Restless Legs Syndrome Foundation Blog

August 15, 2025

RLS Foundation Certifies University of Southern California as a QCC

As an RLS Quality Care Center, the University of Southern California is certified to provide expert care to patients with restless legs syndrome, a chronic neurological sleep disorder.

AUSTIN, TEXAS, August 15, 2025 – The Restless Legs Syndrome (RLS) Foundation announces it has certified the University of Southern California (USC) as an RLS Quality Care Center.

An estimated 2%-3% of adults need daily clinical treatment for RLS, a chronic neurological disease that disrupts sleep and can have a devastating impact on overall quality of life. As an RLS Quality Care Center, USC will serve as a destination for RLS patients who need expert medical care.

“We are honored to receive designation as a Quality Care Center,” says Tammy Wong, MD, interim medical director of the Quality Care Center at USC. “As an RLS Quality Care Center, we aim to enhance our patients' quality of life by controlling RLS symptoms, improving sleep quality and providing RLS education to patients, families and the community,” says Dr. Denise Sharon, clinical assistant professor at USC and RLS Foundation Scientific and Medical Advisory Board member who has been caring for RLS patients for over 25 years.

USC joins a network of 14 other institutions in the US and Europe that are certified by the RLS Foundation as Quality Care Centers. Through this program, the Foundation aims to improve the diagnosis and treatment of the disease worldwide.

RLS Quality Care Centers:

• Provide expert care to RLS patients
• Serve as information and referral resources for healthcare providers who treat patients with RLS and regional support groups
• Support patients and families through educational offerings and literature
• Share information with other centers to improve clinical best practices
• Partner with the RLS Foundation on quality improvement projects to raise the standard of care for RLS patients everywhere

“We are pleased to welcome USC to the RLS Foundation Quality Care Center network,” says RLS Foundation Executive Director Karla Dzienkowski. “People with moderate to severe RLS face significant challenges in symptom management. Access to highly skilled and experienced healthcare providers is essential to effective treatment and improvement in quality of life.”

Dzienkowski adds, “The goal of the Quality Care Center network is to provide RLS patients access to healthcare providers with expertise in RLS management. We look forward to partnership with USC to advance the quality of care for RLS patients.”

The contact information for USC is listed on the RLS Foundation website. Other certified RLS Quality Care Centers are:

• Johns Hopkins Center for Restless Legs Syndrome
• Mayo Clinic Center for Sleep Medicine
• Houston Methodist Neurological Institute
• Stanford Sleep Medicine Center
• Emory Sleep Center
• Yale Center for Restless Legs Syndrome
• Vanderbilt University Medical Center
• Scripps Clinic Viterbi Family Sleep Center
• Neurocenter of Southern Switzerland
• Innsbruck Medical University
• Massachusetts General
• University of Pittsburgh
• University of Virginia at Charlottesville
• Barrow Neurological Institute

To learn more about the RLS Quality Care Center Program, visit www.rls.org/quality-care-centers.

About the RLS Foundation

The Restless Legs Syndrome Foundation is dedicated to improving the lives of all who live with restless legs syndrome (RLS). Founded in 1992, the Foundation’s goals are to increase awareness, improve treatments and advance research to find a cure. The Foundation serves healthcare providers, researchers, over 6,000 members, and an estimated 12 million individuals in the United States who have the disease. The Foundation’s Research Grant Program has awarded over $2 million in funding for medical research on RLS causes and treatments. For more information, visit www.rls.org.

CONTACT
Adrianna Colucci
Communications and Marketing Coordinator
adrianna@rls.org
512-366-9109

August 15, 2025

RLS Foundation Certifies Barrow Neurological Institute as a QCC

As an RLS Quality Care Center, Barrow Neurological Institute is certified to provide expert care to patients with restless legs syndrome, a chronic neurological sleep disorder.

AUSTIN, TEXAS, August 15, 2025 – The Restless Legs Syndrome (RLS) Foundation announces it has certified Barrow Neurological Institute as an RLS Quality Care Center.

An estimated 2%-3% of adults need daily clinical treatment for RLS, a chronic neurological disease that disrupts sleep and can have a devastating impact on overall quality of life. As an RLS Quality Care Center, Barrow will serve as a destination for RLS patients who need expert medical care.

