Anyone have experience with the Nidra Tomac device for RLS?

@lk8 Good to hear from you, lk8, especially with such happy news!

My experience has been so different because I was aware of augmentation before I took any medication for RLS--so I have avoided taking a dopamine agonist medication. Requip (ropinirole) was what my primary care doctor wanted to prescribe, but I refused to take it. Instead, I went through the gabas and an iron infusion, before my RLS specialist prescribed buprenorphine (which has been wonderfully effective for me).

Because you were already taking ropinirole, your neurologist opted to increase your dosage to boost its effectiveness. I can't comment on this, but I think you should stay aware of the risk of augmentation this can bring. I think anyone taking a dopamine agonist should have open discussions with the prescriber about the possibility of augmentation as part of the total picture.

I'm pretty sure my Nidra bands worked from the beginning in terms of stopping individual episodes. But, I think it took months before I became aware that the incidence of episodes had decreased. Maybe, as many as 5 months.

Also, I've experienced a couple times when another factor--over-exercising/over-stretching--made RLS symptoms occur more frequently and more severely for a period of time.

Then, I've also had periods with absolutely no symptoms during the night--these going on for a month or longer. This took months longer--maybe 8-10 months into my Nidra use.

Because you have had simultaneously both an increase in medication AND the bands coming into your life, it's hard to say if your improvements are mostly from one thing, or the other, or a combination of both. It does sound like Nidra does work for you and hurray for that! Evidently, Nidra isn't effective for everybody.

But, if your experience will be like mine, continued use of the bands will re-train your brain, over time, and you will notice both a marked decrease in frequency and in severity. Noctrix says this is common with folks using the Nidra. (And, hurray for that!)

I took the position of not paying too much attention--letting these changes occur in my subconscious without a lot of conscious oversight on my part. My doctor has suggested too much scrutiny can lead to anxiety. That's one reason I'm not more precise as to remembering exactly when changes in RLS occurred after I got my Nidra.

I can tell you with certainty, however, that in the last six months my average amount of sleep has gone from 6 1/2 hours per night to 7 1/2--which has made a difference in how I feel in the daytime.

I do remember, at the beginning, having to think each night about which direction the bands go--clock-wise on the left--counter-clock-wise on the right. Now, I slap them on without any thought.

Do be careful with the velcro (if it hasn't been improved yet). It is a weak point of my bands. Also, put on your calendar when to re-order the sticky pads. Depending where you live in the country it can take days to a week before they arrive via UPS. Each time you email the "re-order" they like you to affirm "no change in insurance or address." (Initially, you will probably re-order through your "helper" but down the road you will email to their supply people directly).

Congratulations on acquiring your bands and in having improvement! Please keep us all posted on your progress.

Ugh, @lk8, that's so frustrating with Medicare. I'm fairly new here, but I've dealt with RLS for years and insurance issues like this are always a headache. You absolutely don't want to just say yes and hope for the best, especially with a device.

When you're looking at a new device like Nidra, sometimes the company that makes it has a patient advocate or a dedicated billing specialist. They often know the specific codes and how to talk to Medicare about their product. I would definitely ask the Nidra consultant if they have someone like that.

They should be able to help you get a written pre-determination. That's what you really need to avoid a surprise bill. It's also a good idea to keep a log of everyone you talk to, their names, and what they say. Getting clarity on coverage is so important before you move forward.

@lk8, I'm so sorry you're still hitting a wall with Medicare. It's incredibly frustrating when you can't get a straight answer, and it makes total sense you don't want a surprise bill.

To your question about just saying yes and hoping for the best, please don't! It's really tough to get pre-approval sometimes, especially with devices. Medicare reps often don't have the specific codes or experience with a newer device like Nidra. That's why pushing the Nidra consultant for their dedicated billing person or advocate is so crucial. They're the ones who know exactly how to speak Medicare's language for their product, and they should be able to get you that written pre-determination.

Hello prospective Nidra users---I got mine in April 2025. My Medicare paid 100% and continues to pay for the sticky pads that are replaced weekly.

For me, Nidra has been extremely effective. I regularly sing its praises on this forum.

