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Iron Deficiency and Restless Sleep/Wake Behaviors in Neurodevelopmental Disorders and Mental Health Conditions
Osman S Ipsiroglu1,2,3, Parveer K Pandher1,2, Olivia Hill1,2
1H-Behaviours Research Lab, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC V5Z 4H4, Canada.
Nutrients
|September 28, 2024
Summary
Iron deficiency (ID) and restlessness are common in children with ADHD and ASD, often linked to sleep disorders. A family history of ID increases the risk for these conditions, highlighting the need for integrated screening.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Nutritional Science
Background:
- Iron deficiency (ID) is linked to sleep/wake disorders like restless legs syndrome (RLS) and neurodevelopmental conditions such as attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).
- A standardized method for assessing ID and restlessness in pediatric patients is currently lacking.
- Restlessness and ID are frequently observed together in clinical settings, suggesting a potential underlying connection.
Purpose of the Study:
- To investigate the prevalence of iron deficiency and its association with sleep/wake disorders in children with ADHD and ASD.
- To determine if a family history of iron deficiency influences the risk of sleep/wake disorders in these pediatric populations.
- To highlight the need for integrated diagnostic approaches for ID and restlessness in children with neurodevelopmental disorders.
Main Methods:
- A retrospective review of iron status and family history data from 199 pediatric patients at a sleep/wake behavior clinic.
- Assessment of restlessness through patient/parent narratives and a clinical immobilization test.
- Statistical analysis, including unadjusted odds ratios, to evaluate associations between family history of ID, ADHD, ASD, and various sleep/wake disorders.
Main Results:
- A high prevalence of ID (94%) and a significant family history of ID (43%) were observed in the study cohort.
- ADHD (46%) and ASD (45%) were common diagnoses, frequently co-occurring with chronic insomnia (61%), sleep-disordered breathing (50%), and parasomnias (22%).
- A family history of ID was significantly associated with increased odds of familial RLS, insomnia, and RLS in patients with ADHD, and with insomnia, RLS/PLMS, RLS, and familial RLS in patients with ASD.
Conclusions:
- Iron deficiency and restlessness are characteristic features in children diagnosed with ADHD and ASD.
- A family history of iron deficiency is a significant risk factor for developing sleep/wake disorders in children with ADHD and ASD.
- Comprehensive blood work and family history assessment are crucial for identifying iron deficiency in pediatric patients presenting with restless behaviors.
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