Restless Leg Syndrome and ADHD

Restless leg syndrome (RLS) is a compelling urge to move one’s legs, usually in the evenings, a feeling a least partly assuaged by actually moving them. ADHD and RLS show considerable overlap, with as many as a third of those with ADHD having RLS and a quarter of those with RLS having ADHD. Somewhere between 5-15% of the US population has RLS.
RLS can profoundly disrupt sleep, which itself could lead to the appearance of ADHD symptoms. Severe RLS symptoms, which can extend into the daytime and resemble hyperactive, may lead to confusion with ADHD. But it seems that much of the overlap between the two conditions is due to common underlying problems with low iron and dopamine dysfunction attributable to genetic causes.
The most commonly used medications (ropiniprole, pramipexole) for RLS are agents that activate dopamine-3 receptors. Some evidence suggests that iron deficiency in certain parts of the brain actually leads to increased dopamine activity, and down-regulation of dopamine D2 receptors. But because of the pronounced circadian rhythms in dopamine production (a morning surge, with lower levels in the evening) this could result in a relative dopamine deficiency at D3 post-synaptic receptors at the end of the day, when RLS symptoms are most prominent.
Only a few case reports indicate that the RLS medications might also be of benefit for ADHD.
References:
Restless legs syndrome and iron deficiency in adults with attention-deficit/hyperactivity disorder (2019)
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Association Between Restless Legs Syndrome and Adult ADHD in a German Community-Based Sample (2015)
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Prevalence of Restless Legs Syndrome in Adult ADHD and Its Subtypes (2015 )
www.tandfonlin...
Restless Legs Syndrome and Attention-Deficit/Hyperactivity Disorder: a Review of the Literature (2005)
academic.oup.c...
Restless legs syndrome: An overview of pathophysiology, comorbidities and therapeutic approaches (2022)
www.ncbi.nlm.n...
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[@DrHill]

Seems the overlap of ADHD, RLS, apnea may all have relationships to the sleep spindle stabilization / sensorimotor rhythm control. Check out the work of Martijn Arns on ADHD and sleep spindles, and also look at Monastra’s work on the theta/beta ratio that first showed huge predictive sensitivity to sort ADHD purely from the EEG, until replication attempts got too many sleep deprived teens in the studies and the discriminant power dropped out.

[@afser1533]

Can you please do a video on Candida infection and ADHD? There are many anecdotal reports of people alleviating their ADHD-like symptoms after treating their Candida infection. What's your view on this?