My husband tells me that Medical plans vary (to a degree) by state and by the letter of the alphabet (I have a G plan). So, some people have a co-pay and I don't.

Yes, the Noctrix Company that makes and sells the Nidra can be very helpful. Call them. They want to sell their product, obviously, and they can advocate for you. Before I was able to get my Nidra, I was in contact with them, asking questions.

NO! You will not be stuck with a bill if Medicare won't pay. That isn't how Noctrix does business. They make sure it is funded by insurance (before sending it to you, is my understanding) And, if it doesn't work for you, you have a period of time to send it back. Call and talk to them. Reassure yourself.

Also, Medicare "rents" the Nidra for 13 months and then it becomes yours. Other insurance types buy it outright. No effect on the customer use (except do send it back, if it doesn't work so Medicare doesn't waste money). This is bit of backstory it took me time to understand.

In terms of "do you qualify" for a Nidra. There is that.

It isn't prescribed as an alternative to medication (although I wished for that myself). It's prescribed when medications aren't working or don't work well enough. If the prescription doesn't tell this story, insurance will deny coverage. The doctor needs to write the prescription saying this.

If the doctor merely writes: has RLS so needs Nidra, it will surely be denied. The prescription needs to say that other things were tried unsuccessfully.

Insurance coverage--or denial--happens for specific reasons. It's not some random thing. From talking to a Nidra representative (before I got mine, a few years ago), I learned that Noctrix made a list of doctors who could write the Rx "correctly" available, because so many primary care doctors didn't emphasize the right reasons it was being prescribed.

I had gone through the gabapentin, pregabalin, IV iron route with no success. Buprenorphine helps but not enough. The fact I never was prescribed a dopamine agonist didn't matter. The fact that buprenorphine helped (to a degree) didn't matter. I was a person for whom medication alone was not enough of a solution.

So, my story was written on the prescription in a fashion that told this story--what Medicare insurance needed to hear.

The Noctrix Company funded research that made the Nidra FDA approved (about 3 years ago). Last June the company was sold to a company that mades C-PAP equipment. My experience with Noctrix was before this sale--but I have gleaned from postings on this board that service continues to be good, if you call.

About effectiveness: I tried to reduce the amount of medication I take when I had over a month--night-after-night--with no RLS symptoms, at all. That didn't work for me. Symptoms returned and I returned to the dose that is effective for me. You might have better luck. I didn't.

I hope that sharing my experience helps you. I hope the Nidra is effective for you (my expert RLS doctor says it hasn't been for everyone he has prescribed it).

Also, if I over-exercise or over-stretch, the Nidra can't control the extreme RLS that results for me. Instead, it takes my legs a week to calm down. For me, Nidra is a piece of the puzzle--not a solution in isolation. I need medication and I need to include good sleep hygiene (like getting up at the same time every day).

I still need to be careful with subconscious, psychological factors--because RLS gave me insomnia and I can fall into anxiety about sleep if I don't put some effort into making bedtime a pleasure and routine.

Generally, for me, I would say the Nidra has been miraculous. Over months, both the severity and the frequency of RLS was reduced through using it. I still put the bands on every night, although I now rarely need to turn them on. (And, I do, occasionally, have RLS now in the late afternoon and evening, if I am sleepy, lying on the sofa, watching TV or on a long car ride--but I can sleep through an entire night without waking).

I hope the best for all RLS sufferers reading this. Please share your experiences obtaining the Nidra (or being denied) so others will learn.

@lk8
I am having the same problem. Nidra keeps saying that if Medicare denies it, I will only have to pay up to my deductible, which doesn't make any sense to me. They keep assuring me that I have been approved by their internal staff, but they can't get pre-approval from Medicare until they ship the bands. And they are not returnable. It sounds like a scam to me but there are so many others who have gotten approval and are very happy with the results.
I also called Medicare with no help and Nidra just keeps reassuring me, but says they can't get a pre-approval.
What have you decided to do? Thanks for any advice you have gotten.

@jame321 Some specific things need Medicare pre-approval. Nidra isn't something Medicare has put in their "needs reapproval" category. Pre-approval (as things stand) just doesn't apply to Nidra. Not because it's a "scam." Because Medicare hasn't required this.

