South Florida Sun-Sentinel (Sunday)
Restless legs syndrome in kids
Q: My child moves around a lot at bedtime and has trouble falling asleep. She describes “bugs” on her legs. As someone who was diagnosed with restless legs syndrome, I am wondering if children can develop restless legs syndrome, too? A:
Yes, children can have restless legs syndrome. You also may hear it called Willis-Ekbom disease, based on the names of the physicians who first described this condition.
Just like adults, children can have sensations in their legs that makes it hard for them to sleep. If the sensation happens regularly, they may have restless legs syndrome, which is a sleep disorder.
Restless legs syndrome can occur in about 2% of school-aged children. It also can run in families. Children with symptoms may have a parent who has restless legs syndrome.
The syndrome does not lead to other health problems in children. Treatments are available that can reduce or eliminate restless legs syndrome.
It can be challenging to diagnose children with restless legs syndrome, which is characterized by an unpleasant or uncomfortable urge to move their legs. Some describe it as a crawling, pulling or burning sensation in the thighs, calves or feet. Children may describe “bugs” or use other such descriptors.
The sensation is temporarily relieved when they get up and move, or when they shift or stretch their legs. Children also can have “growing pains,” which typically wax and wane, and are not associated with the need for movement.
Symptoms of restless legs syndrome typically begin at night after a person has been sitting or
lying down for some time. These symptoms can occur during the day, too, when a person is sitting, but they typically are worse at night. Children may have these feelings while sitting in a car or classroom. In kids, symptoms can start as early as 5 to 6 years old.
Many people have mild leg twitches as they drift off to sleep. These movements, called “hypnic starts,” are a normal part of falling asleep. They are not associated with restless legs syndrome. Restless legs syndrome is much more uncomfortable.
Sometimes muscle and ligament strain can be misinterpreted as restless legs syndrome. Usually, however, a strain is relieved by rest; whereas, the symptoms of restless legs syndrome worsen when limbs are kept still.
Sleep studies are not necessary unless children cannot accurately describe their symptoms. Based on how old they are developmentally, it can be difficult for them to describe the feelings in their legs, so speak with a health care provider about options.
Treatment focuses on relieving symptoms. Taking a warm bath, massaging the legs, or applying warm or cool packs can calm symptoms of restless legs syndrome. Stretching, followed by regular moderate exercise and establishing good
sleep habits also can make a difference. Caffeine, alcohol or tobacco consumption can trigger or worsen symptoms.
Research shows that too little iron in a person’s diet can contribute to restless legs syndrome. Some young children or toddlers have a high consumption of cow’s milk, which can lead to low iron. You may want to speak to your pediatrician about checking their blood iron level.
If the blood iron level is low, eating more iron-rich foods can help. Examples include red meat; dark green leafy vegetables; beans; and iron-fortified breads, cereals and pastas. Your provider also might suggest iron supplements, which is usually the first choice to treat children.
No medications have been approved by the Food and Drug Administration for children with restless legs syndrome. Certain medications may be considered by a sleep medicine physician if children have not responded to other measures.