Exploring the ADHD-Restless Leg Connection
Challenges with movement and fidgeting can be common among people with ADHD, but did you know that restless legs can also be a frequent experience for those with this disorder? Also known as RLS, restless legs syndrome can cause an uncomfortable urge to move the legs at night. This can make it hard to fall asleep, potentially even leading to sleep deprivation and other concerns. ADHD and RLS may be linked, as both conditions are thought to involve differences in dopamine levels. It can be possible to manage ADHD and RLS through a combination of therapy, medication, and lifestyle changes.
ADHD: An overview
Attention-deficit/hyperactivity disorder (ADHD) is a disorder that is often diagnosed during childhood. It typically involves differences in the brain that can affect executive function, which can be defined as your ability to do things like focus, plan ahead, and control your urges. The exact reason for this is still being researched. However, it’s thought that low levels of dopamine, a brain chemical that contributes to pleasure and motivation, may be involved.
ADHD symptoms can take two main forms: inattentiveness and hyperactivity/impulsiveness. People may experience just one or the other, but they may also experience both.
Inattentiveness generally refers to challenges with focus and attention. These may include the following:
- Struggling to start and finish tasks, especially ones that are mentally challenging
- Daydreaming or getting lost in thought often
- Frequently forgetting things, losing things, or overlooking things
- Making frequent “careless” mistakes at work or school
- Becoming easily distracted
Hyperactivity and impulsiveness typically refer to challenges with movement and impulse control. These can look like:
- Fidgeting or moving around when it’s not appropriate
- Having trouble relaxing, or experiencing urges to always be “up and about”
- Talking excessively, interrupting others, or blurting things out without thinking
- Making big decisions and commitments on a whim
- Engaging in high-risk behaviors like unsafe sex, reckless spending, or dangerous driving
These symptoms can lead to challenges at work, school, and in relationships. Left untreated, they may also contribute to other mental health concerns like stress, depression, and anxiety.
What is restless legs syndrome?
RLS (sometimes called “Willis-Ekbom Disease”) can be defined as a sleep disorder that causes an unpleasant, overwhelming urge to move your legs at night. Although movement may relieve the uncomfortable sensation, the urge often starts up again once you stop moving. This can cause sleep disruption and make it hard to relax.
RLS often occurs alongside other conditions. Common sleep disorders linked to RLS may include those listed below:
- Periodic limb movements of sleep (PLMS): PLMS is a disorder that can make your legs and arms periodically jerk and spasm during sleep.
- Sleep apnea: Sleep apnea generally occurs when you stop breathing while you’re asleep, either because your airway is blocked or because your brain stops telling your body to breathe.
- Insomnia: Insomnia is a disorder that can make it hard to fall or stay asleep. It can happen on occasion due to short-term issues like stress, but it can also become chronic.
Although both men and women can experience restless legs syndrome, it tends to be more common in women, and symptoms often get worse with age. Left untreated, RLS can lead to poor sleep, excessive daytime sleepiness, mood changes, trouble concentrating, memory issues, and more.
Understanding the ADHD-restless leg relationship
Aside from causing possible issues with concentration and energy levels, it might not seem like ADHD and RLS have much in common. As it turns out, there may be a connection between these disorders.
Research has found that people with ADHD may have a higher risk of experiencing sleep disorders. In a 2017 study, researchers looked for self-reported sleep problems among 268 adult ADHD patients and 202 adults without ADHD. They found that sleep disorders like restless legs, sleep apnea, and PLMS tended to be significantly more common in the ADHD group than in the control group.
More recent studies also support this connection. In an analysis from 2023, researchers looked at data from 29 different studies of restless legs syndrome. They found that there seemed to be a strong link between RLS symptoms and ADHD.
Although the exact reason for this connection is still being studied, there may be a few possibilities. As discussed previously, ADHD can cause differences in dopamine levels, which may contribute to motivation challenges. However, the dopamine system typically plays a role in movement as well. It’s possible that ADHD-related dopamine issues may also contribute to the overwhelming urge to move the legs caused by RLS.
Genetics may also be to blame. Genetic factors likely play a role in ADHD, which tends to run in families.
Because RLS also frequently runs in families, it’s possible that the same genes that cause ADHD also contribute to the development of RLS. Other possible causes may include ADHD medications, which can affect people’s sleeping patterns, and environmental factors.
Getting help for RLS and ADHD
Untreated RLS and ADHD can both contribute to sleep deprivation, focus problems, and other mental and physical health challenges. However, while they cannot be “cured,” both conditions may be managed for a better quality of life and easier daily functioning. If either one is having negative effects on you, consider talking to your doctor about starting a treatment plan.
Treating restless legs syndrome and ADHD often involves a combination of the following interventions.
Lifestyle changes
These may include changes to your sleep habits, like what time you go to bed or the environment where you sleep. It may also be helpful to start an exercise routine, reduce caffeine and sugar consumption, and practice stress management strategies, like mindfulness and journaling. Certain supplements, like iron, may also reduce symptoms of RLS, although it can be important to consult a doctor before adding any supplements to your regimen.
Medication
Different medications can be prescribed for ADHD and RLS. If you’re interested in exploring medication options, consult your doctor or psychiatrist.
Therapy
Therapy is often useful for managing ADHD symptoms. In particular, cognitive behavioral therapy (CBT) may be helpful for changing negative thought patterns that might worsen ADHD symptoms. For those who have RLS as well, improving ADHD symptoms through therapy may also improve sleep quality.
However, if sleep issues are causing symptoms like daytime sleepiness, this can make it hard to leave the house to attend in-person therapy. Online therapy can enable you to connect with a therapist from the comfort of your own home. This may make it an easier option for people with sleep disorders.
According to research, online therapy can improve symptoms of sleep-related issues. A 2019 study compared the effectiveness of online and in-person CBT programs for shift workers experiencing symptoms of sleep disorders. In general, both groups saw significant improvements in symptoms.
Takeaway
ADHD is a disorder that can cause inattentiveness, hyperactivity, and impulsiveness. People with ADHD usually have an increased risk of sleep disorders. One such disorder is restless legs syndrome (RLS), which typically causes uncomfortable feelings in the legs that can only be relieved with movement. The reason for the ADHD-RLS connection isn’t yet clear. However, it may be due to genetics, environmental factors, or dopamine, which is a brain chemical related to movement that also plays a role in ADHD. While there may not be a “cure” for RLS or ADHD, they can often be treated with lifestyle changes, medication, and in-office or online therapy.
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