Background
nausea, fatigue, constipation, daytime sleepiness, neurological and sleep disorder, RLS
RESTLESS LEGS SYNDROME (RLS)
Restless legs syndrome (RLS) is a neurological and sleep disorder associated with a distressing urge to move the legs that increases during immobility and worsens during the night. Nocturnal RLS symptoms result in sleep disturbances that cause sleep deprivation [Refractory RLS is prevalent due to limitations of the dominant first-line medications. Dopamine agonists (DAs) provide initial relief, but long-term treatment often induces augmentation, treatment-dependent worsening of RLS symptoms associated with emergence of RLS symptoms earlier in the day [Opioids are recommended for refractory RLS [Acute and long-term risks of opioid therapy for refractory RLS could be mitigated by reducing the opioid dose. Acute dose-related side effects are prevalent and include constipation, nausea, fatigue, and daytime sleepiness [The purpose of this study was to determine the feasibility of using tonic motor activation (TOMAC) therapy to reduce the opioid dose for refractory RLS. TOMAC is a nonpharmacological therapeutic device worn bilaterally on the lower legs that electrically stimulates the peroneal nerve to engage the neuromuscular circuitry associated with voluntary leg movements such as walking or standing [