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Circadian Rhythm, Dopamine, and RLS: Why Does It Increase at Night?

Many people with Restless Legs Syndrome (RLS) report that their symptoms worsen in the evening and at night. This is no coincidence; it's related to the body's "internal clock" (circadian rhythm) and the natural fluctuations of certain brain chemicals throughout the day.

Biological Basis for Evening/Nighttime Increase in RLS

Everything in our bodies operates on a 24-hour rhythm: body temperature , hormones , alertness , and desire to sleep . As evening approaches:

  • The body naturally goes into relaxation mode, increasing sitting/lying for long periods of time.
  • The “gas-brake balance” of the muscular and nervous systems changes; in some people, this is felt as tingling in the legs and an urge to move .
  • Pain/threshold perception may differ towards night; minor discomfort may be felt more clearly.

The Dopamine Cycle and Sleep–Wake Rhythm

Dopamine is one of the brain's "motivation and movement" chemicals. Its levels fluctuate throughout the day. Some research suggests that changes in dopamine signaling at night can make RLS symptoms more pronounced . If a person has low iron stores (especially ferritin), it can be even more difficult for dopamine to function properly. The result: an increased need to move the legs at night, and sleep can be disrupted.

Blue Light, Late-Night Eating, Drinking, and Jet Lag Effects

  • Blue light (phone, tablet, TV): Sends the brain the "daytime" signal. It delays the activation of the sleep hormone melatonin , making it harder to fall asleep and feeling restless more noticeable.
  • Late-night meals/heavy snacks: Digestion accelerates and body temperature increases. This can trigger leg discomfort in some people.
  • Caffeine/nicotine/alcohol: If taken in the evening , it stimulates the nervous system and may increase nighttime complaints.
  • Jet lag/night shift work: Sleep is interrupted because it disrupts the internal clock; RLS complaints may be felt more frequently.

Evening Routine Suggestions (Light Hygiene, Warm Shower, Stretching)

  • Light hygiene: Screens can be left off 1–2 hours before bedtime, and room lights can be kept warm and dim .
  • Light movement: Gentle stretching , a short walk around the room, or a leg massage can be helpful.
  • Warm shower/foot bath: Relaxes the muscles and prepares for sleep.
  • Caffeine/nicotine/alcohol may be restricted: Especially in the evening hours.
  • Regular Sleep: It is recommended to sleep and wake up at similar times every day whenever possible.

Mini Checklist

  • Did I turn off the screen early (at least 1 hour ago) this evening?
  • Did I do some gentle stretching/massage before bed?
  • Did I consume caffeine/nicotine/alcohol in the evening ? (Aim for a "No" answer)
  • Is my room cool, dark, and quiet ?
  • Have I talked to my doctor recently about my iron levels ?
“New Routine with Restio”

Restio is a drug-free orthopedic aid worn on the foot . It can be used practically when an attack is coming or during an attack . People who also experience these symptoms in their arms or hands often wear the product on their feet for support (experience varies from person to person).

Check out the Restio product page →

Note: This is not medical advice.

Source

  1. American Academy of Sleep Medicine (AASM) – RLS/RLS management and lifestyle recommendations (clinical guideline summaries).
  2. Silber MH, et al. The Management of Restless Legs Syndrome: An Updated Algorithm . Mayo Clinic Proceedings – practical approach to iron assessment and evening/nighttime increase.
  3. NIH/National Institute of General Medical Sciences – Circadian Rhythms (internal clock and influence of light).
  4. Cleveland Clinic – Restless Legs Syndrome (RLS): Causes, Symptoms & Management (sleep hygiene and triggers).
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