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