N A TIONAL INSTITUTES OF HEAL T H

N A TIONAL HEAR T , LUNG, AND BLOOD INSTITUTE

N a tional Center on Slee p Disor der s Resear c h 

and Of f ice of Pr e v ention, Educa tion, and Contr o l

D ETECTION

AND M ANA GEMENT

I N P RIMAR Y C ARE

R ESTLESS L EGS

S YNDR OME

D ETECTION

AND M ANAGEMENT

I N P RIMARY C ARE

R ESTLESS L EGS

S YNDROME

NATIONAL CENTER ON

SLEEP DISORDERS RESEARCH

NATIONAL HEART, LUNG,

AND BLOOD INSTITUTE

NATIONAL INSTITUTES

O F HEALTH

Produced in collaboration 

with the Restless Legs Syndrome

Foundation through an unrestricted educational grant from

Pharmacia & Upjohn and

Boehringer Ingelheim.

MARCH 2000

NIH PUBLICATION NO. 00-3788
2

MEMBERS OF THE NATIONAL HEART, LUNG, 

AND BLOOD INSTITUTE WORKING GROUP ON

RESTLESS LEGS SYNDROME

Michael Thorpy, M.D. (Chair)

Director

Sleep Disorders Center

Montefiore Medical Center

Bronx, New York

Bruce L. Ehrenberg, M.D.

Director

Clinical, EEG, and Sleep Laboratory

Tufts–New England Medical Center

Boston, Massachusetts

Wayne A. Hening, M.D., Ph.D.

Assistant Clinical Professor of Neurology

UMDNJ–Robert Wood Johnson 

Medical School

New York, New York

Mark Mahowald, M.D.

Director

Minnesota Regional Sleep Disorders Center 

Hennepin County Medical Center

Minneapolis, Minnesota 

Beth A. Malow, M.D., M.S.

Assistant Professor

Department of Neurology

University of Michigan

Ann Arbor, Michigan

Barbara Phillips, M.D., M.S.P.H.

Director

Sleep Apnea Center

Samaritan Hospital

Lexington, Kentucky

Caroline Richardson, M.D.

Robert Wood Johnson Scholars Fellow

University of Michigan Medical School

Ann Arbor, Michigan

Caroline Wellbery, M.D.

Assistant Professor, Family Medicine

Fort Lincoln Family Medical Center

Georgetown University Medical Center

Washington, DC
3

NATIONAL INSTITUTES OF HEALTH STAFF

Mark Hallett, M.D.

Clinical Director

National Institute of Neurological 

Disorders and Stroke 

National Institutes of Health

Bethesda, Maryland

James P. Kiley, Ph.D.

Director

National Center on 

Sleep Disorders Research

National Heart, Lung, and Blood Institute

Bethesda, Maryland

Charlotte McCutchen, M.D.

Program Director

Neuroscience Center

National Institute of Neurological 

Disorders and Stroke

Bethesda, Maryland

Susan Rogus, R.N., M.S.

Coordinator, Sleep Education Activities

Office of Prevention, Education, and Control

National Heart, Lung, and Blood Institute

Bethesda, Maryland

SUPPORT STAFF

Susan Shero, R.N., M.S.

Prospect Associates

Silver Spring, Maryland
4
5

CONTENTS

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Consequences of RLS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Prevalence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Etiology

Primary RLS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Secondary Causes of RLS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Iron Deficiency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Neurologic Lesions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Uremia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Drug-Induced. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Assessment and Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Clinical Criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Physical Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Laboratory Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Differential Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

When To Consider Referral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Conclusion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Appendix: Sleep/Wake Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Where To Get More Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
6
7

RESTLESS LEGS SYNDROME

DETECTION AND MANAGEMENT IN PRIMARY CARE

INTRODUCTION

Restless legs syndrome (RLS) is a common, underdiagnosed, and treatable condition. A neurologic

movement disorder, RLS is often associated with a

sleep complaint.1 Patients with RLS can suffer an

almost irresistible urge to move the legs, usually

due to disagreeable leg sensations that are worse

during inactivity and often interfere with sleep.2

RLS can be described as an agitated inability to

rest that can have a negative impact on the quality

of life due to waking discomfort, chronic sleep

deprivation, and stress. This publication provides

science-based information about RLS and its assessment and management in the primary care setting. 

CONSEQUENCES OF RLS

Direct results of RLS include discomfort, sleep

disturbances, and fatigue.

