Restless sleep disorder in children: a pilot study on a tentative new diagnostic category

A group of children with "restless sleep" who do not fit the criteria for any other sleep disorder but with daytime impairment are studied to identify restless sleep disorder (RSD) clinically and polysomnographically and to differentiate it from other sleep disorders of childhood.

A pilot study of 15 school-aged children with restless sleep and 15 sex- and age-matched children with restless leg syndrome (RLS) and 37 normal controls were included. Data obtained included nocturnal and diurnal parental concerns, iron and ferritin levels and polysomnography (PSG).

Fifteen children with RLS (12 males; three females), with a mean age of 11.9 (SD 3.52), 15 participants with RSD (11 males, four females) with a mean age of 9.5 (SD 3.18), the control participants were 30 males and seven females; mean age was 10.6 with a SD of 3.8. Age and sex did not differ between groups. Parental concerns in RSD included frequent nocturnal large body movements involving limbs, head and trunk, and restless sleep and perception of sleep disruption without nocturnal awakening. Daytime impairment included daytime sleepiness. All children with RSD had low ferritin levels (mean 20, SD 8.87). PSG data showed decreased sleep efficiency similar to RLS group but not prolonged sleep latency.

We have characterized clinically and polysomnographically children with RSD and attempted a new diagnostic category. We also have identified an association between RDS and iron deficiency. Future larger studies are needed to confirm these findings and evaluate the natural progression of restless sleepers.