Further studies on periodic limb movement disorder and restless legs syndrome in children with attention-deficit hyperactivity disorder.
ABSTRACT Fourteen consecutive children who were newly diagnosed with attention-deficit hyperactivity disorder (ADHD) and who had never been exposed to stimulants and 10 control children without ADHD underwent polysomnographic studies to quantify Periodic Limb Movements in Sleep (PLMS) and arousals. Parents commonly gave both false-negative and false-positive reports of PLMS in their children, and a sleep study was necessary to confirm their presence or absence. The prevalence of PLMS on polysomnography was higher in the children with ADHD than in the control subjects. Nine of 14 (64%) children with ADHD had PLMS at a rate of >5 per hour of sleep compared with none of the control children (p <0.0015). Three of 14 children with ADHD (21%) had PLMS at a rate of >20 per hour of sleep. Many of the PLMS in the children with ADHD were associated with arousals. Historical sleep times were less for children with ADHD. The children with ADHD who had PLMS chronically got 43 minutes less sleep at home than the control subjects (p = 0.0091). All nine children with ADHD who had a PLMS index of >5 per hour of sleep had a long-standing clinical history of sleep onset problems (>30 minutes) and/or maintenance problems (more than two full awakenings nightly) thus meeting the criteria for Periodic Limb Movement Disorder (PLMD). None of the control children had a clinical history of sleep onset or maintenance problems. The parents of the children with ADHD were more likely to have restless legs syndrome (RLS) than the parents of the control children. Twenty-five of 28 biologic parents of the children with ADHD and all of the biologic parents of the control children were reached for interview. Eight of twenty-five parents of the children with ADHD (32%) had symptoms of RLS as opposed to none of the control parents (p = 0.011). PLMS may directly lead to symptoms of ADHD through the mechanism of sleep disruption. Alternative explanations for the association between ADHD and RLS/PLMS are that they are genetically linked, they share a common dopaminergic deficit, or both.
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ABSTRACT: To describe sleep problems among youth with and without functional abdominal pain (FAP). Participants were 8-15 years of age diagnosed with FAP (n = 67) or healthy pain-free comparisons (n = 80). Parents and participants completed instruments assessing sleep, psychiatric status, and FAP symptoms. Parent and child reports of sleep problems were compared across groups and the association of FAP to behavioral sleep problems was assessed controlling for psychopathology. Children with FAP were reported to have more symptoms of behavioral sleep disorders (BSD), as well as increased nightmares and daytime tiredness than the comparison group. There were no group differences in total sleep time. Logistic regression analysis indicated that FAP was associated with a significantly increased risk of BSD symptoms [Odds ratio (OR): 4.17] after controlling for psychopathology. Sleep problems in youth with FAP warrant clinical attention and future research should continue to explore sleep problems that co-occur with and independent of psychopathology.Journal of Pediatric Psychology 10/2007; 32(8):938-49. DOI:10.1093/jpepsy/jsm032 · 2.91 Impact Factor
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ABSTRACT: Sleep disturbance in children, whether because of poor sleep hygiene or sleep-related breathing disorders, is associated with significant behavioral and neurocognitive deficits. The mechanisms by which sleep disturbance contributes to the daytime manifestations are unclear, although it seems that sleep fragmentation and intermittent hypoxia are important. The long-term outcome for children with untreated diseases leading to sleep disruption is currently unknown. Increased awareness and early identification and treatment of conditions that lead to altered sleep should yield improved neurocognitive outcomes in affected children.Pediatric Clinics of North America 03/2004; 51(1):187-202. DOI:10.1016/S0031-3955(03)00184-6 · 2.20 Impact Factor
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ABSTRACT: Restless legs syndrome (RLS) is a common neurological disorder characterized by an irresistible desire to move the extremities associated with paraesthesia/dysaesthesia. These symptoms occur predominantly at rest and worsen at night, resulting in nocturnal insomnia and chronic sleep deprivation. In this paper, we show significant evidence of linkage to a new locus for RLS on chromosome 14q13-21 region in a 30-member, three-generation Italian family affected by RLS and periodic leg movements in sleep (PLMS). This is the second RLS locus identified so far and the first consistent with an autosomal dominant inheritance pattern. The new RLS critical region spans 9.1 cM, between markers D14S70 and D14S1068. The maximum two-point log of odds ratio score value, of 3.23 at theta = 0.0, was obtained for marker D14S288. The accurate clinical evaluation of RLS-affected, as well as unaffected, family members allowed for the configuring of RLS as a phenotypic spectrum ranging from PLMS to RLS. Motor component, both while awake and during sleep, was an important aspect of the phenotype in the family analysed. The complementary clinical and genetic studies on multiplex families are likely to be of the utmost importance in unfolding the complete expressivity of RLS phenotype spectrum.Brain 07/2003; 126(Pt 6):1485-92. · 10.23 Impact Factor