3 These consequences

have a secondary impact on functioning by 

affecting occupational activities, social activities,

and family life. Disrupted sleep and an inability to 

tolerate sedentary activities can lead to job loss,

a compromised ability to enjoy life, and problems

with relationships. 

PREVALENCE

RLS is a common disorder. Although the exact

prevalence is uncertain, limited studies have indicated that 2 to 15 percent of the population may

experience RLS symptoms.4,5,6 This wide range

may be due to differences in study methodologies.

Although the prevalence of RLS increases with

age6

, it has a variable age of onset and can occur 

in children.7 In patients with severe RLS, one-third

to two-fifths had their first symptom before 

age 208

, although the precise diagnosis of RLS was

made much later.

ETIOLOGY

Primary RLS

RLS is a central nervous system (CNS) disorder.

9

It is not caused by psychiatric factors or by stress

but may contribute to or be exacerbated by these

conditions. There is a high incidence of familial

cases of RLS, suggesting a genetic origin for 

primary RLS.

8 The exact mode of inheritance 

is unknown.8,10

Secondary Causes of RLS

• Iron deficiency. RLS may be associated with

iron deficiency. A patient’s iron stores may be

deficient without significant anemia. Recent

studies have shown that decreased iron stores

(indicated by ferritin levels below 50 mcg/L)

can exacerbate RLS symptoms.11,12 Patients

with newly diagnosed RLS or RLS patients with

a recent exacerbation of symptoms should have

their serum ferritin levels measured. 

• Neurologic lesions. RLS has been reported 

in association with spinal cord and peripheral

nerve lesions, although an exact pathological

mechanism has not been identified. RLS 

may also emerge in patients with vertebral 

disc disease.

8

• Pregnancy. RLS affects up to 19 percent of

women during pregnancy.

13 Symptoms can 

be severe but usually subside within a few

weeks postpartum. 
8

• Uremia. RLS occurs in up to 50 percent of

patients with end-stage renal failure, and may 

be particularly bothersome during dialysis when

the patient is confined to a resting position.14,15

Improvement in RLS symptoms has been seen

after renal transplantation.16

• Drug-induced. There is some evidence from

published case reports that RLS symptoms may

be worsened or unmasked by medications such

as tricyclic antidepressants,17 selective serotonin

reuptake inhibitors (SSRIs),18 lithium,19 and

dopamine antagonists.20 Caffeine also has been

implicated in the worsening of RLS symptoms.21

ASSESSMENT AND DIAGNOSIS

The diagnosis of RLS is based primarily on the

patient’s history. Often, patients do not bring RLS

symptoms to the physician’s attention; therefore,

it can be helpful to include general sleep questions

in the review of systems. See Appendix. When

RLS is suspected, more specific questions can 

be asked. See Table 1.

Symptoms are described by patients in many ways,

ranging from mild to intolerable.

22 See Table 2.

Although most patients experience the sensations

in their legs, the sensations may also occur in the

arms or elsewhere. RLS symptoms are generally

worse in the evening and night and less severe 

in the morning. RLS needs to be distinguished

from sleep-related leg conditions such as 

nocturnal leg cramps.

Clinical Criteria 

The following criteria for diagnosis of RLS are

based on those developed by the International

Restless Legs Syndrome Study Group.3

Minimal criteria include the following:

1. A compelling urge to move the limbs, usually

associated with paresthesias/dysesthesias. 

Table 1

■ Does the patient report “creeping, crawling, or uncomfortable, difficult-to-describe feelings” in the legs or 

arms that are relieved by moving or rubbing them? 

■ Is there a correlation between RLS symptoms and time of day? Do the symptoms worsen with rest or inactivity?

■ Do sensations interfere with sleep onset or returning to sleep?

■ What daytime consequences does the patient report (e.g., fatigue, sleepiness, confusion, lack of attention)?

■ Does the bed partner report that the patient’s legs or arms jerk during sleep? 

(Relates to periodic limb movements in sleep.)

■ Does the patient have secondary causes of RLS such as low iron stores, diabetes mellitus,

kidney disease, or pregnancy?

■ Are neurological symptoms or diagnoses present?

■ Is there a relationship between symptoms and medications, such as tricyclic antidepressants or SSRIs?

■ Was the onset of symptoms correlated with a change in medication?

■ Do family members report similar symptoms? Have family members been diagnosed with RLS?

