@gloaming Thank you so much for your reply. I really appreciate it. Yes, I have had a formal assessment for peripheral vascular disease--within the last year. No abnormalities found and therefore no treatment suggested. My sleep neurologist and I have also discussed the possibility of my RLS having a vascular component at length (brought up by me)--because (as you stated) it makes sense. He isn't a fan of this theory (while still acknowledging such a theory exists). The reason I was finally diagnosed with RLS is because my symptoms have been associated only with sleep, drowsiness, sleepiness etc AND never happen when I am fully awake and alert. The symptoms stop if I get up and move around. They also used to stop when I use a massager on my legs, but this is less reliable than, say, 5 years ago. If I don't use the massager, or walk, when my symptoms are extremely severe, with unrelenting pain, it can go on for hours and hours (last week after "over-exercising" one episode lasted 4 hours straight). So, not like a temporary response to a cut-off blood supply. I do appreciate your thoughts and agree that PVD has some similarities to when happens to me. My neurologist swears symptoms come from my brain. It helps me to think of it as like seizures--something over which I have little control. Only recently have I really focused on the exercise piece--doing any kind of hamstring stretch. Other than that, nothing behavioral can be tied to my RLS pain. It also helped me to learn that my RLS isn't like the "norm" but there are others like me--presenting with pain. ....Can you tell me what your RLS is like?