{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T14:16:08Z","timestamp":1788790568124,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2010,4,6]],"date-time":"2010-04-06T00:00:00Z","timestamp":1270512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2010,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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\u2010pituitary\u2010adrenal (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\u2010induced sleep disruption to HPA system activation conceivable. \u00a9 2010 Movement Disorder Society<\/jats:p>","DOI":"10.1002\/mds.23026","type":"journal-article","created":{"date-parts":[[2010,4,7]],"date-time":"2010-04-07T01:26:19Z","timestamp":1270603579000},"page":"1047-1052","source":"Crossref","is-referenced-by-count":41,"title":["Restless legs syndrome: Evidence for nocturnal hypothalamic\u2010pituitary\u2010adrenal system activation"],"prefix":"10.1002","volume":"25","author":[{"given":"Claudia","family":"Schilling","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Schredl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Strobl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Deuschle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,6,9]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870100517"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1389-9457(03)00010-8"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.1209"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(02)00443-9"},{"key":"e_1_2_7_6_2","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1378\/chest.129.1.76","article-title":"Prevalence and correlates of restless legs syndrome","volume":"129","author":"Phillips B","year":"2006","journal-title":"Chest"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2006.01.004"},{"key":"e_1_2_7_8_2","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1212\/01.wnl.0000287072.93277.c9","article-title":"Associations of restless legs syndrome and cardiovascular disease in the Sleep Heart Health Study","volume":"70","author":"Winkelman JW","year":"2008","journal-title":"Neurology"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/32.5.589"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/22.5.575"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.4.786"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000259036.89411.52"},{"key":"e_1_2_7_13_2","doi-asserted-by":"crossref","first-page":"489","DOI":"10.5664\/jcsm.26913","article-title":"Do insomnia complaints cause hypertension or cardiovascular disease?","volume":"3","author":"Phillips B","year":"2007","journal-title":"J Clin Sleep Med"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(99)00029-X"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.2.205"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2002.00941.x"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22486"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1999.tb07803.x"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0801278"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.55.7.580"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.psy.0000126207.43307.c0"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.86.8.7778"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3940(02)00192-1"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/PL00007857"},{"key":"e_1_2_7_25_2","first-page":"669","article-title":"Circadian variation in neuroendocrine response to L\u2010dopa in patients with restless legs syndrome","volume":"27","author":"Garcia\u2010Borreguero D","year":"2004","journal-title":"Sleep"},{"key":"e_1_2_7_26_2","volume-title":"A manual of standardized terminology, techniques and scoring for sleep stages in human subjects","author":"Rechtschaffen A","year":"1968"},{"key":"e_1_2_7_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/15.2.174"},{"key":"e_1_2_7_28_2","first-page":"749","article-title":"The ASDA Atlas Task Force. 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