Restless leg syndrome (RLS) is generally thought of as adult condition, but the Restless Leg Syndrome Foundation estimates that 1.5 million children and adolescents have RLS. The Mayo Clinic reports that almost 6 percent of children seen in their sleep clinic have the disease.
What is Restless Leg Syndrome?
RLS is a neurological disorder characterized by tingling, throbbing, pulsing or tickling sensations in the legs. Rarely, the arms and torso are affected as well. The intensity of these feelings can range from irritating to painful and are alleviated by movement. RLS is linked to several diseases such as kidney failure, diabetes, and peripheral neuropathy; it commonly occurs during pregnancy and can also be the result of a lack of iron. Certain medications and alcohol use can also bring on RLS symptoms. A study conducted by the Mayo Institute strongly indicates that a mutation of the MEIS1 gene is at the root of some, though a minority of cases of RLS.
Recognizing Restless Leg Syndrome in Children
RLS is often dismissed in children as growing pains or a stalling tactic to avoid bedtime. It is also occasionally misdiagnosed as attention deficit hyperactivity disorder (ADHD) since it results in constant movement to avoid the sensations and because the sleep loss can result in trouble focusing and other behaviours generally associated with ADHD.
RLS symptoms are usually more intense at night and since movement can alleviate the symptoms most children aren’t bothered until they are trying to rest or sleep. General restlessness or fidgeting by itself is not an indicator since children generally tend to be in motion during their waking hours. If, however, several of the following are true, you may want to consult your family doctor or paediatrician.
- Feels the urge to constantly move legs
- Complains of creepy crawly feelings in the legs which go away with movement
- Symptoms are reduced or eliminated when sitting in a very warm bath
- Consistently has trouble falling asleep
- Wakes frequently during the night
- Moves legs constantly during sleep and when trying to get to sleep
- Is tired during the day
- Has family history of RLS
- Displays behaviours characteristics of ADHD
Treating Restless Leg Syndrome in Children
Unfortunately, treating RLS in children is difficult and even somewhat controversial. Although there have been some studies on the treatment of RLS in children, none have been randomized placebo-controlled trials. As a result, the Standards of Practice Committee of the American Academy of Sleep Medicine has stated that no specific recommendations can be made regarding treatment of children with RLS.
Due to the lack research on drugs for children with RLS, most doctors begin by attempting to reduce the conditions that may aggravate the symptoms. The usual starting point is a blood test since a common secondary cause of RLS is low serum ferritin levels which can be easily treated with multivitamins.
Doctors will also ensure that the child is not taking any medications known to worsen the condition such as selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, sedating antihistamines, and dopamine antagonists. Other non-medical interventions like massage or warm baths in the evening and regular exercise during the day may help. It is also particularly important that substances known to interfere with sleep, such as caffeine be avoided. In severe cases, some doctors may suggest clonidine or clonazepam which have both been studied in children with RLS (although not randomized or placebo- controlled) and were found to be fairly well tolerated.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
References
MedScape: Restless Legs Syndrome in Children (accessed 18 January 2011).
Science Daily: Mayo Clinic Finds Restless Legs Syndrome In Children Linked to Family History, Iron Deficiency (accessed 18 January 2011).
The Restless Legs Syndrome Foundation (accessed 18 January 2011).
Katherine Scrimshaw - Katherine Scrimshaw is a freelance writer and editor with a background in public relations, broadcasting and not-for-profit administration ...
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