Restless Leg Syndrome In Children: Causes, Treatment, Home Care

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Restless leg syndrome in kids is a sensory and motor disorder, leading to uncontrollable sensations accompanied by an urge to move the legs. Most children feel this urge to move their legs when they are inactive or resting, such as during bedtime, while sitting for long hours in the classroom, or during car rides (1).

According to the National Library of Medicine, two to four percent of US children are diagnosed with restless leg syndrome.

The diagnosis of restless leg syndrome or RLS can be challenging in children since it is clinically diagnosed based on the medical history and symptoms. In addition, behavioral problems, such as inattention, hyperactivity, aggression, and daytime somnolence, are seen in some children with RLS (1).

Read on to know the causes, symptoms, and treatments for restless leg syndrome in children.

How Common Is Restless Leg Syndrome In Children?

RLS affects both children and adults. According to the Restless Legs Syndrome Foundation, this neurological condition is estimated to affect 1.5 million children and adolescents. Also, about 35% of patients report RLS during childhood or adolescence, and one in ten children report symptoms onset during the first decade of their lives (2).

Symptoms Of Restless Leg Syndrome In Children

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It is not easy to identify RLS in children, as most of the symptoms are often brushed off as growing pains or typical child behavior.

Here are a few symptoms that also serve as diagnostic criteria for determining RLS in children (1).

• An uncomfortable and unpleasant aching, tingling, twitching, crawling, or burning sensation in the legs causing an uncontrollable urge to move the legs

• The urge begins or gets worse during periods of rest or inactivity, such as when lying down or sitting

• Restlessness starts or gets worse only in the evening or night

• The unpleasant feeling is temporarily relieved by moving, walking, or stretching the legs

• Inability to sleep or stay put to sleep throughout the night

• Unsatisfactory performance at school

• Poor social development and abnormal social interactions

• Habitual use of phrases such as ‘ouchies,’ ‘oowies,’ ‘tickle,’ ‘creepy crawlies,’ ‘want to run,’ ‘a lot of energy in my legs,’ ‘pain,’ and ‘ache.’

Sometimes, these symptoms may also be due to an associated syndrome known as periodic limb movement disorder (PLMD). This disorder is characterized by brief involuntary jerks of the foot or leg for every 20 to 40 seconds. RLS often occurs together with PLMD and is frequently seen in children with attention deficit hyperactivity disorder (ADHD) (1).

What Causes Restless Leg Syndrome In Children?

RLS is known to run in families. Children with RLS are found to have low levels of dopamine, a hormone that controls motion (3). Also, studies have found that children who have iron deficiency are at a higher risk of developing it (1).

Point to consider

Different types of drugs, including the ones used to treat allergies, depression, and psychiatric disorders, may also cause restless leg syndrome (6).

Diagnosis Of Restless Leg Syndrome

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To diagnose RLS in children, they need to have the first four of the symptoms mentioned above. If the child is unable to describe the signs on their own, the doctor might ask you for additional information, such as sleep disturbances or a family history of RLS.

Blood tests to determine the iron (serum ferritin) levels may also be recommended as ferritin levels less than 50 mcg/L might indicate an underlying medical problem (3).

If the doctor suspects PLMD, they might order a polysomnogram (PSG). A periodic limb movement index of five or more per hour of sleep could indicate PLMD (1).

Risks And Complications Of RLS

Children with a family history of RLS and children deficient in iron are at a greater risk for developing RLS. Also, if your child has a history of bleeding disorders or experiences heavy menstrual periods, they may have anemia, which increases the risk.

Although RLS has no life-threatening complications, it may disturb the overall well-being of the child. As children with RLS have difficulty falling asleep, they might experience insomnia, leading to daytime excessive drowsiness and depression.

Treatment For Restless Leg Syndrome

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According to the American Academy of Sleep Medicine, there are no specific medications recommended to treat RLS and PLMD in children. Also, the US Food and Drug Administration has approved no medications for RLS in children.

Although dopamine agonists, benzodiazepines, and alpha-adrenergics have been tried on children with RLS, their long-term effects are unknown. These medications should be used with caution among children as some may relax the upper airway muscles and cause upper airway collapse. Also, the long-term effects of iron therapy are not known while treating RLS.

Your doctor is the best person to evaluate your child’s condition and prescribe the best possible treatment (1). This condition may not fully go away in your child. However, with proper guidance and some home care treatments, you may be able to reduce the intensity of the syndrome and help your child lead a normal life.

Point to consider

Caffeine may worsen the symptoms of RLS and therefore, children should avoid caffeinated products, such as tea, coffee, some medicines, chocolates and colas (7).

Exercises For Restless Leg Syndrome In Children

Keep the following things in mind when exercising to manage RLS in children:

• Ensure daily aerobic exercise and lower-body resistance training, even for just 30 minutes, as it can effectively ease the symptoms.
• Opt for enjoyable activities that focus on leg movement, as moderate exercise significantly reduces RLS symptoms without requiring intense workouts.
• Avoid strenuous exercise, especially close to bedtime, as it might worsen RLS symptoms.
• Highly vigorous exercise and overexertion leading to joint or muscle pain can backfire as it may exacerbate RLS symptoms.

Balancing regular, moderate physical activity based on personal preferences is key in managing and lessening the impact of restless legs syndrome. Discovering the right exercise routine can profoundly improve daily comfort and overall well-being (4).

Home Care Treatments For Restless Leg Syndrome In Children

Along with your doctor’s treatment plan, you may follow some home care treatments to help relieve the symptoms of RLS.

1. Give your child a warm or a cold compress. It might help reduce the unpleasant sensation in the legs.

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2. Walking, stretching, and fidgeting temporarily alleviate the involuntary movements and associated discomfort.

3. Discourage non-sleep-inducing activities such as watching television or playing games near bedtime.

4. Encourage your children to take a warm and relaxing bath before bed.

5. Talk to your child’s pediatrician to know if you can give your child supplements such as vitamins or minerals.

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6. Make sure your child is eating a well-balanced and healthy diet.

Quick tip

Regular gentle exercises such as walking and cycling may help relieve the severity of RLS. However, avoid intense exercises before bedtime (7).

Infographic: Causes Of Restless Legs Syndrome

When the exact cause of restless legs syndrome is unknown, it is called idiopathic restless legs syndrome. However, in many cases, research suggests that it may occur due to an underlying condition. This infographic discusses some conditions that may lead to restless legs syndrome.

Illustration: Momjunction Design Team

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Restless Leg Syndrome is a condition that causes an uncontrollable urge to move your legs. This video provides helpful insight into the condition.

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Dr. Tashawna StokesMD

Dr. TaShawna Stokes is a mom to two beautiful daughters and currently practices in the Atlanta area. She received her undergraduate and medical degrees from Auburn University and The University of South Alabama. She completed her Pediatric Residency at Children’s Hospital of Los Angeles. After completing a chief year, she has worked in urgent care, inpatient and private practice in...more

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Vidya did her post-graduation in Biotechnology from Osmania University, Hyderabad. Her interest in scientific research and writing made her pursue a career in writing, in which she now has over five years of experience. She has done certified biotechnology-related training programs under renowned organizations such as Centre For Cellular & Molecular Biology and Department of Biotechnology. Vidya writes health-based articles...more