The fastest-spinning neutron stars in low-mass X-ray binaries, despite having undergone millions of years of accretion, have been observed to spin well below the Keplerian break-up frequency. We simulate the spin evolution of synthetic populations of accreting neutron stars in order to assess whether gravitational waves can explain this behaviour and provide the distribution of spins that is observed. We model both persistent and transient accretion and consider two gravitational-wave-production mechanisms that could be present in these systems: thermal mountains and unstable $r$-modes. We consider the case of no gravitational-wave emission and observe that this does not match well with observation. We find evidence for gravitational waves being able to provide the observed spin distribution; the most promising mechanisms being a permanent quadrupole, thermal mountains and unstable $r$-modes. However, based on the resultant distributions alone it is difficult to distinguish between the competing mechanisms.