Partial endorsement of “Treatment of restless legs syndrome and periodic limb movement disorder: an American Academy of Sleep Medicine clinical practice guideline” by the World Sleep Society

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2025-08-06 DOI:10.1016/j.sleep.2025.106734

Raffaele Ferri , Yuichi Inoue , Mauro Manconi , Michael H. Silber , Claudia Trenkwalder , Clete A. Kushida

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引用次数: 0

Abstract

Background

The 2025 American Academy of Sleep Medicine (AASM) clinical practice guideline for the treatment of Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD) provides updated, evidence-based recommendations. The World Sleep Society (WSS) conducted an international review to assess the guideline's global applicability and implementation feasibility.

Methods

A structured questionnaire was distributed to representatives of 53 national sleep societies affiliated with the WSS. The survey addressed guideline familiarity, perceived applicability, agreement with 20 treatment recommendations, and availability of key therapies. Responses were analyzed using descriptive statistics and the within-group interrater agreement coefficient (rWG) to assess consensus levels.

Results

Twenty-three national societies (43.9 %) from all inhabited continents responded. The AASM guideline was perceived as fully or partially applicable in most countries. Twelve recommendations were fully supported by the WSS, five partially supported, two (regarding dopamine agonists) endorsed with caveats, and one (dipyridamole) not supported. Key barriers included limited access to certain medications (e.g., IV iron, gabapentin enacarbil), regulatory restrictions, and divergent treatment traditions. There was strong global consensus on discouraging ineffective or harmful treatments (e.g., cabergoline, valproic acid), while the avoidance of dopaminergic agents generated regional disagreement.

Conclusions

The AASM guidelines received broad international support but require region-specific adaptation for optimal implementation. The WSS endorses the guideline's structure and scientific foundation while recommending flexible dissemination strategies and greater clarity in therapeutic algorithms. These findings support the development of globally relevant, context-sensitive guidance in sleep medicine.

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世界睡眠学会部分认可“不宁腿综合征和周期性肢体运动障碍的治疗：美国睡眠医学学会临床实践指南”

2025年美国睡眠医学会（AASM）关于不宁腿综合征（RLS）和周期性肢体运动障碍（PLMD）治疗的临床实践指南提供了最新的、基于证据的建议。世界睡眠学会（WSS）进行了一项国际审查，以评估该指南的全球适用性和实施可行性。方法对隶属于WSS的53个国家睡眠学会的代表进行结构化问卷调查。该调查涉及指南的熟悉度、感知的适用性、与20种治疗建议的一致性以及关键治疗的可用性。使用描述性统计和组内交互协议系数（rWG）来分析响应，以评估共识水平。结果来自各大洲的23个国家协会（43.9%）做出了回应。AASM指南被认为完全或部分适用于大多数国家。12项建议得到了WSS的完全支持，5项部分支持，2项（关于多巴胺激动剂）有附加说明，1项（双嘧达莫）不支持。主要障碍包括获得某些药物的机会有限（例如静脉注射铁、加巴喷丁、那沙比尔）、监管限制和不同的治疗传统。全球对劝阻无效或有害的治疗方法（如卡麦角林、丙戊酸）有强烈的共识，而避免使用多巴胺能药物则产生了区域分歧。结论AASM指南得到了广泛的国际支持，但需要根据具体地区进行调整以实现最佳实施。WSS认可指南的结构和科学基础，同时建议灵活的传播策略和更清晰的治疗算法。这些发现支持了全球相关的、环境敏感的睡眠医学指导的发展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.