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Restless legs syndrome: Evidence for nocturnal hypothalamic‐pituitary‐adrenal system activation
Author(s) -
Schilling Claudia,
Schredl Michael,
Strobl Philipp,
Deuschle Michael
Publication year - 2010
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.23026
Subject(s) - restless legs syndrome , nocturnal , medicine , endocrinology , circadian rhythm , sleep (system call) , psychology , insomnia , psychiatry , computer science , operating system
Epidemiological studies consistently point to a relationship between restless legs syndrome (RLS) and cardiovascular disease. The mechanism underlying this association is unclear. Activation of the hypothalamic‐pituitary‐adrenal (HPA) system has been shown to contribute to the metabolic syndrome and an enhanced cardiovascular risk. We investigated cortisol levels as an indicator of HPA system activity in RLS during the nighttime, when RLS symptoms are at their maximum. We assessed nocturnal urinary cortisol excretion in 73 patients with RLS and 34 healthy controls, controlling for age and gender. Urine sampling was paralleled by polysomnographic recordings. We found significantly enhanced nocturnal cortisol excretion in RLS, demonstrating nocturnal HPA system overactivity in RLS. HPA system overactivity is a possible mechanism contributing to the enhanced load of cardiovascular disease in RLS patients. Nocturnal cortisol release showed weak correlations with some polysomnographic parameters of disturbed sleep, making a potential contribution of RLS‐induced sleep disruption to HPA system activation conceivable. © 2010 Movement Disorder Society