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Children with cystic fibrosis (CF) typically have similar nutritional intake as healthy peers, despite recommendations to consume more calories and fat. Body satisfaction may play a role in nutritional intake: females may be content with their smaller size despite recommendations for weight gain, while males may desire to be larger and more muscular, which is more congruent with medical advice. Females are especially at risk, given their propensity to desire a smaller body size, tendency for lower HRQOL, steeper trajectory of health decline and shorter life expectancy than males. This study evaluated body satisfaction in relation to nutritional adherence and HRQOL in youth with CF. Fifty-four individuals with CF (age 9-17) completed the Cystic Fibrosis Questionnaire-Revised (CFQ-R), the Figure Rating Scale, and a 24-hr diet recall interview with their caregiver. Twenty-four percent of youth were non-adherent with caloric goals, and 40.7% did not obtain the minimum recommendation for fat intake. Youth were classified as inconsistent with treatment goals (TI) if they desired a smaller body size or were content with their current size despite a BMI less than the 50th percentile; 44.8% of females were classified as TI, compared to only 8% of males. Statistical analyses were performed to evaluate the impact of gender and body satisfaction on HRQOL in youth with CF. Linear multiple regression models were fit; TI females had Emotional HRQOL scores 23 points lower than males. Results suggest that improving body satisfaction, especially for females, may help to improve overall quality of life and potentially impact nutritional adherence.

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Study Objectives: In adults with narcolepsy, periodic limb movements of sleep (PLMS) occur more frequently than in control population, and presence of increased PLMS is associated with greater sleep disruption and shorter mean sleep latency. This study was performed to determine whether PLMS are common in children with narcolepsy, and whether the presence of PLMS is associated with greater sleep disruption. Design: Demographic and polysomnographic information were collected from consecutive patients diagnosed with narcolepsy identifi ed retrospectively by diagnosis-based search. Descriptive data were compiled, and sleep characteristics of children with and without PLMS were compared. Setting: Sleep disorders center in a children's hospital. Patients: 44 patients, 6-19 years old (mean 13 years, SD 3.57), were identifi ed. Twenty-eight were African American. interventions: None. Measurements and Results: Four patients had a PLMS index (PLMI) ≥ 5/h (considered abnormal in literature). Sixteen (36%) had "any PLMS" (PLMI > 0/h). The mean PLMI was 1.3/h (SD 2.5). Sleep was signifi cantly more disrupted, and the mean sleep latency was shorter in patients with "any PLMS" as compared to those with no PLMS. There was no correlation between the PLMI and other diagnostic criteria for narcolepsy. "Any PLMS" were present equally in children of African American and Caucasian heritage, 35.7% vs. 37.5%. Conclusions: As in adults, children with PLMS and narcolepsy have more sleep disruption and shorter mean sleep latencies than those with narcolepsy but without PLMS. Our fi ndings also suggest that the use of adult criteria for diagnosis of "signifi cant" PLMS in children may not be suffi ciently sensitive. keywords: Narcolepsy, children, periodic leg movements Citation: Jambhekar SK; Com G; Jones E; Jackson R; Castro MM; Knight F; Carroll JL; Griebel ML. Periodic limb movements during sleep in children with narcolepsy. J Clin Sleep Med 2011;7(6):597-601. S C i e n t i f i C i n V e S t i g A t i O n SP eriodic limb movements during sleep were fi rst described in adults in the 1980s, however; their occurrence in children and adolescents has only been recently appreciated.1 The exact prevalence of these movements, consisting of repetitive small fl exions of the upper and/or lower extremities, in the general pediatric population is unclear. Reported prevalence rates of PLMS at a frequency > 5/h vary between 1.2% to 10% of children not referred specifi cally for PLMS or restless legs syndrome (RLS).2,3 Although the prevalence of PLMS has been reported to be increased in children with other medical comorbidities, 4 the prevalence in children with narcolepsy is largely unknown. A study of 8 children with narcolepsy has shown occurrence of PLMS in 63% of the patients with a mean PLMS index of 49/h. 5In adults, increased PLMS have been shown to be more common in patients with narcolepsy than controls without narcolepsy; the presence of increased PLMS has been shown to be associated with measures of disruption of REM sleep and daytime f...