May 27, 2025
Restless leg syndrome is a common movement and sleep disorder affecting 2-3% of the population. Certain neurologic disorders are associated with a higher incidence, and neuropsychiatric medications prescribed by neurologists and psychiatrists often exacerbate these symptoms. In January, the American Academy of Sleep Medicine published updated guidelines for the evaluation and treatment of RLS. The recommendations shifted from recommending the use of dopamine agonists, to prioritizing iron evaluation and supplementation, alpha-2-delta ligands (gabapentin, gabapentin enacarbil, pregabalin), and recommending against the long-term use of dopamine agonists. The guidelines also recommend opiates for moderate-severe medication refractory RLS. Dr. Winkleman is a Professor of Psychiatry at Harvard Medical School and chief of the Sleep Disorders Clinical Research Program in the Department of Psychiatry at Massachusetts General Hospital. He is the first-author on the new guidelines, and is here to discuss these changes and what is needed to effectively change practice. He is interviewed by Dr. Kara Wyant, Clinical Assistant Professor of Neurology, University of Michigan Medical School. RLS Curbside