A constant pulse to rest and have quality of life

In Spain, Restless Legs Syndrome (RLS), also known as Willis-Ekbom disease, is common and underdiagnosed. The Spanish Society of Neurology estimates that about 5% of the population suffers from it and that up to 90% of cases are undiagnosed; in Europe, the population ranges usually fluctuate between 5% and 10% in adults and between 2% and 4% in the pediatric population.

The most disabling trait of Restless Legs Syndrome is sleep disruption. Symptoms worsen at rest and at night, causing insomnia, wakefulness, and daytime sleepiness. This disruption of sleep is one of the main consequences of the disorder.

Purificación Titos, president of the Spanish Association of Restless Legs Syndrome (AESPI), delves into the impact of the pathology on quality of life and advocates for better training in Primary Care to address this problem more effectively. “The disease affects all spheres of life: family, social, and work,” she explains. She highlights the difficulty of traveling, having to keep the legs still for long periods. “It's important to consider the effect of not being able to sleep or rest properly; the consequences range from depression, recurrent anxiety, and suicidal thoughts or behaviors.”

On the psychological level, current evidence is robust: a meta-analysis from 2024 shows higher levels of depression and anxiety in people with RLS than in the healthy population. In large population bases, Restless Legs Syndrome has also been associated with a higher risk of suicidal behaviors and self-harm, according to a 2019 study published in JAMA Network Open. Within the associative field, patient groups report rates of depression and anxiety several times higher than those of the general population, with substantial diagnostic delays.

Furthermore, the president of AESPI, which will hold its national meeting in Bilbao on the 21st and 22nd of September, emphasizes the misunderstanding that those affected often face. “It's all in your head” or “it's due to stress,” are some of the phrases some patients end up hearing from their own doctor. Hence the importance of promoting the knowledge of existing clinical guidelines, European and American, among professionals. Her premise is straightforward: controlling nighttime symptoms improves day-to-day life. “These guidelines refer to clinically significant improvements in quality of life with gabapentinoids and intravenous iron in patients with iron deficiency; dopaminergic agonists also improve and have been used for a long time, but now it is known that their sustained use requires caution due to increased symptoms and other adverse effects,” explains Purificación Titos.

Another battle is improving early diagnosis. The Spanish Society of Neurology calls for early attention in Primary Care to typical discomforts that worsen at rest, in the evening or at night and improve with movement, to reduce the school, work, and social impact. In clinics, having validated scales helps to monitor the response to treatment beyond symptomatic relief.

Pilot project to improve coordination among professionals

Despite its high prevalence, it continues to be a disease scarcely recognized in the health, social, and work environments. For this reason, the Secretary-General of Health Care Planning and Consumption, Ismael Muñoz, advocated last July for the creation of a pilot document that explains collaborative work between neurophysiology staff in the hospital area and those in Primary Care to train them in the diagnosis and treatment of this disease, after holding a meeting with representatives from the Spanish Association of Restless Legs Syndrome (AESPI).