GoTo Telemed, the nation's leading integrated telehealth ecosystem serving over 10 million patients nationwide , today announced the launch of its comprehensive Restless Legs Syndrome (RLS) Management Program, a dedicated virtual care service designed to address the full spectrum of RLS symptoms through evidence-based diagnostic evaluation, iron management, medication optimization, and lifestyle coaching. Delivered by a network of sleep medicine specialists, neurologists, and primary care physicians, this program brings expert RLS care directly to patients nationwide, aligned with the groundbreaking 2025 American Academy of Sleep Medicine (AASM) clinical practice guidelines.

Restless Legs Syndrome affects approximately 13% of Americans, with prevalence rising to nearly 20% in older adults and up to 80% in pregnant women . The condition is characterized by an irresistible urge to move the legs, often accompanied by unpleasant sensations such as creeping, crawling, tingling, or pulling, which worsen during rest, intensify in the evening, and are temporarily relieved by movement . Despite its high prevalence and significant impact on sleep quality, quality of life, and mental health—patients with RLS experience depression and anxiety at rates four times higher than the general population —access to specialized care remains limited, with long wait times and geographic barriers preventing many from receiving guideline-directed treatment.

"Restless Legs Syndrome is not merely an annoyance—it is a chronic neurological condition that devastates sleep, impairs daytime function, and erodes quality of life. For decades, patients were treated with dopamine agonists, which, while effective in the short term, often made the underlying condition worse over time through a process called augmentation," said a GoTo Telemed spokesperson. "The new 2025 AASM guidelines represent a paradigm shift, moving decisively away from dopamine agonists toward safer, more effective first-line therapies: iron supplementation and alpha-2-delta ligands. Our RLS Management Program operationalizes these guideline changes, bringing evidence-based, personalized care directly to patients through telehealth—eliminating geographic barriers and ensuring that every individual with RLS receives the right treatment at the right time."

Paradigm Shift: Moving Away from Dopamine Agonists

The 2025 AASM guidelines mark a major departure from prior standards. Dopamine agonists (pramipexole, ropinirole, rotigotine), previously considered first-line therapy, are no longer recommended for routine use due to the risk of augmentation—a paradoxical worsening of RLS symptoms that occurs in 7% to 10% of patients per year . Over five years of treatment, augmentation affects 35% to 50% of patients, leading to earlier symptom onset, extension of symptoms to the arms and trunk, and increased symptom intensity, often creating a vicious cycle of dose escalation and further worsening . Additionally, dopamine agonists are associated with impulse control disorders, including pathological gambling, hypersexuality, and compulsive shopping, even at the low doses used for RLS .

Prior Standard (Pre-2025) New Standard (2025 AASM Guidelines)
Dopamine agonists (pramipexole, ropinirole, rotigotine) as first-line Gabapentinoids (gabapentin, gabapentin enacarbil, pregabalin) – strong recommendation
Limited emphasis on iron testing Routine serum ferritin and transferrin saturation testing – good practice statement
Iron supplementation rarely prioritized IV iron preferred first-line for severe RLS with ferritin