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.