RLS-R ELA TED Q UESTIONS
9

2. Motor restlessness as seen in activities such as

floor pacing, tossing and turning in bed, and

rubbing the legs.

3. Symptoms worse or exclusively present at rest

(i.e., lying, sitting) with variable and temporary

relief by activity. 

4. Symptoms worse in the evening and at night.

Other associated features commonly found in RLS

but not required for diagnosis include the following:

• Sleep disturbance and daytime fatigue.

• Normal neurological exam in primary RLS. 

• Involuntary, repetitive, periodic, jerking limb

movements, either in sleep or while awake 

and at rest.

The last feature refers to periodic limb movements

(PLM), also known as PLMS (periodic limb movements of sleep)23 or nocturnal myoclonus,24 which

may be associated with RLS. PLM are stereotyped,

repetitive flexions of the limbs (legs alone or legs

more than arms) usually occurring during sleep.

They occur periodically on an average of every 

20 seconds. The most common movement is a 

dorsiflexion of the ankles and flexion of the 

knees or hips.

Physical Examination

The physical examination is usually normal in

patients with RLS and is performed to identify 

secondary causes and rule out other disorders. 

The following are areas of particular importance:

• A neurological exam with emphasis on spinal

cord and peripheral nerve function. 

• A vascular exam to rule out vascular disorders.

Laboratory Tests

The following laboratory tests can identify 

possible secondary causes of RLS:

• Serum ferritin level (<50mcg/L)

• Serum chemistry to rule out uremia 

and diabetes 

A sleep study (polysomography) is not routinely

indicated in the workup of RLS25 because RLS 

is diagnosed on the basis of history and 

clinical findings.

Differential Diagnosis

Differential diagnoses may include the following:

• Nocturnal leg cramps (typically painful, palpable,

involuntary muscle contractions, often focal,

with a sudden onset; usually unilateral).26

Table 2

Creeping Indescribable Electric current-like

Crawling Pulling Restless

Itching Drawing Painful

Burning Aching

Searing Like water flowing

Tugging Like worms or bugs crawling under the skin

T ERMS U SED T O D ESCRIBE RLS S ENSA TIONS
10

Table 3

P HARMA COLOGIC T REA TMENT FOR RLS

Agent Advantages Disadvantages 

Dopaminergic Agents

Dopamine precursor

combinations such as 

carbidopa-levodopa 

Can be used on a “one time” basis or

as circumstances may require. Useful

for persons with intermittent RLS

because dopamine agonists take

longer to have an effect.

As many as 80 percent of patients 

on carbidopa-levodopa may develop

augmentation.* Therapeutic effect may

be reduced if taken with high-protein

food. Can cause insomnia, sleepiness,

and gastrointestinal problems. 

Dopamine agonists such as 

Pergolide

Pramipexole

Ropinirole

Useful in moderate to severe RLS.

Recent reports indicate high efficacy

of dopamine agonists, but the role of

their long-term use is unknown.29

Can cause severe sleepiness,30 which

may limit its use during daytime.

Agonists can cause nausea. To avoid

this, slow dose increase is important,

especially for pergolide.

Opioids such as 

Codeine

Hydrocodone

Oxycodone

Propoxyphene

Tramadol

Can be used on an intermittent basis.

Can also be used successfully for

daily therapy. 

Can cause constipation, urinary retention, sleepiness, or cognitive changes.

Tolerance and dependence possible

with higher doses of stronger agents.

Benzodiazepines such as 

Clonazepam 

Temazepam

Helpful in some patients when other

medications are not tolerated, and

may help improve sleep.

Can cause daytime sleepiness and

cognitive impairment, particularly 

in the elderly. 

Anticonvulsants such as

Carbamazepine

Gabapentin 

Can be considered when dopamine

agonists have failed. May be useful

in those with coexisting peripheral

neuropathy and/or when RLS 

discomfort is described as pain.

Disadvantages vary depending on

agent, but include gastrointestinal 

disturbance such as nausea,

sedation, dizziness.

Iron (ferrous sulfate) Use in patients with serum ferritin 

levels <50 mcg.

Ideal means of administration has not

been established. Oral treatment may

take several months to be effective 

and may be poorly tolerated.

Clonidine May be useful in hypertensive 

patients.

Has the potential to cause hypotension,

dermatitis, and sleepiness. 

