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International Restless Legs Study Group Severity Rating Scale (IRLS)

Name of questionnaire International Restless Legs Study Group Severity Rating Scale (IRLS)
Type of questionnaire-description,age Subjective scale to measure disease severity of restless legs syndrome in the past week
Number of items 10 questions (maximum score = 40, higher scores indicate more severe symptoms)
Number of domains / categories/subscales

2 subscales; symptoms or symptoms impact subscales
A patient-version also exists: IRLS-PV (16 items). This version was adapted from the IRLS to facilitate patient understanding in order to complete the scale without guidance from an investigator.

Name of categories/domains Subjective assessment of primary features of restless legs syndrome, intensity and frequency, associated sleep problems
Scaling of items 5 Likert scale (No RLS Score=0 to Very severe RLS Score=4) with total score out of 40
Access with permission or free Free for academic research and with fee for “for profit” organizations
Scoring test-retest reliability Yes
Validity & Reliability Good test‐retest reliability at 2 weeks (intraclass correlation coefficient [ICC] = 0.87; P < 0.001); good inter‐rater reliability performed under blinded conditions (ICC = 0.93 for the first application and 0.97 for the second application 2 weeks later; P < 0.001); good internal consistency with a Cronbach's alpha (0.93 and 0.95 for the two administrations); acceptable criterion validity compared to a Clinician's Global Impression (CGI; r = 0.74 on the first application and 0.73 on the second application; P < 0.001), and good discriminant validity determining markedly more-severe IRLS cases (P < 0.001).
Language English
Translations in other languages (if yes, then list the languages)

The translations may not have a full linguistic validation process and may require further work to be used in a study.

Afrikaans for South Africa *

 Arabic for Saudi Arabia *

 Cebuano for the Philippines *

 Chinese for Hong Kong *, Czech for Czech Republic *, Danish for Denmark *, Dutch for Belgium (Flemish) *, Dutch for the Netherlands *, English for Canada *, English for Hong Kong *, English for New Zealand *, English for Singapore *, English for South Africa *, English for the Philippines *, English for the UK *,  Farsi (Persian) for Iran, Finnish for Finland *, French for Belgium *, French for Canada *, French for France *, French for Switzerland *, German for Austria *, German for Germany *, German for Switzerland *, Greek for Greece *, Hindi for India, Hungarian for Hungary *, Italian for Italy *, Italian for Switzerland *, Japanese for Japan *, Korean for South Korea *, Malay for Malaysia *, Malay for Singapore *, Mandarin for China, Mandarin for Singapore *, Mandarin for Taiwan *, Norwegian for Norway *, Polish for Poland *, Portuguese for Brazil *, Portuguese for Portugal *, Romanian for Romania *, Russian for Russia *, Serbian for Serbia, Slovak for Slovakia *, Spanish for Chile *, Spanish for Colombia *, Spanish for Mexico *, Spanish for Peru *, Spanish for Spain *, Spanish for the USA *, Swedish for Sweden *, Tagalog for the Philippines *, Turkish for Turkey *, Zulu for South Africa * 

*Performed by Mapi/ICON

Developer name International RLS Study Group
Developer contact information MAPI Research Trust PROVIDE™
27 rue de la Villette
69003 Lyon France
Phone: +33 (0)4 72 13 66 66
Availability of questionnaire: needs permission from developer, cost or freely available

Use with permission from MAPI Research Trust PROVIDE™ (69003 Lyon

France Phone: +33 (0)4 72 13 66 66), free for students, physicians, clinical practice, not-funded academic users


Responsiveness to change under treatment conditions not assessed fully.
Does not examine number of involved limbs or the rapidity with which symptoms develop when a patient first sits or lies down.

Other comments

IRLS scores differed significantly between different levels of sleep problems and Clinical Global Impression (CGI) of health status providing evidence of responsiveness.

The validity and the reliability of the IRLS as a self-administered scale (sIRLS) is assessed. The sIRLS was found to be a reliable, valid and precise instrument
Link to the questionnaire (if available)
References (original publication)

Walters AS, LeBrocq C, Dhar A, Hening W, Rosen R, Allen RP, Trenkwalder C; International Restless Legs Syndrome Study Group. Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med. 2003 Mar;4(2):121-32. doi: 10.1016/s1389-9457(02)00258-7. PMID: 14592342.

Wunderlich GR, Evans KR, Sills T, Pollentier S, Reess J, Allen RP, Hening W, Walters AS; International Restless Legs Syndrome Study Group. An item response analysis of the international restless legs syndrome study group rating scale for restless legs syndrome. Sleep Med. 2005 Mar;6(2):131-9. doi: 10.1016/j.sleep.2004.10.010. PMID: 15799121.

