Talking Sleep Season 6 | Episode 3

A practical approach to treating RLS

DR. RACHEL SALAS AND DR. SARA BENJAMIN, GUESTS

Johns Hopkins colleagues Dr. Rachel Salas and Dr. Sara Benjamin discuss the basics of treating restless legs syndrome (RLS), focusing on an updated algorithm published in the Mayo Clinic Proceedings in 2021 by the Scientific and Medical Advisory Board of the Restless Legs Syndrome Foundation. Topics of discussion include pharmacological treatment options, the risk of augmentation, potential impulsivity, and non-pharmacologic treatments.

Rachel Salas, MD, MEd, is a professor of neurology and assistant medical director of the Johns Hopkins Center for Sleep and Wellness in Columbia, Maryland.  She has a research interest and clinical expertise in restless legs syndrome and is often asked to provide a second or third opinion on refractory RLS. She earned her medical degree from the University of Texas Medical Branch at Galveston, where she also completed her internal medicine internship and neurology residency. She completed her sleep medicine fellowship at Johns Hopkins and earned a Master of Medical Education at the Johns Hopkins School of Education. She is board-certified in neurology and sleep medicine by the American Board of Psychiatry and Neurology.

Sara Benjamin, MD, is an instructor of neurology and medical director of the Johns Hopkins Center for Sleep and Wellness. She earned her medical degree from the University of Maryland School of Medicine and completed a residency in neurology at the George Washington University School of Medicine and Health Sciences and a fellowship in neurophysiology at Wake Forest Baptist Medical Center. She is board-certified in neurology by the American Board of Psychiatry and Neurology and in sleep medicine by the American Board of Sleep Medicine.

Episode Resources

  1. Silber MH, Buchfuhrer MJ, Earley CJ, Koo BB, Manconi M, Winkelman JW; Scientific and Medical Advisory Board of the Restless Legs Syndrome Foundation. The management of restless legs syndrome: an updated algorithm. Mayo Clin Proc. 2021;96(7):1921-1937. https://doi.org/10.1016/j.mayocp.2020.12.026
  2. Silber MH, Becker PM, Buchfuhrer MJ, Earley CJ, Ondo WG, Walters AS, Winkelman JW; Scientific and Medical Advisory Board, Restless Legs Syndrome Foundation. The appropriate use of opioids in the treatment of refractory restless legs syndrome. Mayo Clin Proc. 2018;93(1):59-67. https://doi.org/10.1016/j.mayocp.2017.11.007
  3. Salas RME, Kalloo A, Earley CJ, et al. Connecting clinical aspects to corticomotor excitability in restless legs syndrome: a TMS study. Sleep Med. 2018;49:105-112. https://doi.org/10.1016/j.sleep.2018.05.002
  4. Salas RE, Kwan AB. The real burden of restless legs syndrome: clinical and economic outcomes. Am J Manag Care. 2012;18(9 Suppl):S207-12. https://www.ajmc.com/view/a409_12oct_salas_s207
  5. Salas RE, Gamaldo CE, Allen RP. Update in restless legs syndrome. Curr Opin Neurol. 2010;23(4):401-6. https://doi.org/10.1097/wco.0b013e32833bcdd8
  6. Salas RE, Rasquinha R, Gamaldo CE. All the wrong moves: a clinical review of restless legs syndrome, periodic limb movements of sleep and wake, and periodic limb movement disorder. Clin Chest Med. 2010;31(2):383-95. https://doi.org/10.1016/j.ccm.2010.02.006