*Augmentation is a worsening of RLS symptoms in the course of therapy. Symptoms may be more severe and start

earlier in the day (e.g. afternoon rather than evening) than before treatment began and may spread to different parts

of the body. Augmentation, which can start soon after therapy is begun or not until months or years later, has also

been reported with dopamine agonists and may occur with other medications. 
11

• Akathisia (excessive movement, without specific

sensory complaints; often does not correlate

with rest or time of day and usually results from

medication such as neuroleptics or other

dopamine blocking agents).27

• Peripheral neuropathy (can cause leg symptoms

that are different from RLS; they are usually not

associated with motor restlessness, nor helped

by movement, and have no evening or night

time worsening. Sensory complaints are typically

numbness, tingling, or pain. Small fiber sensory

neuropathies, as seen in diabetes, are often confused with RLS. Patients with neuropathies may

have both neuropathic and RLS symptoms.)

• Vascular disease (such as deep vein thrombosis).

TREATMENT

The severity of RLS varies from patient to patient.

Although pharmacologic treatment is helpful for

many RLS patients, those with mild symptoms

may not need medications. Since no single medication or combination of medications will work

predictably for all patients, treatment must often be

individualized. Physicians and patients may need

to work together over time to find the medication

or combination of medications and the dosages

that will work best. See Table 3 for a list of 

pharmacologic agents and their advantages and

disadvantages. Therapy for RLS constitutes an 

“off label” use of these pharmacologic agents.

The selection of pharmacologic agents is influenced by a number of factors, including:

• Age of the patient. (For example,

benzodiazepines may cause cognitive 

impairment in the elderly.)

• Severity of symptoms. (Some patients with 

mild symptoms may elect not to use medications; others may benefit from levodopa or 

a dopamine agonist. Patients with severe 

symptoms may require a strong opioid.)

• Frequency or regularity of symptoms. 

(Patients with infrequent symptoms may 

benefit from a single effective p.r.n. dose of 

a medication such as an opioid or levodopa.)

• Presence of pregnancy or comorbid illnesses.

(There are no controlled clinical trials that have

assessed the safety and efficacy of medications

for RLS or PLM during pregnancy.

28)

• Renal failure. (In these patients, pharmacologic

agents are generally safe, but less frequent doses

may be needed if drugs are renally excreted. In

addition, for dialysis patients, some medications

are dialyzable [e.g., gabapentin] and others are

not [e.g., propoxyphene].28)

Dopaminergic agents are the first-line drugs for

most RLS patients. It is important for the primary

care physician to educate the patient about the

nature and actions of the drugs that are prescribed,

including side effects and the uncertainty of 

long-term effects. For example, when prescribed

dopaminergic agents, the patient should be

informed that although these medications are 

usually used to treat Parkinson’s disease, they 

also help to relieve RLS symptoms.
12

RLS medications have received approval from the

Food and Drug Administration for other uses. In

many cases, the therapeutic doses to treat RLS are

much lower than those required for the original

uses. The starting dose is usually very low and is

gradually increased until effective. In addition to

the medications listed in Table 3, agents such as

vitamin E, folate, and magnesium may be useful.

Although many nonpharmacologic treatments have

been reported by patients to be helpful, there is no

scientific evidence that they are useful in the treatment of RLS.

WHEN TO CONSIDER REFERRAL

For most patients, RLS can be effectively managed

by the primary care physician. If the primary care

physician encounters difficulty managing RLS

symptoms in a patient, referral to, or consultation

with, a movement disorders specialist or a sleep

specialist may be helpful. 

CONCLUSION

The primary care physician plays a central role 

in the identification and treatment of RLS.

Incorporating sleep- and RLS-related questions

into the general review of systems can be helpful

in diagnosing RLS. An important aspect of treatment is listening to and supporting patients and

carefully evaluating their complaints. Most patients

with RLS can obtain symptomatic relief with 

commonly prescribed medications and support. 
13

1. Meissner HH, Riemer A, Santiago SM, Stein M,

Goldman MD, Williams AJ. Failure of physician

documentation of sleep complaints in hospitalized

patients. West J Med 1998;169(3):146-149. 

2. Ekbom KA. Restless legs syndrome. 

Neurology 1960;10:868-873. 

3. Walters AS. Toward a better definition of the 

restless legs syndrome. Mov Disord

1995;10(5):634-642.

4. Ekbom KA. Restless legs. A report of 70 new

cases. Acta Med Scand 1950;246(suppl):64-68.

