The Latest Trends in Sleep Medicine

Restless Leg Syndrome Management

Author(s): Shaden O. Qasrawi and Ahmed S. BaHammam * .

Pp: 39-63 (25)

DOI: 10.2174/9789815051032122010006

* (Excluding Mailing and Handling)


Restless legs syndrome (RLS) is a common disorder of unknown cause. The management of RLS is directed at relieving its symptoms. Secondary causes and factors associated with increased symptoms should be recognized and treated whenever possible. Iron stores should be assessed in everyone with RLS, and iron replacement is recommended for iron deficiency patients. Patients with mild intermittent symptoms may be treated with non-pharmacological therapy, but when this is not effective, pharmacological treatment should be selected based on the timing of the symptoms and patients’ needs. Patients with moderate to severe RLS usually need medications on a daily basis to control their symptoms. A range of medications is now available for the management of RLS. Dopaminergic agonists are currently the first-line drugs for patients with moderate to severe RLS; however, drug-related problems like augmentation could restrict their use for long-term therapy. Alpha-2-delta calcium channel ligands are also considered first-line drugs for moderate to severe RLS patients. Opioids can be considered as a treatment option for RLS patients who have failed other therapies. When monitored properly, they can be safe and suitable for long-term therapy. In conclusion, the therapeutic strategy should be tailored to accommodate each patient's presentation and needs.

Keywords: Alpha, Augmentation, Benzodiazepines, Calcium channel, Delta, Dopamine agents, Intermittent, Opioids, Iron, Pharmacologic therapy, Refractory, Restless legs, RLS, Syndrome, Willis–Ekbom.

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