Circadian and Dopamine Factors Drive Nighttime Worsening of Restless Legs Syndrome

Restless legs syndrome worsens at night primarily due to circadian rhythms in the brain that reduce dopamine activity and sensitivity, amplifying the urge to move, often compounded by iron deficiency and genetic factors.

  • Natural brain cycles cause RLS symptoms to peak in the evening, reducing rest quality.
  • Lower nighttime dopamine activity amplifies the irresistible urge to move legs.
FactorScientific ObservationImpact Magnitude
Circadian RhythmsNatural variations in brain dopamine sensitivityEvening peak of RLS symptoms
Dopamine DysfunctionLower activity due to system impairmentAmplifies nighttime urge to move
Brain Iron DeficiencyDisrupts signaling in dopamine pathwaysWorsens rest disruption at night
Genetic FactorsInfluences on circadian clock genesHeightens vulnerability after dark
Source: Garcia-Borreguero et al. (2024), The Lancet NeurologyRLS pathophysiology and circadian variationsExacerbated nighttime symptoms