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Resumen El síndrome de piernas inquietas (SPI) es un trastorno relacionado con la necesidad imperiosa de mover las extremidades inferiores, inicia a diferentes horas del día y empeora en la noche. Es aliviado por la actividad y afecta la calidad de vida y del sueño de quienes lo padecen. A pesar de ser un trastorno común a cualquier edad, en adultos tiene una prevalencia de hasta el 10%, es poco diagnosticado por los médicos de primer nivel y especialistas, por lo cual las intervenciones diagnósticas y terapéuticas se ven retrasadas. Lo anterior contribuye a la perpetuación de sus síntomas y empeoramiento de la calidad de vida. Ya que su diagnóstico es netamente clínico, familiarizarse con este trastorno del ciclo sueño vigilia, es fundamental para garantizar un adecuado enfoque y así descartar otras patologías que suelen confundirse con ésta entidad. El SPI posee etiología multifactorial, que abarca desde un componente genético y hereditario, denominándose SPI primario, hasta su asociación con múltiples patologías, conocido como SPI secundario. En cuanto a su tratamiento farmacológico y no farmacológico está orientado al control de los síntomas, ya que su curación no es posible, aunque ocasionalmente esta entidad puede remitir, para luego en meses o años recaer nuevamente. Abstract Restless legs syndrome is a disorder associated with the imperative need to move the legs, starting at different times of day and it gets worse at night, relieved by activity, affecting the quality of life and sleep who sufferers it. Despite being a common disorder at any age, in adults with a prevalence of up to 10%, is not diagnosed by doctors and frst level specialists that is why diagnostic and therapeutic interventions get delayed contributing to the perpetuation of symptoms and worsening quality of life. Since its diagnosis is purely clinical, getting familiar with this disorder is essential to ensure proper focus and thus rule out other diseases commonly confused with this one. Restless legs syndrome has a multi-factorial etiology that ranges from a genetic and hereditary, which are called primary restless legs syndrome, to its association with multiple pathologies, known as secondary restless legs syndrome. As for its management, drug therapy and non-drug therapy is aimed at symptom control, as its cure is not possible, although occasionally the condition can refer to later repeat in months or years.

Restless legs syndrome is a distressing condition, with negative effects on sleep and daytime activities that affect personal, family and occupational life. The overall impact of restless legs syndrome on quality of life is comparable to that of chronic and frustrating conditions such as depression and diabetes. Misdiagnosis and inappropriate treatment may increase patients' suffering in terms of uncertainty, overuse or misuse of care services and lack of trust. Presenting a synthesis of the main topics in the literature on restless legs syndrome facilitates for a better understanding and its management in primary care settings. El síndrome de las piernas inquietas representa una condición dolorosa, con efectos negativos en las actividades del sueño y del día, influyendo la vida personal, familiar y profesional. El impacto global del síndrome de las piernas inquietas en la calidad de vida es comparable al de condiciones crónicas y frustrantes como la depresión y la diabetes. Un diagnóstico equivocado y un tratamiento poco adecuado pueden aumentar el sufrimiento del paciente en lo que se refiere a la incertidumbre, la utilización excesiva o no adecuada de los servicios de cuidado y la falta de confianza. El presentación de una síntesis de los tópicos principales de la bibliografía sobre este síndrome facilita su mejor entendimiento y tratamiento en el marco del cuidado médico primario.

Objective In idiopathic Parkinson disease (IPD) sleep disorders are common and may antedate the onset of parkinsonism. Based on the clinical similarities between IPD and Parkinson disease associated with LRRK2 gene mutations (LRRK2-PD), we aimed to characterize sleep in parkinsonian and nonmanifesting LRRK2 mutation carriers (NMC). Methods A comprehensive interview conducted by sleep specialists, validated sleep scales and questionnaires, and video-polysomnography followed by multiple sleep latency test (MSLT) assessed sleep in 18 LRRK2-PD (17 carrying G2019S and one R1441G mutations), 17 NMC (11 G2019S, three R1441G, three R1441C), 14 non-manifesting non-carriers (NMNC) and 19 unrelated IPD. Results Sleep complaints were frequent in LRRK2-PD patients; 78% reported poor sleep quality, 33% sleep onset insomnia, 56% sleep fragmentation and 39% early awakening. Sleep onset insomnia correlated with depressive symptoms and poor sleep quality. In LRRK2-PD, excessive daytime sleepiness (EDS) was a complaint in 33% patients and short sleep latencies on the MSLT, which are indicative of objective EDS, were found in 71%. Sleep attacks occurred in three LRRK2-PD patients and a narcoleptic phenotype was not observed. REM sleep behavior disorder (RBD) was diagnosed in three LRRK2-PD. EDS and RBD were always reported to start after the onset of parkinsonism in LRRK2-PD. In NMC, EDS was rarely reported and RBD was absent. When compared to IPD, sleep onset insomnia was more significantly frequent, EDS was similar, and RBD was less significantly frequent and less severe in LRRK2-PD. In NMC, RBD was not detected and sleep complaints were much less frequent than in LRRK2-PD. No differences were observed in sleep between NMC and NMNC. Conclusions Sleep complaints are frequent in LRRK2-PDand show a pattern that when compared to IPD is characterized by more frequent sleep onset insomnia, similar EDS and less prominent RBD. Unlike in IPD, RBD and EDS seem to be not markers of the prodromal stage of LRRK2-PD., This manuscript received support through the grant number 061130/31 from La Fundacio la Marato de TV3 to Eduard Tolosa. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.