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Published on: April 18, 2011
Leg movements during sleep in children treated with serotonergic antidepressants
Raffaele Ferri1, Maria P Mogavero2, Oliviero Bruni3
1Sleep Research Centre, Department of Neurology I.C., Oasi Research Institute - IRCCS, Troina, Italy.
Insights
Children on serotonergic antidepressants exhibit increased periodic leg movements during sleep (PLMS), similar to restless legs syndrome (RLS). This suggests a potential link between antidepressant use and RLS characteristics in pediatric patients.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Pharmacology
Background:
- Serotonergic antidepressants are widely prescribed for pediatric mood disorders.
- Leg movements during sleep (LMS) are a common concern in children.
- Restless legs syndrome (RLS) is a neurological disorder characterized by an urge to move the legs.
Purpose of the Study:
- To compare leg movements during sleep (LMS) in children taking serotonergic antidepressants with those in children with RLS and healthy controls.
- To analyze the temporal structure of intermovement intervals (IMI) for LMS.
Main Methods:
- Recruited three groups: children on antidepressants (n=23), drug-naïve RLS children (n=21), and controls (n=35).
- Assessed LMS using standardized scoring methods.
- Calculated various LMS parameters and analyzed their time structure, focusing on intermovement intervals.
Main Results:
- Children on antidepressants had significantly higher total and periodic LMS (PLMS) indexes than both RLS and control groups.
- LMS periodicity was most pronounced in the antidepressant group, with a distinct intermovement interval peak around 20 seconds.
- Both antidepressant and RLS groups showed a decrease in PLMS throughout the night and more frequent arousals compared to controls.
Conclusions:
- Pediatric patients on serotonergic antidepressants demonstrate increased LMS periodicity, resembling patterns seen in adult RLS.
- Antidepressant-associated PLMS may share characteristics with RLS-related PLMS.
- Further research is needed to determine if these findings indicate an elevated risk for developing RLS later in life.
Study Objectives:
To evaluate leg movements during sleep (LMS) in children taking serotonergic antidepressants, compared to those of children with restless legs syndrome (RLS) and controls, and to assess the time structure of intermovement intervals (IMI).
Methods:
Twenty-three children (12 girls, mean age 14.1 years) on antidepressants and with a total LMS index ≥ 15/h, 21 drug-naïve RLS children (11 girls, mean age 13.6 years) also with total LMS index ≥ 15/h, and 35 control children (17 girls, mean age 14.3 years) were recruited. LMS were scored and a series of parameters was calculated, along with the analysis of their time structure.
Results:
Children taking antidepressants showed higher total and periodic LMS (PLMS) indexes than both controls and RLS children, as well as higher short-interval and isolated LMS indexes than controls. LMS periodicity was highest in children on antidepressants. In children taking antidepressants, a well-defined PLMS IMI peak corresponding to approximately 10-60 s, with a maximum at approximately 20 s was present, which was much less evident in RLS patients and absent in controls. A progressive decrease of PLMS during the night and more frequent arousals were found in children on antidepressants and with RLS.
Conclusions:
Children taking serotonergic antidepressants show higher periodicity LMS than children with RLS or controls and have a higher number of PLMS through the night. Antidepressant-associated PLMS in children seem to have features similar to PLMS of adults with RLS. Whether this is a marker of an increased risk to develop RLS later in life needs to be determined.
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