My own interaction with the Noctrix Company was very positive--why I want to tell you about it.

I read about the company and Nidra in the medical literature on PubMed, then googled their phone number and cold-called them--talked to a wonder, caring nurse (who was really "up" on understanding RLS). I think this was early in 2024.

She explained that Noctrix was a relatively new company and that Nidra wasn't available in my state at that time. It was released state-by-state so the company could arrange support staff in different locations first. Nidra wasn't just dumped on the market to let patients sink or swim to use it successfully. It was well-planned, assuring any necessary support would be available.

They must have put me on a list after my call, because a year later--out of the blue-- I got an email, telling me I could finally get one. I understood they were a new company with a new devise--looking for "business" but I was grateful, nonetheless, that they had some system in place to remember my need and contact me (as opposed to making me check back with them, repeatedly). I got my Nidra in April of 2025.

Every contact I've had with Noctrix employees has been positive. (Of course, I'm predisposed to feel positive about the company because Nidra has been so helpful for my RLS--but I know the difference between good service and bad service--and Noctrix has been good)

Prescribed medical equipment isn't something that is marketed haphazardly. It required FDA approval --verifying that it "works." The FDA looked into the company--it wasn't going to approve something that was set up to scam patients.

The only caveat is that Medicare will only pay for it after there is failure with other RLS treatments--or if other treatments don't help enough. If your doctor doesn't explain this clearly, Medicare will deny. The prescription can't just read "needs for RLS." But, your feedback from Noctrix suggests that your doctor wrote your prescription as needed for Medicare approval.

I think if there is a hold-up on your getting a Nidra, it's more inefficiency of Medicare's part than the company trying to pull a fast one.

My sense is that Noctrix (only selling Nidras through insurance) is set on building a good reputation--which will hardly happen if patients complain to their doctors that Noctrix has scammed them. Nidra has only been available for a few years--building a reputation is key to get doctors to prescribe.

If you got scammed, you would complain to your doctor (who wrote the prescription) and then he wouldn't write more prescriptions for Nidras. Noctrix can only sell Nidra through prescriptions. It doesn't want doctors hearing negative things from their patients about their product.

You can't get a Nidra--even if you paid cash for it yourself--without a doctor's prescription. It isn't sold out of the back of a truck in some dark alley. Noctrix is truly a legitimate company.

I can appreciate how frustrating this is. But, hang in there---Noctrix wants to make sales. It's a for-profit business. They are doing everything possible to obtain insurance approval. Evidently, there has been problems with insurances paying for Nidra. You aren't the only person finding it difficult to get your insurance to do their job---Why? In my opinion, insurance tries to get out of paying, whenever it can...

Why doesn't Medicare do better for us? Maybe, we should be writing our congressmen about this hangup. Medicare is funded by the government--all of us.

People really, really suffer from RLS and having to wait unnecessarily for a long time to get relief isn't right. I agree totally about that. Lots of us hang by our fingernails, trying to manage RLS, trying to get some sleep. And, we hear about something that can help--of course we need better, more timely, service to get a helpful thing...

Reading about your situation, Jim--makes me furious. Finally, something is invented that can help--and has FDA approval--and Medicare is dragging its feet.

I know there is an appeals process when insurance denies something. (And AARP tells us that appealing an insurance denial is most often successful). There should also be a complaint process, when approval is just hanging... Or, seriously, call your elected official.

For me, Nidra (plus medication and plus working on anxiety about sleep) has made a world of difference. I wear my Nidra bands every night, but it's been weeks since I've needed to turn them on.

I hope you get yours soon and I hope you have the same success with them that I have had.

Please, James321, keep us all updated. Let us know when you get yours--let us know how they work. (And, realize the full effects can take a while--you will be told the bands can decrease the frequency of your symptoms--I thought "oh, sure.." but that is what happened for me. I hope it happens to you, also)
Best of luck!

