Hi all, this will be my final update on this post.
Iron levels are back to normal, labs look great.
I had an especially aversive and unusual reaction to neurofeedback which my sleep doc referred me to as a last resort for difficult-to-treat people who don't respond to meds or other sleep treatments. The neurofeedback made me more agitated, irritable, angry, and depressed and I began to feel something was very, very wrong after sessions so I stopped. I would never want to discourage anyone from neurofeedback, for the most part people don't have issues like this or the issues they have are resolved with different frequencies or electrode placement, but I have always been difficult to treat anyway so while it was very disappointing I can't say I was surprised. Those feelings of wrongness and agitation and depression eventually went away but on the plus side I now remember at least one dream per night and it has been over a month since my last session. At least I know I'm getting REM!
My legs have gotten increasingly restless and was beginning to feel it during the day and night and my sleep quality and fatigue had gotten worse. Tried belsomra which made me tired but did not help the restlessness.
I saw something online that said low salt can cause restless leg and when I tried saltwater before bed that gave me some relief, but my need for salt kept increasing a little bit every day.
I have been taking omeprazole and famotidine for stomach pain and reflux. I have taken them both in the past for years and have never had this salt/restlessness issue, but it is all very on brand for my weird medication metabolism. I stopped the meds and the restlessness significantly decreased and now I don't need much salt, though I do need some, but my stomach pain, nausea, and reflux have come raging back. I needed to get off them for a GI test anyway and I also happened to take some fiber tablets during that time and the stomach pain became excruciating. It was late at night and there is a history of appendicitis in my family so I went to the ER because I could not find an urgent care that was open. They gave me some pain medication (not morphine though, they offered but I wouldn't have been able to drive myself home) and zofran for the nausea. Labs looked great, CT was all normal. I didn't think the meds they gave me in the ER did much at the time but when I went home and slept it was easily the best sleep I have gotten in months. And I felt great and had energy the next day, even though the pain and nausea came back. Following up with GI specialist for ongoing GI issues.

TLDR acid blocking medications gave me restless legs. Stopped the meds, slept great. Case closed! Thanks for all your comments and support!