Restless legs syndrome in children and adolescents with attention-deficit/hyperactivity disorder: prevalence, mimic conditions, risk factors, and association with functional impairment

Srifuengfung, Maytinee; Bussaratid, Sontuss; Ratta‐apha, Woraphat; Sanguanpanich, Naratip; Hosiri, Tikumporn

doi:10.1016/j.sleep.2020.05.037

Cited by 9 publications

(3 citation statements)

References 31 publications

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“…Zu beachten ist: ADHS ist nicht immer ADHS (Aufmerksamkeits- und Hyperaktivitätsstörung) [ 30 , 31 ]. Die Bedeutung des Schlafes wird in der ADHS-Diagnostik oft nicht ausreichend berücksichtigt [ 32 , 33 ].…”

Section: Ergebnisse Und Schwerpunkte Der Letzten 5 Jahreunclassified

Aktuelle Entwicklungen in der Schlafforschung und Schlafmedizin – eine Einschätzung der AG „Pädiatrie“

Paditz¹,

Wiater

Ipsiroglu

et al. 2022

Somnologie

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Section: Ergebnisse Und Schwerpunkte Der Letzten 5 Jahreunclassified

Aktuelle Entwicklungen in der Schlafforschung und Schlafmedizin – eine Einschätzung der AG „Pädiatrie“

Paditz¹,

Wiater

Ipsiroglu

et al. 2022

Somnologie

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“…Previous observational and meta-analysis studies have shown that ADHD has a high incidence in patients diagnosed with RLS ( 14 , 16 , 30 , 31 ). Although the two often co-occur, the unclear temporal order leads to ambiguity in the causal relationship, and there are several inconsistent conclusions in current research.…”

Section: Discussionmentioning

confidence: 99%

Association among attention-deficit hyperactivity disorder, restless legs syndrome, and peripheral iron status: a two-sample Mendelian randomization study

Xiao,

Shi,

Lan

et al. 2024

Front. Psychiatry

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BackgroundEpidemiological evidence indicates a high correlation and comorbidity between Attention Deficit Hyperactivity Disorder (ADHD) and Restless Legs Syndrome (RLS).ObjectiveWe aimed to investigate the causal relationship and shared genetic architecture between ADHD and RLS, as well as explore potential causal associations between both disorders and peripheral iron status.MethodsWe performed two-sample Mendelian randomization (MR) analyses using summary statistics from genome-wide meta-analyses of ADHD, RLS, and peripheral iron status (serum iron, ferritin, transferrin saturation, and total iron binding capacity). Additionally, we employed linkage disequilibrium score regression (LDSC) to assess genetic correlations between ADHD and RLS using genetic data.ResultsOur MR results supports a causal effect from ADHD (as exposure) to RLS (as outcome) (inverse variance weighted OR = 1.20, 95% CI: 1.08-1.34, p = 0.001). Conversely, we found no a causal association from RLS to ADHD (inverse variance weighted OR = 1.04, 95% CI: 0.99-1.09, p = 0.11). LDSC analysis did not detect a significant genetic correlation between RLS and ADHD (Rg = 0.3, SE = 0.16, p = 0.068). Furthermore, no evidence supported a causal relationship between peripheral iron deficiency and the RLS or ADHD onset. However, RLS may have been associated with a genetic predisposition to reduced serum ferritin levels (OR = 1.20, 95% CI: 1.00-1.04, p = 0.047).ConclusionThis study suggests that ADHD is an independent risk factor for RLS, while RLS may confer a genetic predisposition to reduced serum ferritin levels.LimitationsThe GWAS summary data utilized originated from populations of European ancestry, limiting the generalizability of conclusions to other populations.Clinical implicationsThe potential co-occurrence of RLS in individuals with ADHD should be considered during diagnosis and treatment. Moreover, iron supplementation may be beneficial for alleviating RLS symptoms.

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“…Maternal iron status and duration of iron supplementation during pregnancy correlate with life skills and school learning in ADHD children and adolescents ( 36 ).…”

Section: The Role Of Ironmentioning

confidence: 99%

Behavioral sleep medicine—The need for harmonization of clinical best practice outcome measures in children and adolescents with intellectual or developmental disabilities and restless sleep

Silvestri

Ipsiroglu

2022

Front. Psychiatry

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In behavioral medicine, sleep disorders, insomnia in particular, may be considered comorbidities and precipitating factors to intellectual or developmental disabilities (IDD). Nevertheless, sleep alterations have often been neglected in favor of daytime features and symptoms, albeit simple behavioral nighttime observations may disclose hypermotor features that characterize restless sleep. The root of most hypermotor restlessness is linked to central iron deficiency. The latter is often exacerbated by vitamin D deficiency (VDD), which interferes with both dopaminergic and serotonergic mechanisms. In this way, an imbalance affecting daytime behavior and mood is created. Several sleep-related motor disorders such as bruxism, periodic and aperiodic leg movements, Restless Legs Syndrome (RLS), and Restless Sleep Disorder (RSD) are commonly seen in Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders (ASD). However, they are rarely diagnosed and often overlooked in affected children and adolescents. As a result, not only are these disorders not adequately addressed therapeutically, but their symptoms may be worsened by the side-effects of drugs used to contain disruptive daytime behavior, such as antipsychotics and antidepressants. In children with IDDs, obesity, inactivity and metabolic effects of antipsychotics often lead to Sleep Disordered Breathing (SDB), which is currently understood as an inflammatory state leading to “hyperactive” lethargy and further alterations of the hypoxic chain and vitamin D levels. Endorsing simple routine blood tests, including inflammatory markers such as C-reactive protein, ferritin, transferrin, and vitamin D levels, may favorably complement caregiver observations and ambulatory sleep recordings, leading to a sleep disorder diagnosis and consequent therapy. In fact, the treatment of SDB, RLS, and RSD has been copiously demonstrated to favorably impact vigilance, behavior, social competence, and academic skills in healthy and, to a greater extent, in IDD children. Thus, consulting and deliberating the root causes of functional and categorical diagnoses within a clinical framework may engender a more precise diagnosis and further benefit pediatric daytime and nighttime management of hyperactive behaviors.

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Restless legs syndrome in children and adolescents with attention-deficit/hyperactivity disorder: prevalence, mimic conditions, risk factors, and association with functional impairment

Cited by 9 publications

References 31 publications

Aktuelle Entwicklungen in der Schlafforschung und Schlafmedizin – eine Einschätzung der AG „Pädiatrie“

Aktuelle Entwicklungen in der Schlafforschung und Schlafmedizin – eine Einschätzung der AG „Pädiatrie“

Association among attention-deficit hyperactivity disorder, restless legs syndrome, and peripheral iron status: a two-sample Mendelian randomization study

Behavioral sleep medicine—The need for harmonization of clinical best practice outcome measures in children and adolescents with intellectual or developmental disabilities and restless sleep

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