADHD and RLS. In 2008, researchers looked at several previous studies that showed a relationship between the two. According to the researchers, there are three theories as to what would link ADHD and RLS:
Sleep disturbances caused by RLS are creating symptoms similar to ADHD. This can include inattention,impulsivity and motor hyperactivity. In children especially, daytime sleepiness can result in hyperactivity being used as a way to stay alert and awake.
Symptoms of RLS, such as the overwhelming need to move around, might be mistakenly seen as hyperactivity. The uncomfortable sensations in the legs might cause inattention. Although RLS symptoms are more prevalent during the night, they do sometimes occur during the day.
Both conditions might have a common denominator: dopamine deficiencies. Some of the reviewed studies showed that both conditions are linked to dopamine deficiencies or dysfunctions of the dopamine systems in the brain.
While some information points to RLS symptoms exacerbating symptoms of ADHD because of disrupted sleep patterns, the scientists also indicated that these two conditions can be comorbid, or exist as two separate conditions. This, however, doesn’t explain the high rate of those with ADHD who also have RLS.
Signs of RLS
An overwhelming urge to move your legs. This feeling may or may not be accompanied by uncomfortable sensations in your legs such as itching, pulling or feeling “creepy-crawly.” While this feeling is more prevalent at night, it can also occur during the day.
You might experience periodic limb movement (PLMS). This is when you experience repetitive movement of your legs, usually every 20 to 30 seconds. PLMS can last for several minutes or longer and can occur off and on throughout the night making it difficult to stay asleep. Not everyone with RLS experiences PLMS and it is not necessary for a diagnosis of RLS.
Symptoms of RLS are worse at night, especially when lying down. They can also occur during the day when you are at rest. Symptoms can begin or worsen during rest and the longer you are resting, the more severe the symptoms.
Your symptoms reduce when you move your legs. Symptoms may not disappear completely, but you feel significantly better when you start moving around.
What to Do if You Think You Have RLS
RLS is considered to be a lifelong, chronic condition. If you think you might have RLS, the first step is to talk with your family doctor. Because it is a neurological problem, your doctor might refer you to a neurologist for further evaluation. There are a number of lifestyle changes that can help to reduce symptoms of RLS. Your doctor might suggest giving up or reducing caffeine, alcohol and smoking and starting a moderate exercise program. He might request blood tests to determine if you have deficiencies in iron, folate or magnesium and, if so, suggest treatment or food choices to combat those deficiencies.
There are also some medications that can help to reduce symptoms, however, you might need a combination of different medications and may need to use trial and error to find the medication, or combination of medications, that work best for you.
For more information on restless legs syndrome:
“Restless Legs Syndrome Fact Sheet,” NIH Publication no. 10-4847, 2010, September, Staff Writer, National Institutes of Health
“The Relationship Between Attention-deficit-Hyperactivity-Disorder and Restless Legs Syndrome,” 2008, Samuele Cortese, Eric Konofal, MIchel Lecendreux, European Neurological Review: DOI: 10.017925/ENR.2008.03.01.111