The Link Between Restless Leg Syndrome and Migraines

The link between migraine and a common sleep disorder called restless leg syndrome (also known as Willis-Ekbom disease) is well recognized in the medical community. However, experts are still piecing together exactly what the connection is.

Restless leg syndrome (RLS) causes people to experience unpleasant leg sensations that are worse during periods of inactivity such as at nighttime when a person is trying to sleep. While the unpleasant sensations resolve with movement due to the urges people experience to move their legs, frequent nighttime awakenings and insomnia often result.

How Common Is RLS in Migraineurs?

In one large study, the prevalence of restless leg syndrome in migraineurs was found to be nearly 20 percent. However, this statistic has not been consistently reported. Some studies have reported the RLS prevalence in migraines to be as low as 8 percent and others have reported the prevalence to be as high as 40 percent.

These variable findings suggest that how commonly these disorders co-occur remains unclear. Further investigation into factors like age, gender, the frequency of RLS symptoms, and the presence of migraine aura may explain some of these differences.

The Connection

It's perfectly reasonable to be perplexed about how a migraine could be connected to a sleep disorder that causes crawling and tingling sensations in your legs. There are several possible connections that have been researched. While none of these connections have been clearly identified as the root cause of RLS in migraineurs, they are each worth exploring.

Dopamine Imbalance

Some experts believe the linking culprit may be a dopamine imbalance or dysfunction, specifically within the hypothalamus (a gland deep within your brain that controls circadian rhythm).

Dopamine is a brain chemical called a neurotransmitter that helps regulate mood and movement. Drugs that bind to and activate dopamine receptors in the brain, such as Mirapex (pramipexole) and Requip (ropinirole), have been found to ease the symptoms of RLS.

Dopamine has also been found to be involved in migraine development, specifically with regards to premonitory symptoms such as yawning, food cravings, and stomach upset.

This all said, while the dopamine theory seems plausible, it's just a start. The role of dopamine in migraine, RLS, and your brain in general, is extremely complex. Therefore, more scientific investigation is needed in this area.

Iron Deficiency

Another potential culprit linking migraine and RLS is iron deficiency. Low iron storage levels (measured by a blood test called ferritin) are believed to cause or worsen RLS symptoms. A correlation between low ferritin and RLS has been observed in numerous studies.

Likewise, iron deficiency anemia (a low number of red blood cells due to insufficient iron) has been linked to the development of menstrual migraines. More specifically, the acute blood loss from menstruation may lead to low iron levels, which can then trigger a migraine, often towards the end of a woman's menstrual period (called an end-menstruation migraine).

This is in contrast to the classic menstrual migraine which occurs just prior to or a few days into a woman's menstrual cycle (and is believed to be due primarily to the acute drop in estrogen).

Poor Sleep Quality

Lastly, poor sleep quality needs to be considered when evaluating the RLS/migraine connection. Due to frequent nighttime urges to move one's legs, a person often experiences poor sleep quality — and this may trigger migraines in susceptible individuals.

Conclusion

Taking a step back, it's important to keep in mind that just because you have migraines does not mean you will develop RLS or vice versa.

In addition, please note that migraine is not the only health condition linked to RLS. Other medical conditions that may influence or contribute to the development of RLS include:

• Iron deficiency anemia
• Kidney failure
• Depression
• Pregnancy
• Parkinson's disease
• Multiple sclerosis

Lastly, for many people, RLS exists alone, meaning their RLS is deemed idiopathic or due to an unknown cause. In these cases, experts suspect genetics may play a role; although no specific gene mutations have been found yet.

A Word From Verywell

In summary, while a link exists between RLS and migraine, the factors mediating this link have not been fully teased out. Regardless, if you do have migraines and are experiencing insomnia or excessive tiredness during the day, it's reasonable to discuss screening for RLS with your healthcare provider. While it's not known if treating RLS will improve your migraines, it's worth a try. Remember, you deserve a good night's sleep.