Impact, diagnosis and treatment of restless legs syndrome (RLS) in a primary care population: the REST (RLS epidemiology, symptoms, and treatment) primary care study

Sleep Med. 2004 May;5(3):237-46. doi: 10.1016/j.sleep.2004.03.006.


Objectives: To assess the frequency, impact, and medical response to the restless legs syndrome (RLS) in a large multi-national primary care population.

Method: Questionnaire surveys of matched patients and primary care physicians (PCPs) in five modern industrialized western countries.

Results: An RLS screening questionnaire was completed by 23,052 patients: 2223 (9.6%) reported weekly RLS symptoms; 1557 of these patients had medical follow-up questionnaires completed both by themselves and by their physician. An RLS sufferer subgroup (n=551) likely warranting treatment was defined as reporting at least twice weekly symptoms with appreciable negative impact on quality of life. A total of 88.4% of RLS sufferers reported at least one sleep-related symptom. Most reported impaired sleep consistent with a diagnosis of insomnia. Out of 551 sufferers, 357 (64.8%) reported consulting a physician about their RLS symptoms, but only 46 of these 357 (12.9%) reported having been given a diagnosis. PCPs reported that 209 (37.9%) RLS sufferers consulted them about RLS symptoms, but only 52 (24.9%) were given an RLS diagnosis. In most countries, sufferers, regardless of diagnosis, were prescribed therapies not known to be effective in RLS.

Conclusions: RLS significantly impairs patients' lives, often by severely disrupting sleep. The marked under-diagnosis and inappropriate treatment of RLS indicates that PCPs need better education about this condition. Recognizing how often disrupted sleep results from RLS should improve diagnosis.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Drug Therapy / methods
  • France / epidemiology
  • Germany / epidemiology
  • Humans
  • Prevalence
  • Primary Health Care*
  • Quality of Life*
  • Restless Legs Syndrome* / diagnosis
  • Restless Legs Syndrome* / drug therapy
  • Restless Legs Syndrome* / epidemiology
  • Spain / epidemiology
  • Surveys and Questionnaires
  • United Kingdom / epidemiology
  • United States / epidemiology