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DOI: 10.1055/s-2005-837685
Georg Thieme Verlag KG Stuttgart · New York
Restless Legs Syndrome and Sleep Problems in Children and Adolescents with Insulin-Dependent Diabetes Mellitus Type 1
Publication History
Received: December 1, 2004
Accepted after Revision: March 16, 2005
Publication Date:
11 April 2005 (online)
Abstract
The restless legs syndrome (RLS) occurs in adulthood with a prevalence of 5 to 10 % and can be associated with diabetes mellitus. The prevalence in childhood, however, is unknown. We asked consecutive children with type 1 (insulin-dependent) diabetes mellitus as well as their parents and siblings about RLS according to a standardised questionnaire. Altogether, 46 patients (25 female, 12.0 ± 3.7 years), 50 siblings (29 female, 12.3 ± 5.5 years) and 75 parents (41 mothers, 40.4 ± 5.1 years; 34 fathers, 42.5 ± 5.3 years; 1.3 % with diabetes mellitus) were included. One patient (2.2 %), one sibling (2.0 %), and 14 parents (18.7 %) were diagnosed as having RLS. Disturbances of sleep initiating, sleep maintenance and daytime tiredness were similar in patients and siblings. There was a significant association of higher HbA1c values (mean 7.7 ± 2.2 %) with sleep initiating problems. The mean dose of international units of insulin/kg body weight/day (0.79 ± 0.26 IU) was not associated with the presence of RLS or sleep problems. To conclude, there seems to be no association of diabetes mellitus type 1 with RLS in children and adolescents. However, there is a relationship between diabetes and sleep disturbances and an optimally controlled diabetes mellitus might be an important factor for an improved sleep initiation.
Key words
Restless legs syndrome - children - adolescents - diabetes mellitus type 1 - sleep
References
- 1 Allen R P, Picchietti D, Hening W A, Trenkwalder C, Walters A S, Montplaisir J. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med. 2003; 4 101-119
- 2 American Sleep Disorder Association .Periodic Limb Movement Disorder. International Classification of Sleep Disorders. Rev. ed. (ICSD-R). Rochester MN; Davies Printing Co 1997: 65-68
- 3 Archbold K H, Pituch K J, Panahi P, Chervin R D. Symptoms of sleep disturbances among children at two general pediatric clinics. J Pediatr. 2002; 140 97-102
- 4 Arens R, Wright B, Elliott J, Zhao H, Wang P P, Brown L W. et al . Periodic limb movement in sleep in children with Williams syndrome. J Pediatr. 1998; 133 70-74
- 5 Berger K, Luedemann J, Trenkwalder C, John U, Kessler C. Sex and the risk of restless legs syndrome in the general population. Arch Intern Med. 2004; 164 196-202
- 6 Chervin R D, Archbold K H. Hyperactivity and polysomnographic findings in children evaluated for sleep-disordered breathing. Sleep. 2001; 24 313-320
- 7 Chervin R D, Archbold K H, Dillon J E, Pituch K J, Panahi P, Dahl R E. et al . Associations between symptoms of inattention, hyperactivity, restless legs and periodic leg movements. Sleep. 2002; 25 213-218
- 8 Ekbom K A. Growing pains and restless legs. Acta Paediatr Scand. 1975; 64 264-266
- 9 Feldmann S, Böhm D, Bauer G, Dobberstein P. Familiäres RLS bei Kindern und Jugendlichen: Symptomatik und Verlauf am Beispiel einer RLS-Familie. Somnologie. 2001; 5 (Suppl 2) 17
- 10 Hornyak M, Happe S, Trenkwalder C, Scholle S, Schlüter B, Kinkelbur J. and members of the study groups “movement disorders” and “pediatrics” of the German Sleep Society . Restless legs syndrome in childhood: a consensus proposal for diagnostic criteria. Somnologie. 2002; 6 133-137
- 11 Kinkelbur J, Hellwig J, Hellwig M. Frequency of RLS symptoms in childhood. Somnologie. 2003; 7 (Suppl 1) 34-[abstract]
- 12 Lavigne G J, Montplaisir J Y. Restless legs syndrome and sleep bruxism: prevalence and association among Canadians. Sleep. 1994; 17 739-743
- 13 Lipinski J F, Sallee F R, Jackson C, Sethuraman G. Dopamine agonist treatment of Tourette disorder in children: results of an open-label trial of pergolide. Mov Disord. 1997; 12 402-407
- 14 Lu L R, Peat J K, Sullivan C E. Snoring in preschool children: prevalence and association with nocturnal cough and asthma. Chest. 2003; 124 587-593
