Non-REM sleep instability in children with restless sleep disorder

DelRosso, Lourdes M.; Hartmann, Simon; Baumert, Mathias; Bruni, Oliviero; Ruth, Chris; Ferri, Raffaele

doi:10.1016/j.sleep.2020.07.033

Cited by 22 publications

(18 citation statements)

References 34 publications

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“…Finally, a mechanism of hyperarousal, similar to that of insomnia, has been suggested to exist in RLS (Lanza & Ferri, 2019), at least in the early night hours. This is supported by studies showing increased alpha and beta EEG bands during both wakefulness preceding sleep and the sleep onset period (Ferri et al, 2014) or sympathetic activation during relaxed wakefulness preceding sleep and during sleep (DelRosso et al, 2020; Manconi, Ferri, Zucconi, Clemens, et al, 2011a).…”

Section: Neurophysiology and Periodic Leg Movementsmentioning

confidence: 77%

Restless legs syndrome: Over 50 years of European contribution

Khachatryan

Ferri

Fulda

et al. 2022

Journal of Sleep Research

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Summary Restless legs syndrome (RLS) is a sensorimotor neurological disorder characterised by an urge to move the limbs with a circadian pattern (occurring in the evening/at night), more prominent at rest, and relieved with movements. RLS is one of the most prevalent sleep disorders, occurring in 5%–10% of the European population. Thomas Willis first described RLS clinical cases already in the 17th century, and Karl‐Axel Ekbom described the disease as a modern clinical entity in the 20th century. Despite variable severity, RLS can markedly affect sleep (partly through the presence of periodic leg movements) and quality of life, with a relevant socio‐economic impact. Thus, its recognition and treatment are essential. However, screening methods present limitations and should be improved. Moreover, available RLS treatment options albeit providing sustained relief to many patients are limited in number. Additionally, the development of augmentation with dopamine agonists represents a major treatment problem. A better understanding of RLS pathomechanisms can bring to light novel treatment possibilities. With emerging new avenues of research in pharmacology, imaging, genetics, and animal models of RLS, this is an interesting and constantly growing field of research. This review will update the reader on the current state of RLS clinical practice and research, with a special focus on the contribution of European researchers.

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Section: Neurophysiology and Periodic Leg Movementsmentioning

confidence: 77%

Restless legs syndrome: Over 50 years of European contribution

Khachatryan

Ferri

Fulda

et al. 2022

Journal of Sleep Research

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“…In fact they do not have difficulty falling asleep or extended nocturnal awakenings [ 12 ]. Sleep disruption in RSD, however, is likely to be secondary to microstructural interruptions during sleep with higher sleep instability [ 15 ], possibly associated with the frequent movements and repositioning through the night. In this respect, it is important to emphasize that sleep microstructure has been reported to be correlated with cognitive processing and next-day cognitive performance [ 47 , 48 , 49 ]; thus, it might also have a role in cognitive changes in RSD.…”

Section: Discussionmentioning

confidence: 99%

“…RSD is found in 7.7% of children referred to sleep centers, a prevalence around that of insomnia (7.3%), and below the prevalence of restless legs syndrome (10.3%) [ 14 ]. The pathophysiology of RSD has not been completely elucidated, but some postulated theories include sleep instability, sympathetic activation, and iron deficiency [ 12 , 15 , 16 ]. Treatment with oral or intravenous iron has been shown to improve the symptoms of RSD [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Executive and Cognitive Functions in Children with Restless Sleep Disorder: A Pilot Study

et al. 2022

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Restless sleep disorder affects children and is characterized by frequent nocturnal movements, iron deficiency, and daytime symptoms such as poor school performance or behavioral problems. Although sleep parameters have been thoroughly studied and daytime sleepiness has been previously assessed, neurocognitive and executive functions have not. In this study, we evaluated neurocognitive functions in a group of 13 children diagnosed with restless sleep disorder using the National Institute of Health Toolbox (NIH toolbox). The mean age was 10.62 (S.D. 2.785). Among them, seven were male and six were female. The fully corrected T-scores (adjusted for demographic variables: age, ethnicity, and education level) showed the lowest values for the Flanker test (selective attention) and dimensional change card sorting test (cognitive flexibility and inhibitory control), with a very large effect size vs. the corresponding expected frequencies. For all the other tests, the average scores were 50; however, individual children scored low on pattern recognition and two composite scores (fluid and total). In conclusion, these data support the fact that cognitive functions are affected in children with restless sleep disorder, especially selective attention. Clinicians must recognize sleep disorders and daytime impairment in order to promptly intervene and prevent cognitive impairments.

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“…A recent study showed that children with RSD demonstrate abnormal CAP structure, suggesting alterations in sleep stability 30 . These findings were characterized by a lower percentage of A3 subtypes (arousals) than controls, shorter duration of the B phase of the CAP cycle, and shorter CAP cycle, indicating a faster than normal sleep instability, especially in slow‐wave sleep.…”

Section: Rsdmentioning

confidence: 99%

Restless sleep disorder, restless legs syndrome, and periodic limb movement disorder—Sleep in motion!

DelRosso

Mogavero

Ferri

2021

Pediatric Pulmonology

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Sleep‐related movement disorders (SRMDs) represent an important part of pediatric sleep disorders. The most common complaint in SRMD is restless sleep at night. Restless sleep is reported in up to 80% of children with restless legs syndrome (RLS) and children with periodic limb movements of sleep (PLMS) disorder (PLMD). However, restless sleep causing daytime behavioral consequences can be seen in children without another apparent condition and has recently been identified as a new independent primary pediatric sleep disorder, called restless sleep disorder (RSD). This study describes these three main SRMDs (RSD, RLS, and PLMD), explains the new consensus criteria for RSD, emphasizes the rapidly evolving areas of research in this field, and proposes recommendations for future research. In particular, the published data constitute convincing evidence that sleep‐related movements are disruptors of sleep quality and continuity. However, while important advancements have recently been reported in adults, a detailed analysis of the phenomenology and consequences of sleep‐related movements has just started in children. New approaches, standardized diagnostic methods, and specific guidelines are needed in the field of pediatric SRMD.

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Non-REM sleep instability in children with restless sleep disorder

Cited by 22 publications

References 34 publications

Restless legs syndrome: Over 50 years of European contribution

Restless legs syndrome: Over 50 years of European contribution

Assessment of Executive and Cognitive Functions in Children with Restless Sleep Disorder: A Pilot Study

Restless sleep disorder, restless legs syndrome, and periodic limb movement disorder—Sleep in motion!

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