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Published on: July 12, 2024
Treatment of pediatric restless legs syndrome
Lourdes DelRosso1, Oliviero Bruni2
1University of Washington and Seattle Children's Hospital, Seattle, WA, United States.
Insights
Restless Legs Syndrome (RLS) in children, affecting 2% of them, impacts sleep and behavior. Treatment includes lifestyle changes and, often, iron supplementation, though more pediatric data is needed.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Clinical Pharmacology
Background:
- Restless Legs Syndrome (RLS) affects approximately 2% of children, significantly impacting their quality of life, sleep, cognition, and behavior.
- Diagnosing RLS in young children presents challenges, but established guidelines exist for symptom description.
Purpose of the Study:
- To review and discuss non-pharmacological and pharmacological treatment options for pediatric Restless Legs Syndrome.
- To highlight the current evidence base and data limitations for RLS treatments in children.
Main Methods:
- Review of existing literature and clinical guidelines for pediatric RLS diagnosis and management.
- Discussion of non-pharmacological interventions, including behavioral and lifestyle modifications.
- Analysis of pharmacological treatment options, focusing on iron supplementation and other therapies with data from adult studies.
Main Results:
- Non-pharmacological interventions are recommended for all families affected by RLS in children.
- Iron supplementation is considered a first-line therapy for pediatric RLS, with recent promising results from intravenous administration.
- Limited robust data exists for the effectiveness and long-term safety of pharmacological interventions in children, often relying on adult study data.
Conclusions:
- A combination of non-pharmacological strategies and targeted pharmacological treatments, particularly iron, forms the basis of pediatric RLS management.
- Further research is crucial to establish definitive evidence for pharmacological treatments in children with RLS.
- Comprehensive management strategies are essential to improve the quality of life for children suffering from RLS.
Abstract:
Restless legs syndrome (RLS) is not uncommon in children with an estimated prevalence of 2%. There is clear evidence that RLS affects quality of life, sleep, cognition and behavior in children and adults. Although the diagnosis of RLS can be challenging in young children, the International Restless Legs Study Group (IRLSSG) has published guidelines for diagnosis which include description of symptoms in the child's own words. Once the diagnosis is made, treatment options must be explored. It is commonly accepted that non-pharmacological interventions be recommended to all affected families. These include maintaining a consistent bedtime routine, establishing healthy eating habits and exercise, avoiding caffeine and other substances that can exacerbate RLS, and stretching before bedtime. Pharmacological interventions in children are challenged by the lack of solid data supporting effectiveness and long-term safety. Historically and based on pathophysiology, iron supplementation is the first line therapy in children. Recently intravenous iron supplementation has shown promising results, following studies in adults. Most studies in children on various pharmacological options follow a robust body of data previously published in adult patient with RLS, yet data in children remain scarce. This chapter will discuss both non-pharmacologic and pharmacologic treatment options for children with RLS.
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