Tonic Motor Activation (TOMAC) Therapy in Patients With Restless Legs Syndrome and Dopaminergic Augmentation

Inclusion Criteria: * Adult 18 years of age or older when written informed consent is obtained. * Diagnosis of restless legs syndrome confirmed by IRLSSG criteria. * Moderate-severe RLS, IRLS ≥15 points at study entry * Dopaminergic augmentation based on clinician assessment and ASRS (augmentation severity rating scale) ≥5 points at study entry * Subject agrees to not change the dose or schedule of antidepressants and sleep medications. * Currently taking stable dose and schedule of dopamine agonist over the 4 weeks prior to enrollment, with average daily dose \>= 25mg Levodopa Equivalent Daily Dose (LEDD, https://pdmedcalc.co.uk/calculator). * Patient reports ≥3 nights per week in the 30d prior to study entry: waking during the sleep period with RLS symptoms that interfered with sleep re-initiation * RLS sensory symptoms in lower legs and/or feet are equally or more distressing than RLS sensory symptoms in all other anatomical locations. * The subject possesses the necessary equipment, internet/phone accessibility, and communication ability to complete electronic questionnaires and respond to electronic communications and phone calls from the research staff throughout the in-home portion of the study. * The subject has signed a valid, IRB-approved informed consent form and can understand the requirements of the study and instructions for device usage. Exclusion Criteria: * Baseline ferritin \<75 ng/mL or patient is unwilling to consider iron supplementation. * IV iron sup…