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| Restless legs diagnosis missed in kids |
15-Aug-2007 |
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By Bianca Nogrady
RESTLESS legs syndrome is under-diagnosed in children and could be an underlying cause of behavioural and sleep problems, experts say.
A US survey of more than 10,000 families found 1.9% of children aged 8-11 years and 2% of children aged 12-17 years met the criteria for restless legs syndrome, but only 11% of these patients had been previously diagnosed with the condition.
Sleep disturbances and a history of “growing pains” were significantly more common in children identified as having restless legs syndrome compared with controls, the data, published in Pediatrics (August), showed.
“These population-based data suggest that restless legs syndrome is prevalent and troublesome in adolescents, occurring more commonly than epilepsy or diabetes,” the authors wrote.
Paediatric sleep physician Dr Arthur Teng said this was the first prevalence study to use proper diagnostic criteria, and showed the condition was being missed in many children.
Restless legs syndrome could have many daytime presentations, including anxiety, attentional deficits, irritability, sleepiness and ADHD, said Dr Teng, head of the department of sleep medicine at Sydney Children’s Hospital at Randwick.
It was important to ask parents about their child’s sleeping habits when they presented with these symptoms, he said.
“Ask about their bedtime routine, what time do they go to bed, what time does the child go to sleep, during sleep what happens,” he said.
The study also identified a strong family association, with at least one biological parent reporting similar symptoms to the child in 70% of cases.
While there were several pharmacological treatments available for adults with restless legs syndrome, Dr Teng said few of these were tested in, or suitable for, children.
Iron supplements were one option in patients with ferritin levels less than 40µg/L, although evidence for their efficacy was “variable”.
Pediatrics 2007; 120:253-66.
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