Restless Legs Syndrome

Restless Legs Syndrome (RLS) significantly affects more than 7 million adults in the United States.1 For patients with primary RLS, the disease is chronic and often causes them to seek treatment.2 For many patients with moderate to severe symptoms, rls is debilitating—disrupting sleep, influencing mood, and negatively affecting everyday life.3

Diagnosing RLS

RLS is typically diagnosed in a patient interview. At present, no lab test can confirm or deny that a patient has the disease.2 rls frequently runs in families, but it may also be specific to the individual or related to iron deficiency, chronic renal failure, and other conditions.1

RLS is commonly misdiagnosed as poor circulation, arthritis, or a back or spinal problem.3

In an rls study conducted in a primary care setting, physicians reported correctly diagnosing only 25% (52) of the 209 rls sufferers who consulted them.4

RLS Treatment

People with primary rls commonly manage their symptoms with a prescription medication. The medications approved in the United States for the treatment of rls include dopamine agonists and an alpha-2-delta ligand.5


When certain medications for RLS are used long term, they can cause augmentation—a severe worsening of symptoms. The risk of a patient experiencing augmentation increases the longer he or she uses the medication. Studies suggest that the length of therapy and type of medication are factors in the occurrence and rate of augmentation.6

Because augmentation can severely exacerbate symptoms, it should be evaluated and managed carefully.5

Recommendations for Augmentation

Augmentation presents a challenge for physicians treating rls in daily practice. For this reason, the International rls Study Group created a task force with the European rls Study Group, and the United States–based rls Foundation. The goal of the task force was to create recommendations for identifying, preventing, and treating rls augmentation. The International rls Study Group (IRLSSG) recently published these recommendations in a white paper.

About the International RLS Study Group
The IRLSSG is an organization of doctors, researchers, and other professionals committed to advancing basic and clinical research on RLS. The group’s mission is to plan, implement, analyze, and report on multicenter rls studies with an international focus. In 2013, the group published guidelines and best practices for the long-term treatment of rls in Sleep Medicine.

Additional Resources

If you are interested in sharing information on rls and augmentation with your colleagues or your patients, download the guides below.

For Healthcare Professionals

Restless Legs Syndrome: A Guide to the Disease

For RLS Patients

Could Your RLS Treatment
Make Your Symptoms Worse?


  1. Restless Legs Syndrome Foundation. Restless legs syndrome: causes, diagnosis and treatment for the patient living with restless legs syndrome (RLS). Accessed November 21, 2016.
  2. Willis-Ekbom Disease Foundation. WED/RLS Medical Bulletin: A Publication for Healthcare Providers. Rochester, MN: Willis-Ekbom Disease Foundation; 2014.
  3. Allen RP, Walters AS, Montplaisir J, et al. Restless legs syndrome prevalence and impact: rest general population study. Arch Intern Med. 2005;165:1286-1292.
  4. Hening W, Walters AS, Allen RP, Montplaisir J, Myers A, Ferini-Strambi L. Impact, diagnosis and treatment of restless legs syndrome (RLS) in a primary care population: the REST (RLS epidemiology, symptoms, and treatment) primary care study. Sleep Med. 2004;5(3):237-246.
  5. García-Borreguero D, Kohnen R, Silber MH, et al. The long-term treatment of restless legs syndrome/Willis–Ekbom disease: evidence-based guidelines and clinical consensus best practice guidance: a report from the International Restless Legs Syndrome Study Group. Sleep Med. 2013:14(7):675-684.
  6. Liu GJ, Wu L, Wang SL, et al. Incidence of augmentation in primary restless legs syndrome patients may not be that high: evidence from a systematic review and meta-analysis. Medicine. 2016;95(2):e2504. doi:10.1097/MD.0000000000002504.