Respiratory and sleep medicine
Restless legs syndrome and periodic limb movements of sleep
The five IRLSSG criteria and the mimics, secondary causes (iron deficiency, kidney failure, pregnancy, drugs), iron thresholds for RLS, why the AASM 2024 guideline moved gabapentinoids ahead of dopamine agonists, recognising augmentation, and periodic limb movement disorder.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- RLS is a clinical diagnosis: an evening urge to move the legs at rest, relieved by movement. About 2 to 3% of adults have clinically significant symptoms, women twice as often as men.
- Check ferritin and transferrin saturation in everyone. Iron treatment is indicated at a ferritin of 75 µg/L or less, far above the anaemia threshold.
- Remove aggravating drugs, especially antihistamines, metoclopramide, antipsychotics and antidepressants.
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Sources
- Therapeutic Guidelines: Neurology (restless legs syndrome)AU/NZTherapeutic Guidelines Ltd, current eTG edition (version not verified)
- PBS Schedule: pramipexole (restricted benefit, primary severe restless legs syndrome)AU/NZPharmaceutical Benefits Scheme, November 2026
- Clinical resources and guidelines for sleep disordersAU/NZAustralasian Sleep Association
- Treatment of restless legs syndrome and periodic limb movement disorder: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med 2025;21:137-52American Academy of Sleep Medicine (Winkelman JW et al), 2024 (published online 2024, print 2025)
- Partial endorsement of the AASM clinical practice guideline on treatment of restless legs syndrome and periodic limb movement disorder, by the World Sleep Society. Sleep Med 2025;134World Sleep Society (Ferri R et al), 2025
- Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated IRLSSG consensus criteria. Sleep Med 2014;15:860-73International Restless Legs Syndrome Study Group (Allen RP et al), 2014
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback