Sleep- RLS

Question 1

RLS definition

Answer 1

Parathesias felt deep in the calf muscles, thighs, and arms with an urge to keep limbs in motion which temporarily relieves it

Question 2

Parasthesias in RLS are usually what: unilateral or bilateral?

Answer 2

Bilateral

Question 3

RLS is believed to be associated with what?

Answer 3

Dopaminergic function

Question 4

RLS is associated with what disease states?

Answer 4

CKS, iron and vitamin B/folate deficiency, pregnancy, peripheral neuropathies

Question 5

Ruling out/treating causes of RLS: nutrition

Answer 5

Treat iron deficiency, vitamin B/folate deficiency, reduce caffeine and alcohol use, weight loss

Question 6

Ruling out/treating causes of RLS: other factors

Answer 6

Smoking cessation, regular moderate exercise, sleep

Question 7

What medications should you try to D/C in RLS?

Answer 7

Centrally-acting antihistamines like meclizine, hydroxyzine, diphenhydramine, and doxylamine

TCAs, SSRIs, SNRIs

APS

Antinausea drugs like metoclopramide and promethazine

Question 8

Nonpharm treatment of RLS

Answer 8

Walking, biking, soaking limbs, leg massage, activities to improve mental alertness at times of rest/boredom, yoga, acupuncture

Question 9

Pharm treatment of intermittent RLS symptoms

Answer 9

Carbidopa-levodopa, BZDRA, low-dose opioid

Question 10

Pharm treatment of chronic and persistent RLS symptoms

Answer 10

Pregabalin, gabapentin

Question 11

Pharm treatment of RLS symptoms: dopamine agonists

Answer 11

IR pramipexole, ropinirole, rotigotine