The treatment of restless legs syndrome and periodic limb movement disorder in adults--an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses: an American Academy of Sleep Medicine Clinical Practice Guideline
- PMID: 22851801
- PMCID: PMC3397811
- DOI: 10.5665/sleep.1988
The treatment of restless legs syndrome and periodic limb movement disorder in adults--an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses: an American Academy of Sleep Medicine Clinical Practice Guideline
Abstract
A systematic literature review and meta-analyses (where appropriate) were performed to update the previous AASM practice parameters on the treatments, both dopaminergic and other, of RLS and PLMD. A considerable amount of literature has been published since these previous reviews were performed, necessitating an update of the corresponding practice parameters. Therapies with a STANDARD level of recommendation include pramipexole and ropinirole. Therapies with a GUIDELINE level of recommendation include levodopa with dopa decarboxylase inhibitor, opioids, gabapentin enacarbil, and cabergoline (which has additional caveats for use). Therapies with an OPTION level of recommendation include carbamazepine, gabapentin, pregabalin, clonidine, and for patients with low ferritin levels, iron supplementation. The committee recommends a STANDARD AGAINST the use of pergolide because of the risks of heart valve damage. Therapies for RLS secondary to ESRD, neuropathy, and superficial venous insufficiency are discussed. Lastly, therapies for PLMD are reviewed. However, it should be mentioned that because PLMD therapy typically mimics RLS therapy, the primary focus of this review is therapy for idiopathic RLS.
Keywords: PLMD; RLS; Restless legs syndrome; periodic limb movement disorder; sleep-related movement disorders.
Figures
![Figure 1](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3397811/bin/aasm.35.8.1039a.gif)
![Figure 2](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3397811/bin/aasm.35.8.1039b.gif)
![Figure 3](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3397811/bin/aasm.35.8.1039c.gif)
![Figure 4](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3397811/bin/aasm.35.8.1039d.gif)
![Figure 5](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3397811/bin/aasm.35.8.1039e.gif)
![Figure 6](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3397811/bin/aasm.35.8.1039f.gif)
![Figure 7](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3397811/bin/aasm.35.8.1039g.gif)
![Figure 8](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3397811/bin/aasm.35.8.1039h.gif)
![Figure 9](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3397811/bin/aasm.35.8.1039i.gif)
![Figure 10](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3397811/bin/aasm.35.8.1039j.gif)
![Figure 11](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3397811/bin/aasm.35.8.1039k.gif)
![Figure 12](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3397811/bin/aasm.35.8.1039l.gif)
![Figure 13](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3397811/bin/aasm.35.8.1039m.gif)
Comment in
-
Update to the AASM Clinical Practice Guideline: "The treatment of restless legs syndrome and periodic limb movement disorder in adults-an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses".Sleep. 2012 Aug 1;35(8):1037. doi: 10.5665/sleep.1986. Sleep. 2012. PMID: 22851800 Free PMC article. No abstract available.
Similar articles
-
Practice parameters for the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder.Sleep. 2004 May 1;27(3):557-9. doi: 10.1093/sleep/27.3.557. Sleep. 2004. PMID: 15164914
-
Diagnosis and management of restless legs syndrome in children.Sleep Med Rev. 2009 Apr;13(2):149-56. doi: 10.1016/j.smrv.2008.12.002. Epub 2009 Jan 31. Sleep Med Rev. 2009. PMID: 19186083 Free PMC article. Review.
-
A mixed treatment comparison of gabapentin enacarbil, pramipexole, ropinirole and rotigotine in moderate-to-severe restless legs syndrome.Curr Med Res Opin. 2014 Nov;30(11):2267-78. doi: 10.1185/03007995.2014.946124. Epub 2014 Jul 31. Curr Med Res Opin. 2014. PMID: 25050588
-
Practice guideline summary: Treatment of restless legs syndrome in adults: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.Neurology. 2016 Dec 13;87(24):2585-2593. doi: 10.1212/WNL.0000000000003388. Epub 2016 Nov 16. Neurology. 2016. PMID: 27856776 Free PMC article.
-
ADMET considerations for restless leg syndrome drug treatments.Expert Opin Drug Metab Toxicol. 2012 Oct;8(10):1247-61. doi: 10.1517/17425255.2012.708023. Epub 2012 Jul 18. Expert Opin Drug Metab Toxicol. 2012. PMID: 22808933 Review.
Cited by
-
Expert opinion on diagnosis and management of epilepsy-associated comorbidities.Epilepsia Open. 2024 Feb;9(1):15-32. doi: 10.1002/epi4.12851. Epub 2023 Nov 27. Epilepsia Open. 2024. PMID: 37876310 Free PMC article. Review.
-
Review of the role of the endogenous opioid and melanocortin systems in the restless legs syndrome.Brain. 2024 Jan 4;147(1):26-38. doi: 10.1093/brain/awad283. Brain. 2024. PMID: 37633259 Free PMC article.
-
Long-term efficacy and safety of tonic motor activation for treatment of medication-refractory restless legs syndrome: A 24-Week Open-Label Extension Study.Sleep. 2023 Oct 11;46(10):zsad188. doi: 10.1093/sleep/zsad188. Sleep. 2023. PMID: 37439365 Free PMC article. Clinical Trial.
-
G protein-coupled receptors in neurodegenerative diseases and psychiatric disorders.Signal Transduct Target Ther. 2023 May 3;8(1):177. doi: 10.1038/s41392-023-01427-2. Signal Transduct Target Ther. 2023. PMID: 37137892 Free PMC article. Review.
-
Pramipexole Augmentation for Treatment-Resistant Unipolar and Bipolar Depression in the Real World: A Systematic Review and Meta-Analysis.Life (Basel). 2023 Apr 19;13(4):1043. doi: 10.3390/life13041043. Life (Basel). 2023. PMID: 37109571 Free PMC article. Review.
References
-
- Balshem H, Helfand M, Schunemann H, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64:401–6. - PubMed
-
- Hening W, Allen R, Earley C, Kushida C, Picchietti D, Silber M. The treatment of restless legs syndrome and periodic limb movement disorder. Sleep. 1999;22:970–99. - PubMed
-
- Hening W, Allen R, Earley C, Picchietti D, Silber M. An update on the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder. Sleep. 2004;27:560–83. - PubMed
-
- Littner M, Kushida C, McDowell Anderson W, et al. Practice parameters for the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder. Sleep. 2004;27:557–9. - PubMed
-
- Chesson A, Wise M, Davila D, et al. Practice parameters for the treatment of restless legs syndrome and periodic limb movement disorder. Sleep. 1999;22:961–8. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical