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Growing pains and periodic limb movements of sleep in children
Man Wai Wong1, Bruce D Williamson, Wen Qiu
1School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
Insights
Children with growing pains (GP) were three times more likely to have periodic limb movements of sleep (PLMS). This suggests GP may be linked to restless legs syndrome, potentially sharing genetic factors.
Area of Science:
- Pediatric Sleep Medicine
- Neurology
- Genetics
Background:
- Growing pains (GP) are common in children, but their underlying mechanisms are not fully understood.
- Periodic limb movements of sleep (PLMS) are characterized by repetitive limb movements during sleep.
- Restless legs syndrome (RLS) shares potential genetic links with GP, suggesting a possible connection.
Purpose of the Study:
- To determine if there is an association between growing pains (GP) and periodic limb movements of sleep (PLMS) in children.
- To explore the hypothesis that GP may be part of the phenotypic spectrum of restless legs syndrome (RLS).
Main Methods:
- Retrospective review of 903 children (aged 3-16) who underwent polysomnography (PSG) between January 2009 and May 2010.
- Inclusion criteria: children without neuromuscular or neurological/developmental disorders, assessed by a single sleep physician.
- Data collected: current GP, PLMS index, apnea/hypopnea index, and demographics; GP diagnosed pre-PSG.
Main Results:
- Growing pains (GP) were present in 43 of 230 eligible children.
- Children with GP had a significantly higher PLMS index (≥ 5/h) at 25.6% compared to 10.2% in children without GP (OR 3.04, P=0.014).
- The association between GP and PLMS remained significant after adjustment (aOR 2.53, P<0.05); both were linked to restlessness as an indication for PSG.
Conclusions:
- Children with growing pains (GP) were three times more likely to exhibit periodic limb movements of sleep (PLMS) during polysomnography (PSG).
- The findings support an association between GP and PLMS.
- This suggests GP may be a phenotypic manifestation within the spectrum of restless legs syndrome (RLS).
Aim:
To investigate whether there was any association between growing pains (GP) and periodic limb movements of sleep (PLMS) in children referred for polysomnography (PSG), in light of the possible shared genetic determinants between GP and restless legs syndrome.
Methods:
Records of all 903 children who underwent PSG at a paediatric hospital between January 2009 and May 2010 were retrospectively reviewed. Children aged 3-16 years, without neuromuscular or neurological/developmental disorders who were seen by a single sleep physician were included in the analysis. Data extracted included: current GP, PLMS index, mixed obstructive apnoea/hypopnoea index and patient demographics. GP was diagnosed in the pre-PSG consultation.
Results:
GP was recorded in 43 of the eligible 230 children referred for PSG of whom 25.6% had a PLMS index ≥ 5/h, significantly higher than in the children without GP (10.2%) (odds ratio 3.04, χ(2) = 6.0, P = 0.014). The adjusted odds ratio for the association between GP and PLMS remained significant at 2.53 (95% CI 1.1-6.1, P < 0.05). A PLMS index ≥ 5/h was recorded in 30 of the 230 participants. GP and PLMS were also significantly multivariately associated with restlessness as the indication for PSG.
Conclusions:
Children with GP were three times more likely to have a PLMS index ≥ 5/h than children without GP on PSG. These results suggest that GP may be associated with PLMS, giving greater support for the hypothesis that GP might lie on the phenotypic spectrum of restless legs syndrome.
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