5. Strang RR. The symptom of restless legs.

Med J Aust 1967;1:1211-1213.

6. Lavigne GJ, Montplaisir JY. Restless legs 

syndrome and sleep bruxism: prevalence and 

association among Canadians. Sleep

1994;17(8):739-743.

7. Walters AS, Picchietti DL, Ehrenberg BL, Wagner

ML. Restless legs syndrome in childhood and 

adolescence. Pediatr Neurol 1994;11(3):241-245.

8. Walters AS, Hickey K, Maltzman J, et al. 

A questionnaire study of 138 patients with restless

legs syndrome: the ‘Night-Walkers’ survey.

Neurology 1996;46:92-95.

9. Chokroverty S, Jankovic J. Restless legs syndrome.

A disease in search of identity. Neurology

1999;52:907-910.

10. Montplaisir J, Boucher S, Poirier G, Lavigne G,

Lapierre O, Lésperance P. Clinical, polysomnographic, and genetic characteristics of restless legs

syndrome: a study of 133 patients diagnosed with

new standard criteria. Mov Disord 1997;12(1):61-65.

11. Sun ER, Chen CA, Ho G, Earley CJ, Allen RP. 

Iron and the restless legs syndrome. Sleep

1998;21(4):371-377.

12. Aul EA, Davis BJ, Rodnitzky RL. The importance

of formal serum iron studies in the assessment of

restless legs syndrome. Neurology 1998;51:912.

13. Goodman JD, Brodie C, Ayida GA. Restless leg

syndrome in pregnancy. BMJ

1988;297(6656):1101-1102.

14. Wetter TC, Stiasny K, Kohnen R, Oertel WH,

Trenkwalder C. Polysomnographic sleep measures

in patients with uremic and idiopathic restless legs

syndrome. Mov Disord 1998;13(5):820-824.

15. Winkelman JW, Chertow GM, Lazarus JM.

Restless legs syndrome in end-stage renal disease.

Am J Kidney Dis 1996;28(3):372-378.

16. Yasuda T, Nishimura A, Katsuki Y, Tsuji Y.

Restless legs syndrome treated successfully by 

kidney transplantation—a case report.

Clin Transpl 1986;12:138.

17. Garvey MJ, Tollefson GD. Occurrence of

myoclonus in patients treated with cyclic antidepressants. Arch Gen Psychiatry 1987;44:269-272.

18. Bakshi R. Fluoxetine and restless legs syndrome.

J Neurol Sci 1996;142:151-152.

19. Terao T, Terao M, Yoshimura R, Abe K. 

Restless legs syndrome induced by lithium.

Biol Psychiatry 1991;30:1167-1170.

20. Ward NG. Akathisia associated with droperidol

during epidural anesthesia. Anesthesiology

1989;71:786-787.

21. Lutz EG. Restless legs, anxiety and caffeinism.

J Clin Psychiatry 1978;39:693-698.

22. Ondo W, Jankovic J. Restless legs syndrome:

clinicoetiologic correlates. Neurology

1996;47:1435-1441.

REFERENCES
14

23. American Sleep Disorders Association.

International classification of sleep disorders,

revised: diagnostic and coding manual. 

Rochester, Minnesota: American Sleep 

Disorders Association, 1997. Pgs. 65-68.

24. Lugaresi E, Cirignotta F, Coccagna G, Montagna P.

Nocturnal myoclonus and restless legs syndrome.

Adv Neurol 1986;43:295-307.

25. Chesson AL Jr., Ferber RA, Fry JM, et al. 

The indications for polysomnography and related

procedures. Sleep 1997;20(6):423-487.

26. Riley JD, Antony SJ. Leg cramps: differential 

diagnosis and management. Am Fam Physician

1995;52(6):1794-1798.

27. Walters AS, Hening W, Rubinstein M, Chokroverty

S. A clinical and polysomnographic comparison 

of neuroleptic-induced akathisia and the 

idiopathic restless legs syndrome. Sleep

1991;14(4):339-345.

28. Hening W, Allen R, Earley C, Kushida C,

Picchietti D, Silber M. The treatment of restless 

legs syndrome and periodic limb movement 

disorder. Sleep 1999;22(7):970-999.

29. Montplaisir J, Nicolas A, Denesle R,

Gomez-Mancilla B. Restless legs syndrome

improved by pramipexole. A double-blind 

randomized trial. Neurology 1999;52:938-943.

