Prevalence and correlates of restless legs syndrome in adolescents

Abstract

ESS Epworth Sleepiness Scale IRLSSG International Restless Legs SyndromeStudy Group PLMS Periodic limb movements in sleep RLS Restless legs syndrome SDQ Strengths and Difficulties Questionnaire AIM The aim of this study was to determine the prevalence and correlates of restless legs syndrome (RLS) in adolescents.METHOD A sleep questionnaire aimed at identifying 'definite' RLS criteria (also including the Strengths and Difficulties Questionnaire and the Epworth Sleepiness Scale) was completed by 3304 high school adolescents aged 15 to 18 years (49% male; 51% female) in Gaziantep, Turkey. The diagnosis of RLS was confirmed by face-to-face or phone interviewing. The v 2 or Student's t-test and logistic regression tests were used for statistical evaluation.RESULTS 'Definite' RLS was diagnosed in 3.6% of participants. RLS symptoms were reported to occur on more than one occasion per week (frequent RLS) in 2% of participants and to make it to difficult to fall asleep or stay asleep (RLS with sleeping difficulty) in 1.7%. The prevalence of the combination of frequent symptoms and sleeping difficulty was 0.8%. Logistic regression analysis revealed that RLS was independently associated with nocturnal bed-wetting (4.2% vs 0.8%; p=0.004), sleeping difficulty (47% vs 32%; p=0.011), Epworth Sleepiness Scale score (4.9 vs 3.9; p=0.036), hyperactivity ⁄ inattention (25% vs 14%; p=0.049), awakening with discomfort in the legs (51% vs 30%; p<0.001), and parents with RLS-implying symptoms (56% vs 38%; p=0.006). RLS with sleeping difficulty was associated with hyperactivity ⁄ inattention (p=0.007); frequent RLS was associated with arm restlessness (p=0.006).INTERPRETATION 'Definite' RLS is not rare in adolescents; furthermore, it may be accompanied by several comorbid conditions that can impair quality of life in adolescents.Restless legs syndrome (RLS) is a sensorimotor disorder of the legs. According to the diagnostic criteria revised by the International RLS Study Group (IRLSSG) in 2003, 1 RLS has four essential characteristics: (1) an irresistible urge to move the legs, usually associated or caused by unpleasant and uncomfortable sensations, that (2) begins or worsens during periods of rest, (3) is relieved by movement, and (4) occurs or worsens in the evening or at night. These essential criteria have been proposed for the diagnosis of 'definite' RLS in adults and adolescents aged 12 or older. Supportive criteria have been proposed for special populations such as children and individuals with cognitive impairment. Individuals who do not meet all the criteria of 'definite' RLS may be defined as having 'probable' or 'possible' RLS. 1 Several epidemiological surveys have been conducted in adults. However, there are few studies in children and adolescents, 2,3 and only one epidemiological study has been based on the latest diagnostic criteria in a paediatric population. 4 Laberge et al. 2 found leg restlessness at bedtime in 6.1% of children in their study. Kotagal and Silber 3 reported a prevalence of RLS of 5.9%, with a ratio o...

Restless Legs Syndrome, Sleep, and Quality of Life among Adolescents and Young Adults

“…22 In the present study, univariate analyses showed that participants with symptoms consistent with RLS were more likely to admit to learning problems (14.3%) than those without RLS symptoms (8.0%), although the difference did not reach statistical significance. Potential participants with ADHD were excluded from the initial TuCASA study to avoid the effects of ADHD on home PSGs.…”

“…6,21 Yilmaz and associates noted that adolescents with RLS were more likely to experience difficulty falling asleep than those adolescents without RLS (47% vs. 32%) and that adolescents with RLS had generally higher Epworth Sleepiness Scale scores. 22 Arbuckle et al noted that 79% of children and adolescents with RLS had problems falling asleep and 70% felt tired or sleepy during the day. 23 However, the direction of the association between EDS and trouble falling asleep cannot be determined in a cross-sectional design.…”

Psychiatric Comorbidity in Children and Adolescents with Restless Legs Syndrome: A Retrospective Study

“…4,5 The conclusion from all 3 studies is that childhood RLS is a common disorder, and comorbid mental health conditions are being increasingly recognized. [3][4][5] In a case series of 18 children and adolescents who met diagnostic criteria for pediatric RLS, Picchietti and Stevens described other comorbid disorders such as parasomnias in 7 of 18 subjects, attention deficit hyperactivity disorder (ADHD) in 13 of 18 subjects, oppositional defiant disorder in 4 of 18 subjects, anxiety disorders in 6 of 18 subjects, and depression in 5 of 18 subjects. 6 Yilmaz and colleagues also found a high co-occurrence of ADHD symptoms in children with definite RLS.…”

Brazilian consensus on guidelines for diagnosis and treatment for restless legs syndrome

“…However, it is noteworthy that there are no studies with level I evidence to guide therapeutic choices of RLS in children. The non-pharmacological treatment consists in improve sleep hygiene: encourage regular physical activity and improve sleep routines in order to avoid sleep deprivation and exacerbating factors such as caffeinated substances 130,131 .…”