{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:58:41Z","timestamp":1792292321080,"version":"4.4.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Study Objectives<\/jats:title>\n                    <jats:p>Large long-term assessments of opioid effectiveness and dose stability for those with dopamine agonist augmentation of restless legs syndrome (RLS) are lacking. We present 5-year longitudinal findings from the National RLS Opioid Registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five-hundred participants taking opioids for RLS were interviewed at baseline about RLS symptoms, opioid medications and doses, sleep, and mental health. Participants subsequently completed online surveys every 6\u00a0months. Changes from baseline to 5-year follow-up in morphine milligram equivalents (MMEs), excluding those taking buprenorphine, were evaluated by group-based trajectory modeling. Independent associations with opioid dose changes were determined using multiple logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At 5 years of follow-up, 410 (364 excluding any taking buprenorphine) participants remained for this analysis. Most participants are female (57.1 per cent) and white (98.3 per cent), with an average age of 64.7 (\u00b110.6) and 88.8 per cent had a history of dopamine agonist augmentation. The median daily MME at 5 years was 37.5 (equivalent to methadone 8.0\u00a0mg or oxycodone 25.0\u00a0mg), an increase of 7.5 MME from baseline. Opioid doses increased from baseline to 5 years in 49.5 per cent of participants and decreased in 20.0 per cent of participants. Group-based trajectory analysis identified four distinct groups: decrease (3.4 per cent of participants; average MME change\u2009=\u2009\u221215.7\u2009\u00b1\u200912.4), no\/little change (66.1 per cent of participants; average MME change\u2009=\u20091.5\u2009\u00b1\u20098.0), small increase (23.9 per cent of participants; average MME change\u2009=\u200922.0\u2009\u00b1\u200911.6), and large increase (3.4 per cent of participants; average MME change\u2009=\u200949.2\u2009\u00b1\u200918.7). RLS severity was stable from baseline (13.3\u2009\u00b1\u20099.6) to 5 years (13.1\u2009\u00b1\u20099.0) according to the International Restless Legs Syndrome Study Group Severity Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Opioid doses in augmented RLS remain largely stable over 5 years of follow-up. Low-dose opioids provide an effective long-term option for augmented RLS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/sleep\/zsag008","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T12:38:13Z","timestamp":1768394293000},"source":"Crossref","is-referenced-by-count":5,"title":["Effectiveness and dose stability of opioids in patients with restless leg syndrome: 5-year findings from the National Restless Legs Syndrome Opioid Registry"],"prefix":"10.1093","volume":"49","author":[{"given":"John W","family":"Winkelman","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital, Department of Psychiatry , Boston, Massachusetts ,","place":["United States"]},{"name":"Harvard Medical School, Department of Psychiatry , Boston, Massachusetts ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adysn","family":"Kilty","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Department of Psychiatry , Boston, Massachusetts ,","place":["United States"]},{"name":"George Washington University, School of Medicine and Health Sciences , Washington, DC ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3143-5627","authenticated-orcid":false,"given":"Benjamin","family":"Wipper","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women\u2019s Hospital , Boston, Massachusetts ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordana","family":"Zackon","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine , Boston, Massachusetts ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Sherfey","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Department of Psychiatry , Boston, Massachusetts ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"issue":"11","key":"2026051210212166100_ref1","doi-asserted-by":"publisher","first-page":"1286","DOI":"10.1001\/archinte.165.11.1286","article-title":"Restless legs syndrome prevalence and impact: REST general population study","volume":"165","author":"Allen","year":"2005","journal-title":"Arch Intern Med"},{"key":"2026051210212166100_ref2","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.jsmc.2021.02.005","article-title":"The long-term psychiatric and cardiovascular morbidity and mortality of restless legs syndrome and periodic limb movements of sleep","volume":"16","author":"Wipper","year":"2021","journal-title":"Sleep Med Clin"},{"key":"2026051210212166100_ref3","doi-asserted-by":"publisher","first-page":"CD006009","DOI":"10.13078\/jsm.230030","article-title":"Dopamine 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