“We are proud to be recognized with this esteemed designation,” says Nicki Niemann, MD, director of the Quality Care Center at Barrow. “We’re honored to be recognized as an RLS Quality Care Center and excited to bring national attention to the critical needs of this patient population. By uniting Barrow’s expertise in sleep medicine and movement disorders, we’re uniquely positioned to provide innovative, patient-centered care for even the most complex RLS cases. Through this partnership with the RLS Foundation, we hope to advance clinical standards, expand access to expert care in the Southwest and inspire a new level of understanding for a condition that is too often overlooked,” says Dr. Neimann.

Barrow joins a network of 14 other institutions in the US and Europe that are certified by the RLS Foundation as Quality Care Centers. Through this program, the Foundation aims to improve the diagnosis and treatment of the disease worldwide.

RLS Quality Care Centers:

• Provide expert care to RLS patients
• Serve as information and referral resources for healthcare providers who treat patients with RLS and regional support groups
• Support patients and families through educational offerings and literature
• Share information with other centers to improve clinical best practices
• Partner with the RLS Foundation on quality improvement projects to raise the standard of care for RLS patients everywhere

“We are delighted to welcome Barrow to the RLS Foundation Quality Care Center network,” says RLS Foundation Executive Director Karla Dzienkowski. “Individuals with RLS in the Southwestern part of the United States face significant challenges in finding healthcare providers who can manage moderate to severe forms of RLS. Barrow Neurological Institute provides access to knowledgeable and skilled healthcare providers who can provide personalized treatment plans to improve quality of life for those living with RLS.”

Dzienkowski adds, “The goal of the Quality Care Center network is to provide RLS patients access to healthcare providers proficient in RLS management. We look forward to our partnership with Barrow Neurological Institute to provide treatment access, management and quality of life improvement for RLS patients.”

Contact information for Barrow Neurological Institute is listed on the RLS Foundation website. Other certified RLS Quality Care Centers are:

• Johns Hopkins Center for Restless Legs Syndrome
• Mayo Clinic Center for Sleep Medicine
• Houston Methodist Neurological Institute
• Stanford Sleep Medicine Center
• Emory Sleep Center
• Yale Center for Restless Legs Syndrome
• Vanderbilt University Medical Center
• Scripps Clinic Viterbi Family Sleep Center
• Neurocenter of Southern Switzerland
• Innsbruck Medical University
• Massachusetts General
• University of Pittsburgh
• University of Virginia at Charlottesville
• University of Southern California

To learn more about the RLS Quality Care Center Program, visit www.rls.org/quality-care-centers.

About the RLS Foundation

The Restless Legs Syndrome Foundation is dedicated to improving the lives of all who live with restless legs syndrome (RLS). Founded in 1992, the Foundation’s goals are to increase awareness, improve treatments and advance research to find a cure. The Foundation serves healthcare providers, researchers, over 6,000 members, and an estimated 12 million individuals in the United States who have the disease. The Foundation’s Research Grant Program has awarded over $2 million in funding for medical research on RLS causes and treatments. For more information, visit www.rls.org.

CONTACT
Adrianna Colucci
Communications and Marketing Coordinator
adrianna@rls.org
512-366-9109

Clinical Insights Into Observational Studies

By Dr. William Ondo, Director of the RLS Quality Care Center at Houston Methodist Neurological Institute

Medical epidemiological studies, also called observational studies, assess information from existing data sources. These studies often make news headlines, reporting “associations” between some factor (e.g., medicine, food, activity) and some outcome (typically a feared medical condition). No epidemiology/observational study can ever deduce that one factor “caused” the other, a distinction that is often blurred by media sources. A classic example: there is an extremely high association between ice cream consumption and deaths by drowning. However, it is unlikely that ice cream consumption causes death by drowning and unlikely that death by drowning causes more ice cream consumption. It is much more likely that both occur more in summer, which explains the association. Although a useful, fast, and inexpensive mode of study has heralded many medical advances, in isolation, retrospective epidemiology studies are among the least scientific and potentially misleading forms of analysis.