Abetz L, Arbuckle R, Allen RP, Garcia-Borreguero D, Hening W, Walters AS, Mavraki E, Kirsch JM. The reliability, validity and responsiveness of the International Restless Legs Syndrome Study Group rating scale and subscales in a clinical-trial setting. Sleep Med. 2006 Jun;7(4):340-9. doi: 10.1016/j.sleep.2005.12.011. Epub 2006 May 19. PMID: 16713344.

Walters AS, Frauscher B, Allen R, Benes H, Chaudhuri KR, Garcia-Borreguero D, Lee HB, Picchietti DL, Trenkwalder C, Martinez-Martin P, Schrag A, Stebbins G. Review of Severity Rating Scales for Restless Legs Syndrome: Critique and Recommendations. Mov Disord Clin Pract. 2014 Sep 30;1(4): p. 317-324.

Sharon D, Allen RP, Martinez-Martin P, Walters AS, Ferini Strambi L, Högl B, Trotti LM, Buchfuhrer M, Swieca J, Bogan RK, Zak R, Hensley JG, Schaefer LA, Marelli S, Zucconi M, Stefani A, Holzknecht E, Olvera V, Meaklim H, Laska I, Becker PM; International RLS Study Group. Validation of the self-administered version of the international Restless Legs Syndrome study group severity rating scale - The sIRLS. Sleep Med. 2019 Feb;54:94-100. doi: 10.1016/j.sleep.2018.10.014. Epub 2018 Oct 29. PMID: 30529783.

Kurtis MM, Balestrino R, Rodriguez-Blazquez C, Forjaz MJ, Martinez-Martin P. A Review of Scales to Evaluate Sleep Disturbances in Movement Disorders. Front Neurol. 2018 May 29;9:369. doi: 10.3389/fneur.2018.00369. PMID: 29896152; PMCID: PMC5986889.

Masuko AH, Carvalho LB, Machado MA, Morais JF, Prado LB, Prado GF. Translation and validation into the Brazilian Portuguese of the restless legs syndrome rating scale of the International Restless Legs Syndrome Study Group. Arq Neuropsiquiatr. 2008 Dec;66(4):832-6. doi: 10.1590/s0004-282x2008000600011. PMID: 19099121.

Ahmed AE. Validation of Arabic versions of three sleep surveys. Qatar Med J. 2014 Dec 9;2014(2):130-6. doi: 10.5339/qmj.2014.20. PMID: 25745603; PMCID: PMC4344987

Inoue Y, Oka Y, Kagimura T, Kuroda K, Hirata K. Reliability, validity, and responsiveness of the Japanese version of International Restless Legs Syndrome Study Group rating scale for restless legs syndrome in a clinical trial setting. Psychiatry Clin Neurosci. 2013 Sep;67(6):412-9. doi: 10.1111/pcn.12074. Epub 2013 Aug 5. PMID: 23910574.

Stubbs PH, Walters AS. Tools for the Assessment of Pediatric Restless Legs Syndrome. Front Psychiatry. 2020 May 5;11:356. doi: 10.3389/fpsyt.2020.00356. PMID: 32431628; PMCID: PMC7214695.

Elrassas HH, Elsayed YAR, Abdeen MS, Shady MM, Shalash A, Morsy M. Restless Legs Syndrome among patients receiving antipsychotic and antidepressant drugs. Hum Psychopharmacol. 2022 Mar;37(2):e2817. doi: 10.1002/hup.2817. Epub 2021 Sep 17. PMID: 34533852.

Garcia-Borreguero D, Larrosa O, de la Llave Y, Granizo JJ, Allen R. Correlation between rating scales and sleep laboratory measurements in restless legs syndrome. Sleep Med. 2004 Nov;5(6):561-5. doi: 10.1016/j.sleep.2004.08.003. PMID: 15511702.

Gupta R, Lahan V, Goel D. Translation and validation of International Restless Leg Syndrome Study Group rating scale in Hindi language. Ann Indian Acad Neurol. 2011 Oct;14(4):257-61. doi: 10.4103/0972-2327.91939. PMID: 22346013; PMCID: PMC3271463.

Shalash AS, Elrassas HH, Monzem MM, Salem HH, Abdel Moneim A, Moustafa RR. Restless legs syndrome in Egyptian medical students using a validated Arabic version of the Restless Legs Syndrome Rating Scale. Sleep Med. 2015 Dec;16(12):1528-31. doi: 10.1016/j.sleep.2015.07.032. Epub 2015 Sep 25. PMID: 26611951.

Bjorvatn B, Leissner L, Ulfberg J, Gyring J, Karlsborg M, Regeur L, Skeidsvoll H, Nordhus IH, Pallesen S. Prevalence, severity and risk factors of restless legs syndrome in the general adult population in two Scandinavian countries. Sleep Med. 2005 Jul;6(4):307-12. doi: 10.1016/j.sleep.2005.03.008. PMID: 15923140.
Updated by  Bilgay Izci Balserak
The last date of update January 2023