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Restless legs syndrome

Last reviewed: 18 Sep 2025
Last updated: 10 Sep 2025

Summary

Definition

History and exam

Key diagnostic factors

  • urge to move the legs
  • dysesthesias
  • evening or night symptoms
  • relieving factors (movement, stretching, massage)
  • location in lower extremities, less commonly upper extremities and torso
Full details

Other diagnostic factors

  • alcohol use
  • caffeine use
  • female sex
Full details

Risk factors

  • conditions associated with iron deficiency
  • pregnancy
  • family history of RLS
  • use of certain drugs
  • female sex
  • increased age
  • obesity
  • diabetes mellitus
  • Parkinson disease
  • multiple sclerosis
  • peripheral neuropathy
Full details

Diagnostic tests

1st tests to order

  • clinical diagnosis
  • iron studies
Full details

Treatment algorithm

ACUTE

intermittent RLS: nonpregnant

intermittent RLS: pregnant

chronic persistent RLS: nonpregnant

chronic persistent RLS: pregnant

ONGOING

refractory RLS: nonpregnant

refractory RLS: pregnant

Contributors

Authors

Nitun Verma, MD, MBA

Sleep Physician

AC Wellness

Cupertino

CA

Disclosures

NV declares that he has no competing interests.

Clete A. Kushida, MD, PhD, RPSGT

Acting Medical Director

Stanford Sleep Medicine Center

Director

Stanford Center for Human Sleep Research

Associate Professor

Stanford University Medical Center

Stanford Sleep Medicine Center

Redwood City

CA

Disclosures

CAK is an author of a number of references cited in this topic.

Peer reviewers

Magdolna Hornyak, MD

Associate Professor

Interdisciplinary Pain Center and Department for Psychiatry and Psychotherapy

University Medical Center Freiburg

Freiburg

Germany

Disclosures

MH declares that she has no competing interests.

K Ray Chaudhuri, MD, FRCP, DSc, FEAN

Professor of Movement Disorders and Neuroscience and Clinical Director

Parkinson Foundation International Centre of Excellence

King's College Hospital and King's College

Campus Research Director and Assistant Medical Director

King's College Hospital NHS Foundation Trust

London

UK

利益声明

KRC declares that he has no competing interests.

Brian Koo, MD

Associate Professor of Neurology

Yale University

New Haven

CT

利益声明

BK declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Winkelman JW, Armstrong MJ, Allen RP, et al. 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):2585-93.全文  摘要

American Academy of Sleep Medicine. The AASM international classification of sleep disorders - third edition, text revision (ICSD-3-TR). Jun 2023​ [internet publication].全文

Silber MH, Buchfuhrer MJ, Earley CJ, et al. The management of restless legs syndrome: an updated algorithm. Mayo Clin Proc. 2021 Jul;96(7):1921-37.全文  摘要

Winkelman JW, Berkowski JA, DelRosso LM, et al. Treatment of restless legs syndrome and periodic limb movement disorder: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2025 Jan 1;21(1):137-52.全文  摘要

Allen RP, Picchietti DL, Auerbach M, et al. Evidence-based and consensus clinical practice guidelines for the iron treatment of restless legs syndrome/Willis-Ekbom disease in adults and children: an IRLSSG task force report. Sleep Med. 2018 Jan;41:27-44.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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