The treatment of restless legs syndrome and periodic limb movement disorder: a plain language summary of the American Academy of Sleep Medicine Clinical Practice Guidelines

What is this summary about? In 2012, the American Academy of Sleep Medicine (AASM) released a clinical practice guideline (CPG) to help clinicians treat patients suffering with restless legs syndrome (RLS) and periodic limb movement disorder (PLMD) [1]. At the time, they believed factors like genetics and abnormal iron and dopamine levels were causing symptoms of RLS and PLMD. Therefore, the AASM recommended use of dopamine agonists to treat patients’ RLS and PLMD symptoms. However, after reviewing ten years’ worth of clinical and research experience from patients who took dopamine agonists since the 2012 CPG, the AASM found that while dopamine agonist medications may help in the short term, they can also cause the symptoms of RLS to worsen over time. As a result in 2019, the academy commissioned a task force of experts in sleep medicine to update its CPG (which was published in 2024) and provide guiding recommendations for clinicians in choosing specific treatments for RLS and PLMD, including alpha-2- delta ligands (gabapentinoids) such as gabapentin enacarbil and others. What does this mean? The AASM now suggests against the standard use of dopamine agonists for RLS and recommends a more cautious approach to the use of these medications. The AASM also provides recommendations for PLMD [2]. This is an abstract of the Plain Language Summary of Publication article. View the full Plain Language Summary PDF of this article to read the full-text