Restless Legs Syndrome and Mental Health Disturbances: Clinical Implications and Current Treatment Options

Abstract Purpose of Review Restless legs syndrome (RLS) is usually framed as a sleep-related movement disorder, but its clinical burden often depends on psychiatric symptoms, insomnia, cognitive complaints, and reduced quality of life. This review reframes recent evidence on RLS and mental health for a treatment-oriented neurology audience. Recent Findings Recent observational and interventional studies support a bidirectional and complex relationship between RLS and depression, anxiety, and different mental health disturbances, which may worsen the RLS itself and the quality of life of patients. In this context, suicidal ideation deserves specific attention because it may persist even when depressive symptoms improve. Current treatment guidance has also shifted toward systematic evaluation of iron status, correction of exacerbating factors, and preferential use of alpha-2-delta ligands or iron therapy, with more cautious dopaminergic prescribing. Summary RLS management should routinely include screening for mental health symptoms, sleep disruption, suicide risk, medication triggers, and comorbid sleep disorders. Conversely, patients with psychiatric disorders and sleep complaints should be screened for RLS. Integrated treatment may improve both nocturnal symptoms and daytime neuropsychiatric functioning.