One recent observational study correlated the use of gabapentin with developing dementia.¹ This study incorporated many of the statistical strategies used to improve the accuracy of observational studies. However, even the most strenuous and well-meaning analysis can’t overcome the potential for bias in any retrospective (analyzing previously collected data) study. This specific study compared 26,416 patients who used gabapentin for low back pain against 1,103,678 patients who did not take gabapentin for low back pain. All diagnoses were based on recorded standardized electrical diagnosis codes. The researchers from this study then used a complex process to make the larger non-gabapentin group more similar to the gabapentin group by specifically selecting a subset of 26,000 individuals from the non-gabapentin group to use in the direct comparison. By doing this, the researchers can “correct” for some intrinsic differences to make the comparison relatively more fair. Patients with other established risk factors for dementia that might bias the group (independent of gabapentin use) were excluded. At the end of this correction, the two groups were similar for age, sex, race, hypertension, diabetes, heart disease and some other disorders that have been associated with developing dementia, based on electronic medical record data.¹

However, researchers can’t correct for every factor. Fortunately, the authors of this study included the baseline characteristics of the 26,000 gabapentin group vs. the 1.1 million non-gabapentin group. Overall, the gabapentin group was much “sicker,” older, and had many additional factors that would otherwise increase their risk for dementia. Although the researchers corrected for some of these, they could not correct for many other potential dementia risk factors, such as hearing loss, social isolation, obesity, physical activity/exercise, and general attitudes toward health/healthy lifestyles. The published results do not allow us to determine whether the gabapentin group had more of the unmeasured dementia risk factors. However, because they had higher risks across almost every other reported baseline characteristic, it is reasonable to infer that they likely had more of these unmeasured risk factors as well. It was also indicated that the gabapentin baseline group were prescribed a greater number of opioids and other pain treatments. Based on this information, the gabapentin baseline group likely had more severe pain issues, which would at least suggest less exercise and more social isolation.

Potentially the biggest uncorrected risk factor for these types of observational studies is the frequency of health care visits. The more a person seeks medical assistance, the more likely they are to receive treatment and obtain a diagnosis for medical conditions. No individual who has not seen a physician is diagnosed with dementia and patients who visit a physician less often are also less likely to receive a subsequent diagnosis of dementia. This is a major, although underrecognized, intrinsic bias with all observational studies.

Other issues that may account for bias include the accuracy of the medical records, since no patient was interviewed or completed any type of questionnaire for this study. Further, generalizations to one disease (back pain) cannot always be attributed to another (RLS). For example, alpha-2-delta ligand medications (gabapentin, gabapentin enacarbil and pregabalin) improve sleep in RLS, which is known to lessen dementia risk in general. Specifically, they increase deep (delta) sleep, which is also hypothesized to reduce dementia.

Unfortunately, proper scientific studies to prove causality require prospective (collecting data moving forward in time) trials, which are lengthy, expensive and very challenging. With respect to this study, proving an association between gabapentin and dementia would require randomizing thousands of similar people to take either gabapentin or a placebo, with no chance of taking similar medicines. Participants are followed regularly for 10-15 years, examining how many in each group develop dementia. That idealized version of the study is essentially impossible on practical, financial and ethical grounds. There are high quality, but short (12-48 week) randomized prospective trials demonstrating the benefit of gabapentin enacarbil and pregabalin for RLS, however these can’t definitively eliminate the possibility of side effects that occur only after many years. Interestingly, there have been only a few small studies of gabapentin for RLS, but because of its low cost, long-established safety profile, and similarity to gabapentin enacarbil and pregabalin, it is commonly used.

At this point, I do not feel this association study of gabapentin with dementia should deter people from using gabapentin for RLS. We consider this medicine to be among the safest overall options for RLS.

1. Eghrari NB, Yazji IH, Yavari B, Van Acker GM, Kim CH. Risk of dementia following gabapentin prescription in chronic low back pain patients. Reg Anesth Pain Med. Published online July 10, 2025. doi:10.1136/rapm-2025-106577

RLS Foundation and American Academy of Sleep Medicine Foundation Announce 2025 Research Grant Awardees

August 4, 2025