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Millions in Spain may have restless legs syndrome without a diagnosis

Richard Reid RUSSPAIN.com

Post by Richard Reid

Millions in Spain may have restless legs syndrome without a diagnosis RUSSPAIN.com © russpain.com
Millions in Spain may have restless legs syndrome without a diagnosis © russpain.com

More than two million people in Spain may have restless legs syndrome. Up to 90% of cases may go undiagnosed while symptoms disrupt sleep and daily rest.

More than two million people in Spain may be living with restless legs syndrome without knowing what is causing their symptoms. The Spanish Society of Neurology says up to 90% of cases could remain undiagnosed. Diagnosis can take more than ten years. The delay is especially serious when the disorder begins in childhood because its signs can be mistaken for growing pains or ADHD.

Restless legs syndrome is more than an urge to move. It causes tingling, itching, pain or other discomfort in the legs. These sensations appear or worsen during inactivity and improve for a time with movement. Symptoms usually become stronger in the afternoon and at night. That can make it harder to fall asleep and get restorative rest.

Recent Spanish reports estimate that restless legs syndrome affects about 11.6% of the population, while more severe forms account for roughly 2–3% of cases.

La Razón and El Mundo

The condition can disrupt ordinary activities before bedtime even begins.

Up to 60% of affected people have trouble sitting still or relaxing. The syndrome often causes insomnia and poor sleep quality. Some medicines may make its symptoms worse. Patients can end up treating the effects of lost sleep again and again without addressing the neurological disorder behind them. Diario Vasco has also reported that the first diagnosis is generally clinical. Doctors may order tests such as iron and kidney-function assessments when they need to look for an underlying cause.

The SEN estimates that SPI affects up to 10% of adults and nearly 4% of children and adolescents. Women are affected approximately twice as often as men. Low iron levels and metabolic changes matter particularly during pregnancy and periods of heavy menstruation, although iron deficiency does not explain every case. A regional report by Heraldo put the number of potentially affected people in Aragón at about 55,000. That figure shows the scale of the problem beyond national estimates.

Specialists quoted by Spanish sleep-medicine sources warn that the burden is not limited to insomnia: persistent restless legs symptoms have been associated with a higher risk of depression, anxiety and suicidal behaviour. This makes timely recognition important not only for sleep quality but also for broader mental health follow-up.

Spanish Society of Sleep

Pregnancy can bring on the disorder in women who had no previous symptoms. Between 11% and 30% of such women may develop SPI during gestation, especially in the third trimester. Family history is also common. Around 65% of people with the syndrome have relatives with the condition. Chronic kidney failure, diabetes and certain neuropathies have also been associated with it.

The diagnostic challenge affects every age group, but the symptoms can look different. In children, the first signs may be confused with normal growth-related discomfort or ADHD. In adults, they can be blamed on rheumatic diseases or circulatory problems. Some patients and clinicians may first label them as ordinary insomnia or anxiety. This gap in diagnosis deserves the same sustained attention given to other neurological conditions in earlier health reporting.

Dr Celia García Malo of the SEN's Study Group on Wakefulness and Sleep Disorders says the first step is to look for a possible underlying cause. Neurological follow-up is then needed so treatment can be adjusted as the patient's stage and needs change. The SEN's position is practical. Shorter delays can reduce inappropriate treatment and allow a better approach to begin sooner.

Treatment guidance is also changing. The SEN is updating its SPI recommendations after the American Academy of Sleep Medicine made a substantial change in 2024. The new approach moves away from routine long-term use of dopaminergic medicines. It gives priority to checking and correcting iron levels alongside other treatment options.

That change matters because SPI is a chronic disorder. Medication can cause adverse effects if treatment is not reviewed over time. The evidence points to a clear priority for Spain: recognise the pattern earlier, investigate possible causes and maintain neurological follow-up. Years of sleep disruption should not pass without a diagnosis. A condition affecting millions should not remain hidden behind labels such as poor circulation, growing pains or ordinary insomnia.

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