A large International Restless Legs Syndrome (RLS) Study Group has been formed. As its first task, the group has taken upon itself the role of defining the clinical features of the RLS. As minimal criteria for diagnosis, the group proposes the following four features: (a) desire to move the extremities, often associated with paresthesias/dysesthesias; (b) motor restlessness; (c) worsening of symptoms at rest with at least temporary relief by activity, and (d) worsening of symptoms in the evening or night. Other features commonly seen in RLS include sleep disturbance, periodic limb movements in sleep and similar involuntary movements while awake, a normal neurological examination in the idiopathic form, a tendency for the symptoms to be worse in middle to older age, and, in some cases, a family history suggestive of an autosomal dominant mode of inheritance.

We suggest that, by increasing breastfeeding, bedsharing might be protective against SIDS, at least in some contexts. Furthermore, maternal reproductive physiology could be impacted because nursing frequency affects ovulation. This is the first study to directly measure nocturnal breastfeeding behavior in any cultural group.

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Routinely bed sharing infants also exhibited more frequent TAs in stage 3-4 than the routine solitary sleepers in both conditions. In both groups, the number of infant arousals (EWs ؉ TAs) that overlapped the mother's was doubled during bed sharing, with infant arousals leading most often.Conclusions. Mother-infant bed sharing promotes infant arousals. Together with a previous report that bed sharing reduces stage 3-4 sleep, this suggests that normative values for infant sleep must be interpreted within the context of the sleeping environment in which they were established. Given that arousability is diminished in stage 3-4, we speculate that, under otherwise safe conditions, the observed changes in stage 3-4 sleep and arousals associated with bed sharing might be protective to infants at risk for SIDS because of a hypothesized arousal deficit. The responsivity of the mother to infant arousals during bed sharing might also be protective. Pediatrics 1997;100:841-849; bed sharing, cosleeping, solitary sleeping, infant arousals, SIDS, infant sleep.

Contrary to popular perception, studies show that parent-infant bedsharing is not uncommon in American society. A belief that bedsharing with infants negatively impacts the quality of adult sleep also appears wide-spread. This has not been substantiated, however, because the few studies that have measured the impact of bedsharing on adult sleep examined only bedsharing with another adult. In the present study, laboratory polysomnography was performed in 20 routinely bedsharing and 15 routinely solitary-sleeping, breastfeeding, Latino mother-infant pairs comparing the mothers' sleep when bedsharing to solitary-sleeping nights. Infants were 11-15 weeks old at the time. Irrespective of routine sleeping arrangement, mothers' total sleep time was not decreased on the bedsharing night compared to the solitary night. Across the two groups, percent Stage 3-4 sleep (of total sleep time) was significantly reduced on the bedsharing night but only by 3.9%, while Stage 1-2 sleep was increased 3.7%. Episodes of both Stages 3-4 and 1-2 were significantly shorter. The amount of rapid eye movement (REM) sleep was unaffected. Overall, arousal frequency was significantly increased by 3.6 hour-1. As the increase in arousal frequency was stage specific, it could account for the pattern of stage changes. Nocturnal wakefulness was not increased, however, because awakenings were of shorter duration. these effects of bedsharing did not habituate with routine bedsharing because they were not diminished in the routinely bedsharing mothers compared to the routinely solitary-sleeping mothers. We find that the impact of bedsharing on maternal sleep is modest and somewhat different from the reported impact of sleeping with another adult. From the infant's standpoint, the effects on maternal sleep are adaptive to the extent that opportunities to monitor the infant's status are enhanced. The mother's caregiver role is likely germane to differential effects on sleep of bedsharing with an infant versus another adult.