PURPOSE OF REVIEW: This article reviews the sleep-related movement disorders, 
including restless legs syndrome (RLS; Willis-Ekbom disease), periodic limb 
movement disorder, rhythmic movement disorders, sleep-related bruxism, and 
sleep-related leg cramps.
RECENT FINDINGS: The prevalence of clinically significant RLS is 1.5% to 3.0%. 
The pathophysiology of RLS may involve abnormal iron transport across the 
blood-brain barrier and down-regulation of putaminal D2 receptors. The 
availability of the rotigotine patch provides an additional form of dopaminergic 
therapy for RLS. Calcium channel alpha-2-delta ligands (gabapentin, gabapentin 
enacarbil, and pregabalin) provide alternative therapies for RLS especially in 
patients with augmentation, impulse control disorders, or hypersomnia induced by 
dopamine agonists. Long-term use of opioid medication is safe and effective for 
refractory cases of RLS.
SUMMARY: RLS is a common disorder causing considerable morbidity. Accurate 
diagnosis and appropriate investigations are essential. Many effective therapies 
are available, but the side effects of each class of medication should be 
considered in determining optimal treatment. Periodic limb movements of sleep, 
bruxism, and rhythmic movement disorders are sleep-related phenomena often 
accompanying other sleep disorders and only sometimes requiring primary therapy. 
Sleep-related leg cramps are generally idiopathic. Management is challenging 
with few effective therapies.