The AASM Guidelines for the Treatment of Restless Legs Syndrome (RLS) in the Context of Latin America

Sep 28, 2026

Restless Legs Syndrome (RLS) presents a major clinical challenge worldwide, yet its management differs by region because healthcare resources and medication access vary. The American Academy of Sleep Medicine (AASM) provides treatment guidelines, but in Latin America their use depends on drug availability, infrastructure, and health-system features. Regional prevalence shows wide country-to-country variability, with diagnostic and iron-status assessment limitations in many areas. Pharmacologic access and ongoing use of dopamine agonists despite augmentation risk are discussed, alongside benzodiazepine use, scarce opioids, and complementary lifestyle or traditional approaches. The need to adapt guidelines and expand research is emphasized.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Abstract

Introduction

Prevalence variability across Latin America

Diagnostic challenges and iron status

Pharmacological treatment constraints and risks

Alternative and complementary therapies

Need to adapt international guidelines

Article published online: 2025-12-31 Overviews 447 The AASM Guidelines for the Treatment of Restless Legs Syndrome (RLS) in the Context of Latin America Karem Parejo 1 Ulises Jimenez-Correa2 Lourdes M. DelRosso3 1 Shaio Clinic Foundation, Bogota, Colombia 2 National Autonomous University of Mexico, Mexico 3 University of California San Francisco-Fresno, Fresno, California, United States Sleep Sci 2025;18(4):e447–e450 . Address for correspondence Karem Parejo, MD,(e-mail: [karemparejo@gmail.com](karemparejo@gmail.com)). Abstract Keywords ► restless legs syndrome ► Latin America ► iron deficiency ► pharmacological treatment ► sleep disorders Restless Legs Syndrome (RLS) represents a signiﬁcant clinical challenge globally, with management varying by region due to differences in healthcare resources. The American Academy of Sleep Medicine (AASM) has established guidelines for the treatment of RLS;1 however, their applicability in Latin America is inﬂuenced by medication availability, healthcare infrastructure, and the speciﬁc characteristics of the region’s health systems. The prevalence of RLS in Latin America shows substantial variability among countries. The American Association of Sleep Disorders (ALADS), explores diagnostic challenges, emphasizing the importance of evaluating iron status, which remains limited in many regions. Additionally, pharmacological treatment options are examined, highlighting the difﬁculty in accessing ﬁrst-line therapies such as gabapentinoids, while dopamine agonists continue to be used despite the risk of symptom augmentation. The frequent use of benzodiazepines and the limited availability of opioids are also discussed. Alternative therapies, including lifestyle modiﬁcations and traditional medicine, are considered as complementary strategies in resource-limited settings. Finally, the need to adapt international guidelines to local realities and to promote research to optimize RLS management in Latin America is underscored. Introduction Restless Legs Syndrome (RLS) represents a signiﬁcant challenge in global clinical practice, and its management varies depending on the resources available in each region. The American Academy of Sleep Medicine (AASM) guidelines provide recommendations based on the best available evidence 1 ; however, their applicability in Latin America is constrained by medication availability, healthcare services received April 22, 2025 accepted August 24, 2025 DOI [https://doi.org/](https://doi.org/)[ ](https://doi.org/)10.1055/s-0045-1813730 . ISSN 1984-0659. (such as sleep disorder clinics), and the speciﬁc characteristics of regional health systems. The prevalence of RLS in Latin America varies signiﬁcantly. A study in Colombia determined the prevalence of RLS among adults in three Colombian cities: Bogota (high altitude), Bucaramanga (moderate altitude), and Santa Marta (low altitude), assessing associations with demographic and health factors such as age, sex, and body mass index (BMI) . The overall prevalence was 37.7%, with signiﬁcant variations © 2025 . Brazilian Sleep Academy. All rights reserved. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by-nc-nd/4.0/](licenses/by-nc-nd/4.0/)) Thieme Revinter Publicações Ltda. , Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil 448 Treatment of RLS in the Context of Latin America Parejo et al. between cities. Santa Marta, at the lowest altitude, had the highest prevalence (54.5%), while Bucaramanga and Bogota reported lower rates (35 . 7% and 36 .9%, respectively).

FAQs

Why do AASM RLS treatment guidelines differ in applicability across Latin America?

Applicability is shaped by differences in medication availability, healthcare infrastructure, and specific characteristics of regional health systems.

What role does iron status play in diagnosing RLS in Latin America?

Diagnostic challenges are highlighted, emphasizing evaluation of iron status, which remains limited in many regions.

What pharmacological and non-pharmacological treatment issues are discussed for the region?

Access to first-line options such as gabapentinoids is difficult, dopamine agonists are still used despite augmentation risk, benzodiazepines are frequently used and opioids are limited; lifestyle modifications and traditional medicine may complement care in resource-limited settings.

Sep 28, 2026

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