@missjb
Wow, I am so impressed and thankful for you taking the time to write such a reassuring response!! After I wrote that, I was able to talk to someone at Medicare who explained that Medicare does not do pre-authorizations for Durable Medical Equipment. So what Nidra was telling me made a lot more sense. And if Noctrix Health is enrolled in Medicare and accepts assignment, I should be able to trust they are legit. I feel much better after reading your letter also. I am proceeding with the process. They are not currently licensed in Florida but thought by the end of the month they would be. I could have it shipped to another state and then have someone ship it to me, but didn't want to complicate the process if I truly only need to wait a few weeks. I am really looking forward to trying this. I really hope it helps me as it has helped many others. I will follow-up when I have some results to convey. Thank you so much for sharing your experiences!!

@jame321 I'm so happy you received my reassurance as it was intended.

I went out-of-state to pickup my Nidra and had my "activation session" in a motel. The nice lady who did this came in full hospital garb and the fellow at the front desk must have wondered "what was up" when she and I went of to my room for an hour, while my husband sat in the lobby.

Activation--you may wonder--is having the Nidra adjusted and set to a level of sensation that you feel will "do something" but not be "too much" --like our eye-doctors asking if "image one of two" is more clear.

For me, there was an adjustment period--getting used to how it felt. I think it worked (stopping RLS episodes) right away, but I was all analytical about "was it working" "how did it feel" --so it took a while before I could just turning it on and immediately go back to sleep.

Dr Aggarwal (Restless Leg expert at the University of Pittsburgh) introduced me to the term "neuromodulation." Over time, the Nidra can re-train the brain to have less and less RLS and/or reduce the severity of symptoms. This doesn't happen with everyone, but did for me. This took me about 5 months , however-- my brain (evidently) being slow to retrain ; )

Sometimes, my foot will move up and down while the Nidra is on and that is annoying.

Currently, I am on a roll--sleeping without waking and having no RLS during the night.

After I started using the Nidra (getting good results) I began to have RLS in the evening, laying on the sofa, watching TV. Like if RLS couldn't "get out" during my sleep-time, it was intent to "get out" at another time. This is easier to handle than when RLS would wake me during the night. Nidra works, but requires a change of clothes to put the bands on, so I often just get up and walk--and it's not daily in the evening--just occasional.

My suggestion is to just use the bands with an open mind--but no specific expectations. RLS is from our brains and it takes a while for our brains to adjust. Neuromodulation is all subconscious.

Stopping the episodes by turning on the bands is physical as well as (hopefully) affecting the brain through neuromodulation.

After over a month with no night-time RLS, I tried to reduce the amount of my medication. When I did this, it took a full month for me to get back to symptom-less nights. I need both medication and the Nidra (as well as working on reducing sleep anxiety). I had to try this--but it was a failure.

Also, over-exercising or over-stretching are RLS triggers for me and when I aggravate my legs because of these triggers, Nidra cannot overcome the symptoms that follow. I have to wait a miserable week of hell until my legs calm back down and then the Nidra/medication starts to work again.

These are the patterns I have had. You might have a different experience. I am crossing my fingers that the Nidra is helpful for you. It is so wonderful and remarkable for me to be able to sleep again. I want this for all my fellow RLS sufferers.

Finally, with Medicare, they rent the Nidra for you for 13 months and then it will just be yours forever. You will see the rental fee on the Medicare statements you get. Noctrix also supplies sticky-pads that conduct on your Nidra bands and Medicare pays for the monthly resupply (which you will need to email Noctrix and ask for each month).

...If Nidra really doesn't work for you, you can send the bands back, so Medicare won't have to pay the rental for no benefit.

Medicare advantage plans and private insurances buy the Nidra outright. Medicare insisted on a rental agreement. (I wondered if the rental fee was going on forever and talked to Noctrix's billing department--where I picked up this information. I asked one little question to the sticky-pad re-supplying department, and the next thing I knew someone from billing called me to ask about my question).

The Noctrix Company was bought just last June, but so far I haven't picked up on any change in their service standards.

We all look forward to hearing about your experience, when you have something to report.

@missjb
Once again, I am so thankful for you sharing your experience and insight. This is extremely helpful. Thank you so much!! I will share my experience once Noctrix is able to ship to Florida. If it seems to be taking too long, I will have them send it to my daughter. It will give me a good reason to visit her. More later.