As a behavioral pediatrician I often see children who have sleep issues–whether it be taking a long time to sleep, night wakings or refusing to sleep. One of the first things I must do is to determine whether there is a medical reason for the sleep challenges or if it is purely behavioral. One of the conditions that might be affecting your child is called, RESTLESS LEG SYNDROME. This is a neurological condition that tends to run in families. It affects adults and children. To learn more, I have a wonderful guest blog post by Dr. Stephanie Jackson, a pediatric neurologist who specializes in sleep medicine and an assistant clinical professor at Indiana University School of Medicine. Please read on!
What is Restless Leg Syndrome?
Contributed by Dr. Stephanie Jackson
Restless legs syndrome, or “RLS,” is a neurologic condition that causes an uncomfortable and irresistible urge to move the legs. The symptoms are triggered when you have been sitting or lying down for a long time, and it tends to be worse in the evenings / at night. Some people describe a weird tingly sensation, creepy-crawlies, or even pain, and RLS can make it hard to fall asleep at night.
RLS affects about 2% of children, and is more common in kids who have ADHD.
What causes RLS?
RLS is commonly associated with iron deficiency, but you don’t have to have anemia or be iron-deficient to have RLS. Even if you just don’t have enough iron stored up in your body (think: not enough in your body’s “pantry”), this can cause RLS too. Doctors can check your iron storage level with a blood test called “Ferritin” — and to prevent problems with RLS (and restless sleep), the goal ferritin level is >50-75 ng/ml.
Other medical conditions that can cause RLS are kidney disease and neuropathy (nerve damage), but these disorders are not typically seen in children.
Certain over-the-counter and prescription medications can cause RLS symptoms: cold & allergy meds/antihistamines, antidepressants, nausea medications.
What Restless Legs Syndrome is NOT:
RLS is not the same thing as being a restless sleeper – but the two often go hand in hand.
RLS is not the same as being antsy. Mindless toe tapping (for example: what some people do when they are bored or feeling anxious) is sometimes mistaken for RLS, but usually these things are not related.
Treatment for RLS:
If your ferritin level is low, an iron supplement may be all that is needed! Remember that you always want to have your ferritin level checked before starting an iron supplement—because too much iron can be toxic!
How To Treat Restless Legs with Iron Supplements by Brandon Peters, MD (VeryWellHealth.com)
Prescription drugs that are sometimes used to treat RLS include: gabapentin, clonidine, and some other medications that raise the dopamine levels in our body (although this last type of med is not usually used in pediatric patients).
There are some non-medication treatment options as well — including foot wraps and pads that can provide soothing relief.
Things you can do at home: Keep a regular bedtime routine, make sure you are getting enough sleep at night, take a walk or bike ride in the evening, massage the legs, use a warm or cool compress, avoid smoking, limit caffeine intake.
RELATED: Download the one page handout, “What is Sleep Hygiene?” (English only)
When to ask your doctor about RLS:
If your child has trouble falling asleep at night, especially if they kick or want you to rub their legs at bedtime.
If you or other people in your family have RLS (It tends to run in families!)
If your child is a restless sleeper.
If your child has ADHD or other behavioral problems and you are concerned about his/her sleep.
If your child is experiencing “growing pains.”
Where to find more information:
Restless Legs Syndrome Foundation – www.rls.org
Sleep Advice from Dr. Jodi Mindell (Parents.com)
Iron Rich Foods for Children by Vincent Iannelli, MD (VeryWellFamily.com)