- 15 Machtey I, Tiqwa P. Restless legs syndrome: a metabolic disorder?. Arch Intern Med. 1996; 156 2386
- 16 Michaelis D, Jutzi E, Vogt L. Epidemiology of insulin-treated diabetes mellitus in the East-German population: differences in long-term trends between incidence and prevalence rates. Diabetes Metab. 1993; 19 110-115
- 17 Montplaisir J, Boucher S, Poirier G, Lavigne G, Lapierre O, Lesperance P. Clinical, polysomnographic, and genetic characteristics of restless legs syndrome: a study of 133 patients diagnosed with new standard criteria. Mov Disord. 1997; 12 61-65
- 18 Montplaisir J, Boucher S, Nicolas A, Lesperance P, Gosselin A, Rompre P. et al . Immobilization tests and periodic leg movements in sleep for the diagnosis of restless leg syndrome. Mov Disord. 1998; 13 324-329
- 19 Naish J M, Apley J. “Growing pains”: Clinical study of non-arthritic limb pains in children. Arch Dis Child. 1951; 26 134-140
- 20 Oster J, Nielsen A. Growing pains: a clinical investigation of a school population. Arch Paediatr Scand. 1972; 61 329-334
- 21 Phillips B, Young T, Finn L, Asher K, Hening W A, Purvis C. Epidemiology of restless legs symptoms in adults. Arch Intern Med. 2000; 160 2137-2141
- 22 Picchietti D L, Walters A S. Moderate to severe periodic limb movement disorder in childhood and adolescence. Sleep Res. 1994; 23 303
- 23 Picchietti D L, England S J, Walters A S, Willis K, Verrico T. Periodic limb movement disorder and restless legs syndrome in children with attention-deficit hyperactivity disorder. J Child Neurol. 1998; 13 588-594
- 24 Picchietti D L, Underwood D J, Farris W A, Walters A S, Shah M M, Dahl R E. et al . Further studies on periodic limb movement disorder and restless legs syndrome in children with attention-deficit hyperactivity disorder. Mov Disord. 1999; 14 1000-1007
- 25 Picchietti D L, Walters A S. Moderate to severe periodic limb movement disorder in childhood and adolescence. Sleep. 1999; 22 297-300
- 26 Rosenbauer J, Icks A, Giani G. Incidence and prevalence of childhood type 1 diabetes mellitus in Germany - model-based national estimates. J Pediatr Endocrinol Metab. 2002; 15 1497-1504
- 27 Rothdach A J, Trenkwalder C, Haberstock J, Keil U, Berger K. Prevalence and risk factors of RLS in an elderly population. The MEMO study. Neurology. 2000; 54 1064-1068
- 28 Scholle S, Scholle H C, Zwacka G. Periodic leg movements and sleep-disordered breathing in children. Somnologie. 2001; 5 153-158
- 29 Skomro R P, Ludwig S, Salamon E, Kryger M H. Sleep complaints and restless legs syndrome in adult type 2 diabetics. Sleep Med. 2001; 2 417-422
- 30 Tayag-Kier C E, Keenan G F, Scalzi L V, Schultz B, Elliott J, Zhao H. et al . Sleep and periodic limb movement in sleep in juvenile fibromyalgia. Pediatrics. 2001; 106 E70
- 31 The International Restless Legs Syndrome Study Group . Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med. 2003; 4 121-132
- 32 Walters A S, Picchietti D L, Ehrenberg B L, Wagner M L. Restless legs syndrome in childhood and adolescence. Pediatr Neurol. 1994; 11 241-245
- 33 Walters A S. Toward a better definition of restless legs syndrome. The International Restless Legs Syndrome Study Group. Mov Disord. 1995; 10 634-642
- 34 Walters A S, Hickey K, Maltzman J, Joseph D, Hening W, Wilson V. et al . A questionnaire study of 138 patients with restless legs syndrome: the “night walkers” survey. Neurology. 1996; 46 92-95
- 35 Walters A S, Mandelbaum D E, Lewin D S, Kugler S, England S J, Miller M. Dopaminergic therapy in children with restless legs/periodic limb movements in sleep and ADHD. Pediatr Neurol. 2000; 22 182-186
- 36 Walters A S. Is there a subpopulation of children with growing pains who really have restless legs syndrome? A review of the literature. Sleep Med. 2002; 3 93-98
- 37 Waltz S, Baumgarten-Walczak A, Langner M, Stephani U. Restless legs syndrome in childhood. Neuropediatrics. 2000; 31 A40
MD Svenja Happe
Department of Clinical Neurophysiology
University of Göttingen
Robert-Koch-Straße 40
37099 Göttingen
Germany
Email: shappe@gwdg.de