JAMA Clinical Reviews Restless Legs Syndrome
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Jan 21, 2026 Join John W. Winkelman, a Harvard Medical School psychiatry professor and expert in sleep disorders, as he unravels the mysteries of restless legs syndrome (RLS). He discusses defining symptoms like the evening urge to move and dives into genetic and neurochemical factors, including the role of iron and dopamine. Winkelman also reveals prevalence patterns, effective diagnosis techniques, and first-line treatments like gabapentinoids. Plus, explore nonpharmacologic strategies and hear about the RLS Foundation’s resources for those affected!
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PLMS Versus RLS Relationship
- Periodic limb movements of sleep (PLMS) are common and overlap with RLS, but PLMS alone does not diagnose RLS.
- Winkelman describes RLS as a smaller circle mostly within a larger PLMS circle, so ask about symptoms when PLMS appears on sleep study.
Discontinue Exacerbating Drugs
- Stop or review medications that worsen RLS, including SSRIs, antihistamines, dopamine antagonists, and alcohol use.
- Coordinate with prescribers before changing treatments and counsel patients about alcohol's consistent worsening effect.
Behavioral Strategies For Symptom Relief
- Try nonpharmacologic measures: evening stretching, moderate daytime exercise, massage, and hot baths for temporary relief.
- Use a Goldilocks approach to exercise (not too much or too little) and apply these tactics for mild-to-moderate RLS.