Raffaele Ferri , Yuichi Inoue , Mauro Manconi , Michael H. Silber , Claudia Trenkwalder , Clete A. Kushida
{"title":"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”","authors":"Raffaele Ferri , Yuichi Inoue , Mauro Manconi , Michael H. Silber , Claudia Trenkwalder , Clete A. Kushida","doi":"10.1016/j.sleep.2025.106734","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106734"},"PeriodicalIF":3.4000,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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\",\"authors\":\"Raffaele Ferri , Yuichi Inoue , Mauro Manconi , Michael H. Silber , Claudia Trenkwalder , Clete A. Kushida\",\"doi\":\"10.1016/j.sleep.2025.106734\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>\",\"PeriodicalId\":21874,\"journal\":{\"name\":\"Sleep medicine\",\"volume\":\"134 \",\"pages\":\"Article 106734\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-08-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sleep medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1389945725004095\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1389945725004095","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
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
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.
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.