Pro & Con Sessions
Moderators: Raffaele Ferri (Italy) & Christopher Earley (USA)
Structure:
Pro Argument – 10 Minutes
Con Argument – 10 Minutes
Discussion – 10 Minutes
Optimizing Augmentation Treatment
“When to Consider Alpha-Delta Drugs and the Role of Iron & Vitamin D3 Supplementation”
Learning Objectives:
Evaluate the benefits of alpha-delta drugs, iron, and vitamin D supplementation as safe and effective treatment options with minimal risk of provoking or sustaining augmentation.
Rosalia Silvestri (Italy)
Professor Rosalia Silvestri is as Associate Professor of Neurology at the Department of Clinical and Experimental Medicine of the “G. Martino” University Hospital in Messina. In addition to her academic role, she is the Medical Director of the Regional Center for the Diagnosis and Treatment of Sleep Disorders, which operates within the Neurophysiopathology and Movement Disorders Unit at the same institution.
Her primary research interests and clinical expertise include sleep-related movement disorders, particularly Restless Legs Syndrome (RLS), gender differences in sleep pathologies, epilepsy, parasomnias, and the interplay between sleep dysfunction and neurological disorders.
Professor Silvestri served as President of the European Restless Legs Syndrome Study Group (EURLS-SG) from 2019 to 2023. Currently, she is a board member of the International Restless Legs Syndrome Study Group (IRLSSG).
“The Judicious Use of Opioids to Facilitate Tapering of Dopamine Agonists”
Learning Objective:
Create a plan for treatment of augmentation that includes tapering of a dopamine agonist and initiation of an opioid medication.
Andy Berkowski (USA)
Dr. Berkowski is board certified by the American Board of Psychiatry and Neurology in Sleep Medicine. He specializes in the management of complex sleep disorders including a research interest in restless legs syndrome. Dr. Berkowski is a member of the American Academy of Sleep Medicine (AASM), the International Restless Legs Syndrome Study Group (IRLS SG), and serves as a volunteer on the Scientific and Medical Advisory Board of the Restless Legs Syndrome Foundation. His most prominent work is as vice chair of the AASM’s Clinical Practice Guidelines Task Force for the Treatment of RLS published on the first day of 2025. Throughout his career, Dr. Berkowski has taught medical residents and fellows in sleep medicine and has lectured extensively on the topic of sleep disorders and RLS.
When Should We Use Dopaminergic Agents for RLS?
Learning Objective:
Understand the indications and precautions surrounding the use of dopamine agonist for restless legs syndrome.
Michael Silber (USA)
Dr. Michael H. Silber attended medical school at the University of Cape Town. He trained in Internal Medicine and Neurology at Groote Schuur Hospital, Cape Town, and completed a fellowship in Neurology at the Mayo Clinic, Rochester, MN, USA. He is a Fellow of the College of Physicians of South Africa, and is board certified by the American Board of Psychiatry and Neurology, and the American Board of Sleep Medicine. He is a fellow of the American Neurologic Association, the American Academy of Neurology, and the American Academy of Sleep Medicine.
Dr. Silber is a Professor of Neurology in the Mayo Clinic College of Medicine and Science. He is the Elliot and Marlys Badzin Neuro-Degenerative Sleep Disorder Professor. He is a past Co-Director of the Mayo Clinic Center for Sleep Medicine and past Dean of the Mayo Clinic School of Health Sciences. He is a Past President of the American Academy of Sleep Medicine, Past President of the American Board of Sleep Medicine and past Chair of the Sleep Medicine Fellowship Directors’ Council. He received the 2010 Nathaniel Kleitman Award from the American Academy of Sleep Medicine for distinguished service to the profession, the 2013 Sleep Science Award from the American Academy of Neurology, and the 2017 Excellence in Education Award from the American Academy of Sleep Medicine. He received the 2024 Mayo Clinic Distinguished Educator Award. His research interests include restless legs syndrome, REM sleep behavior disorder and narcolepsy. He has published 140 peer reviewed publications, 30 book chapters and 3 books.
Learning Objectives:
Understand the rationale for making treatment decisions in RLS.
Identify early signs of dopaminergic augmentation.
Understand how to maximize the therapeutic potential of intravenous iron and other non-dopaminergic treatments.
Diego Garcia-Borreguero (Spain)
Diego García-Borreguero is the Director of the Sleep Research Institute in Madrid, Spain. Until 2005, he was Director of the Sleep Disorders Center at the Department of Neurology of the Fundación Jiménez Díaz (Autonomous University of Madrid). He has completed fellowships in sleep medicine and sleep research at the National Institutes of Health in Bethesda, Maryland, USA and underwent residency training at the Max Planck Institute in Munich, Germany. He received his MD from the University of Navarre (Pamplona, Spain) and completed his PhD at the University of Munich.
García-Borreguero’s main area of research is movement disorders in sleep, and restless legs syndrome (RLS) in particular. He has published extensively in this field in international peer-reviewed journals. He is also a member of numerous professional organizations related to the field of sleep science, such as the World Association of Sleep Medicine (WASM) and the American Academy of Sleep Medicine (elected fellow).