The Power of Language in the Criteria for Restless Leg Syndrome: A Latin American Perspective

Adapting the American Academy of Sleep Medicine (AASM) Guidelines for restless legs syndrome (RLS) to Latin America is a complex challenge, given the region's 33 countries and vast socioeconomic diversity. Such an endeavor requires comprehensive data and consensus from a broader representation of these populations. There is a need to assess the effect of social vulnerability on the prevalence of symptoms of periodic leg movements that may be erroneously called RLS and mimic the primary nosological diagnosis for itself. We aim to discuss the Asociación Lationoamericana de Sueño's (Latin American Sleep Association, ALADS, in Spanish) position statement to contextualize the 2025 AASM clinical practice guidelines for the treatment of RLS and periodic limb movement disorder. Their intention of advocating for future systematic studies employing standardized criteria in Latin America. While the Scientific Committee for Sleep Disorders of the Brazilian Academy of Neurology partially endorses those opinions, offering some counterpoints concerning, especially, the following issues: 1) challenges to the reportedly wide variability in Latin American RLS prevalence, with apparently very high prevalences exceeding the expected values in some locations; 2) the importance of complementing clinical history with structured RLS diagnostic questionnaires; and 3) amendments to the proposed summary of treatment recommendations, particularly regarding Iron supplementation. Finally, the presence of comorbidities and RLS in epidemiological studies must be considered and data from Latin America can contribute to the discussion on global criteria applied worldwide for RLS that need to be revised according to regional, social, and cultural issues.