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VOLUME 35, ISSUE 08

TREATMENT OF RLS AND PLMS DISORDER IN ADULTS: PRACTICE PARAMETERS
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

http://dx.doi.org/10.5665/sleep.1988

R. Nisha Aurora, MD1; David A. Kristo, MD2; Sabin R. Bista, MD3; James A. Rowley, MD4; Rochelle S. Zak, MD5; Kenneth R. Casey, MD, MPH6; Carin I. Lamm, MD7; Sharon L. Tracy, PhD8; Richard S. Rosenberg, PhD8

1Johns Hopkins University, School of Medicine, Baltimore, MD; 2University of Pittsburgh, Pittsburgh, PA; 3University of Nebraska Medical Center, Omaha, NE; 4Division of Pulmonary, Critical Care, and Sleep Medicine, Wayne State University School of Medicine, Detroit, MI; 5Sleep Disorders Center, University of California, San Francisco, San Francisco CA; 6Cincinnati Veterans Affairs Medical Center, Cincinnati, OH; 7Children's Hospital of NY–Presbyterian, Columbia University Medical Center, New York, NY; 8American Academy of Sleep Medicine, Darien, IL



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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.

Citation:

Aurora RN; Kristo DA; Bista SR; Rowley JA: Zak RS; Casey KR; Lamm CI; Tracy SL; Rosenberg RS. 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;35(8):1039-1062.

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