SLEEP 2026 | Emerging technology treatments for restless legs syndrome and insomnia

Outside of just the, you know, the medication treatments that I mentioned for restless legs as an example, we have emerging technologies that are indicated for the treatment of moderate to severe treatment-refractory cases of RLS. So one such mechanism of action is TOMAC, tonic motor activation by way of peroneal nerve stimulation. So there are devices that act through this mechanism of action and it’s non-pharmacologic, you know you just wear two knee bands they provide electrical stimulation of the peroneal nerve and the way that they work is, simply put, people with RLS will tell you if they move around a lot or walk or shake their leg off the restless leg syndrome symptoms go away on a temporary basis. So the peroneal nerve activation is able to achieve the same effect without having any movements of the legs. So it’s compatible with sleep. So I think that that is an opportunity that, you know, we should probably consider more. So peroneal nerve stimulation. And then the other things that we should not forget is the use of opioid treatment in treatment-resistant restless leg syndrome. We know that for a lot of the folks that have augmentation due to long-term use of dopamine agonists, that they do require treatment via opioid pain medications. And some of the guidelines suggest oxycodone extended release. But we know that looking into the national RLS opioid registry, that many patients are doing very well on methadone and buprenorphine. So longer-acting low-dose opioids. As for insomnia, outside of just the traditional psychological therapies, I think there’s an emphasis that we should try to deliver those types of therapies, not just on a one-on-one basis, but also taking advantage of internet-based therapies, smartphone-based therapies, self-guided therapies using technology. There are also emerging technology treatments for insomnia. So of which, you know, vestibular nerve stimulation is one example. So this is a technology where you put some electrodes on your mastoid bones behind your ears. It delivers electrical stimulation to the vestibular nerve. And the net effect is easier sleep and shorter sleep onset latency, I suppose. So, you know, these are emerging things. We’re sort of at a point where technology and sleep is moving away from just monitoring sleep metrics, but also interventions.

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