Restless leg syndrome (RLS) is a sensory and motor disorder that causes an uncontrollable sensation in the legs and is often accompanied by an urge to move the legs. This urge is mostly seen during bedtime or when the legs are inactive, such as while sitting for long hours during car rides or in the classroom (1).
The diagnosis is purely clinical, based on the patient’s medical history and symptoms, making it challenging to diagnose the condition in children. Children with RLS may exhibit behavioral problems such as aggression, inattention, hyperactivity, and daytime somnolence (1).
Read this post to understand the causes, symptoms, and treatment options 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, RLS 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
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 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 difficulty in maintaining 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 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).
Diagnosis Of Restless Leg Syndrome
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 prescribe for 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
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 supplements 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.
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.
- Give your child a warm or a cold compress. It might help reduce the unpleasant sensation in the legs.
- Encourage your child to follow healthy sleep habits, such as maintaining a regular sleep-wake schedule and avoiding heavy meals and fluids before bedtime.
- Discourage non-sleep-inducing activities such as watching television or playing games near bedtime.
- Encourage your children to take a warm and relaxing bath before bed.
- Talk to your child’s doctor to know if you can give your child supplements such as vitamins or minerals.
- Make sure your child is eating a well-balanced and healthy diet.
Restless Leg Syndrome can cause discomfort and irritability in children and affect their day-to-day activities. So, make sure your child is diagnosed properly, as unrecognized RLS can cause behavioral issues in children and teenagers. As the diagnosis is challenging, make sure you observe your child carefully and tell your doctor all the symptoms.
2. RLS & Kids; Restless Legs Syndrome Foundation
3. Restless Leg Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD); Children’s Hospital Colorado
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