30. Frucht S, Rogers JD, Greene PE, Gordon MF,

Fahn S. Falling asleep at the wheel: motor vehicle

mishaps in persons taking pramipexole and 

ropinirole. Neurology 1999;52:1908-1910.
15

• How has the patient been sleeping recently?

(Ask patient and bed partner.)

SUGGESTED QUESTIONS FOLLOWING

A SLEEP COMPLAINT

• When did the problem begin? 

(To determine acute vs. chronic insomnia) 

• Does the patient have a psychiatric or medical

condition that may cause insomnia?

• Is the sleep environment conducive to sleep (relative to noise, interruptions,

temperature, light)?

• Does the patient report “creeping, crawling,

or uncomfortable, difficult-to-describe feelings”

in the legs or arms that are relieved by moving

them? (Relates to restless legs syndrome.)

• Does the bed partner report that the 

patient’s legs or arms jerk during sleep? 

(Relates to periodic limb movement in sleep.)

• Does the patient snore loudly, gasp, choke,

or stop breathing during sleep? 

(Relates to obstructive sleep apnea.)

• Is the patient a shift worker? What are the 

work hours? (Relates to circadian sleep 

disorders/sleep deprivation.)

• What are the bedtimes and rise times on 

weekdays and weekends? (Relates to poor 

sleep hygiene and sleep deprivation.)

• Does the patient use caffeine, tobacco,

or alcohol? Does the patient take 

over-the-counter or prescription medications

(such as stimulating antidepressants, steroids,

decongestants, beta-blockers)? (Relates to 

substance-induced insomnia.)

SIGNS OF SLEEPINESS

• What daytime consequences does the 

patient report?

• Does the patient report dozing off or 

difficulty staying awake during routine 

tasks, especially while driving?

APPENDIX: SLEEP/WAKE PROFILE
W HERE T O G E T M ORE I NFORMA TION

16

• National Center on Sleep Disorders Research (NCSDR)

The NCSDR, located in the National Heart, Lung, and Blood Institute, supports research,

scientist training, dissemination of health information, and other activities on sleep disorders 

and related concerns. The NCSDR also coordinates sleep research activities with other 

Federal agencies and with public and nonprofit organizations.

National Center on Sleep Disorders Research

Two Rockledge Centre

Suite 10038

6701 Rockledge Drive, MSC 7920

Bethesda, MD 20892-7920

(301) 435-0199

(301) 480-3451 (fax)

NCSDR Web site: http://www.nhlbi.nih.gov/about/ncsdr

• National Heart, Lung, and Blood Institute (NHLBI) Health Information Network

The NHLBI Health Information Network acquires, analyzes, promotes, maintains, and 

disseminates programmatic and educational information related to sleep and sleep disorders,

as well as cardiovascular, pulmonary, and blood diseases. Write for a list of available 

publications or to order additional copies of this brochure.

NHLBI Health Information Network

P.O. Box 30105

Bethesda, MD 20824-0105

(301) 592-8573

(301) 592-8563

NHLBI Web site: http://www.nhlbi.nih.gov

• Restless Legs Syndrome Foundation, Inc. 

The foundation is a nonprofit organization dedicated to helping the public,

patients, families, and physicians better understand RLS.

Restless Legs Syndrome Foundation, Inc.

819 Second Street, S.W.

Rochester, MN 55902-2985

RLS Foundation Web site: www.rls.org
Discrimination Prohibited: Under provisions

of applicable public laws enacted by Congress

since 1964, no person in the United States

shall, on the grounds of race, color, national

origin, handicap, or age, be excluded from

participation in, be denied the benefits of,

or be subjected to discrimination under 

any program or activity (or, on the basis of

sex, with respect to any education program 

or activity) receiving Federal financial 

assistance. In addition, Executive Order

11141 prohibits discrimination on the basis 

of age by contractors and subcontractors in 

the performance of Federal contracts, and

Executive Order 11246 states that no federally

funded contractor may discriminate against any

employee or applicant for employment because

of race, color, religion, sex, or national origin.

Therefore, the National Heart, Lung, and 

Blood Institute must be operated in compliance

with these laws and Executive Orders.
U.S. DEPARTMENT OF HEALTH AND 

HUMAN SERVICES

Public Health Service

National Institutes of Health

National Heart, Lung, and Blood Institute

NIH Publication No. 00-3788

March 2000