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SLEEP 2026 | Updates in RLS: recent treatment guidelines and advances in non-pharmacological treatments
Ambra Stefani, MD, PhD, Medical University of Innsbruck, Innsbruck, Austria, comments on the latest updates in the research field of restless legs syndrome (RLS). These include revised treatment guidelines highlighting the risks of augmentation associated with long-term use of dopaminergic agents and new non-pharmacological treatments, such as peroneal nerve stimulation. This interview took place at the 40th annual meeting of the Associated Professional Sleep Societies (APSS) in Baltimore, MD.
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Transcript
Well, there’s also a lot going on in the research field in RLS. So, the most important updates are related to treatment guidelines that have been updated by the American Academy of Sleep in last year. There is another statement which came out recently by the RLS Foundation and the most important thing is that we are much more aware about augmentation which is related to long-term use of dopaminergic agents so that they are not considered anymore the first-line treatment despite being efficacious, but because of the high risk of augmentation, which is a worsening of symptoms using treatment...
Well, there’s also a lot going on in the research field in RLS. So, the most important updates are related to treatment guidelines that have been updated by the American Academy of Sleep in last year. There is another statement which came out recently by the RLS Foundation and the most important thing is that we are much more aware about augmentation which is related to long-term use of dopaminergic agents so that they are not considered anymore the first-line treatment despite being efficacious, but because of the high risk of augmentation, which is a worsening of symptoms using treatment. And we have, however, very limited treatment options in RLS. So the first-line treatment now is with alpha-2-delta ligands. There is an important role of iron, and there are several sessions also in this meeting about iron in RLS. So in the pathogenesis of RLS, brain iron deficiency plays a central role, and iron treatment is also essential for patients with RLS, and we have different cut-offs, for example, for ferritin values compared to the general population and this should always be considered in patients with RLS and there are also new non-pharmacological treatments that are available, for example, in the US, peroneal nerve stimulation, there is a device which is FDA approved and not available outside the US for now, but showing very promising results.
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