Periodic Limb Movements in Sleep and Iron Status in Children

Simakajornboon, Narong; Gozal, David; Vlašić, Vukmir; Mack, C.; Sharon, Denise; McGinley, Brian M.

doi:10.1093/sleep/26.6.735

Cited by 146 publications

(82 citation statements)

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“…This is greater than the percentage of subjects with low serum ferritin levels reported in a study of 27 adult RLS patients (63%) 5 and in a study of 39 children with PLMS (72%). 18 The median serum ferritin level in our patients was also similar to the 17g/L mean level found in three teenagers with RLS by Kryger and colleagues. 19 Oral iron therapy has resulted in subjective improvement in sleep-wake function in children with low serum ferritin levels.…”

Section: Discussionsupporting

confidence: 90%

Childhood‐onset restless legs syndrome

Kotagal

Silber

2004

Annals of Neurology

172

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The clinical characteristics of childhood-onset restless legs syndrome are described. Thirty-two of 538 subjects (5.9%) examined in our sleep disorders center received diagnoses of restless legs syndrome. They were classified based on published criteria into probable (n = 9/32 or 28%) and definite (n = 23/32 or 78%) categories. Apart from an earlier age of diagnosis of the probable group, no differences were found between the two categories. Sleep onset or sleep maintenance insomnia was the most common symptoms, being present in 28 of 32 subjects (87.5%). Inattentiveness was seen in 8 of 32 subjects (25%). Serum ferritin levels were measured in 24 of 32 subjects and were below 50 microg/L in 20 of 24 subjects (83%). A family history of restless legs syndrome was present in 23 of 32 (72%) subjects, with mothers almost three times more likely to be affected than fathers (p = 0.02). We conclude that iron deficiency and a strong family history are characteristic of childhood-onset restless legs syndrome.

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Section: Discussionsupporting

confidence: 90%

Childhood‐onset restless legs syndrome

Kotagal

Silber

2004

Annals of Neurology

172

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“…Both groups of children had minimal caffeine intake at the time of the study. PLMS in children are frequently associated with iron deficiency (44), for which ex-preterm children may potentially be at increased risk.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Effects of Caffeine Therapy for Apnea of Prematurity on Sleep at School Age

Marcus

Meltzer

Roberts

et al. 2014

Am J Respir Crit Care Med

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Rationale: Apnea of prematurity is a common condition that is usually treated with caffeine, an adenosine receptor blocker that has powerful influences on the central nervous system. However, little is known about the long-term effects of caffeine on sleep in the developing brain.Objectives: We hypothesized that neonatal caffeine use resulted in long-term abnormalities in sleep architecture and breathing during sleep.Methods: A total of 201 ex-preterm children aged 5-12 years who participated as neonates in a double-blind, randomized, controlled clinical trial of caffeine versus placebo underwent actigraphy, polysomnography, and parental sleep questionnaires. Coprimary outcomes were total sleep time on actigraphy and apnea-hypopnea index on polysomnography.Measurements and Main Results: There were no significant differences in primary outcomes between the caffeine group and the placebo (adjusted mean difference of 26.7 [95% confidence interval (CI) = 215.3 to 2.0 min]; P = 0.13 for actigraphic total sleep time; and adjusted rate ratio [caffeine/placebo] for apnea-hypopnea index of 0.89 [95% CI = 0.55-1.43]; P = 0.63). Polysomnographic total recording time and total sleep time were longer in the caffeine group, but there was no difference in sleep efficiency between groups. The percentage of children with obstructive sleep apnea (8.2% of caffeine group versus 11.0% of placebo; P = 0.22) or elevated periodic limb movements of sleep (17.5% in caffeine group versus 11% in placebo group) was high, but did not differ significantly between groups.Conclusions: Therapeutic neonatal caffeine administration has no long-term effects on sleep duration or sleep apnea during childhood. Ex-preterm infants, regardless of caffeine status, are at risk for obstructive sleep apnea and periodic limb movements in later childhood.

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“…This motoric relationship may be particularly relevant to our observations, since restless legs syndrome (RLS) and periodic limb movements during sleep (PLMS) have been associated with iron deficiency and conditions characterized by compromised iron status [73]. Moreover, dietary iron supplementation has been shown to alleviate RLS symptoms and to reduce PLMS in adult patients [74] and to be associated with clinical improvement in some children with PLMS [75,76].…”

Section: Discussionmentioning

confidence: 81%