Restless Legs Syndrome (RLS) in Children and Adolescents
What is restless legs syndrome (RLS)?
Restless legs syndrome (RLS), also called Willis-Ekbom disease, is a sleep disorder in which the child or adolescent reports an uncomfortable and irresistible urge to move his or her legs. This urge usually happens at bedtime but can occur at other times when the legs have been inactive, such as when sitting still for a long period of time (eg, during long car rides or while watching a movie).
To relieve the discomfort, the child or adolescent moves his or her legs, stretches his or her legs, tosses and turns, or gets up and walks or runs around. The relief experienced is usually immediate.
How many children have restless legs syndrome (RLS)?
In the United States, approximately 1.5 million children and adolescents are estimated to have restless legs syndrome (RLS). About 35% of patients who report having RLS say it started before 20 years of age.
What causes restless legs syndrome (RLS)?
The exact cause of restless legs syndrome varies from child to child. In some cases, the cause is not known. In other children, RLS can be related to a low iron level or sometimes is associated with diabetes, kidney or some neurological diseases. RLS sometimes runs in families and there is thought to be a genetic link in these cases. Many different types of drugs including those used to treat depression, allergies, and psychiatric disorders may cause RLS as a side effect.
What are the symptoms of restless legs syndrome (RLS)?
Symptoms of restless legs syndrome include:
- Leg discomfort or "heebie-jeebies:" Uncomfortable leg sensations often described by adults as creeping, itching, pulling, crawling, tugging, throbbing, burning, or gnawing. Feeling of "cola running through the veins" has been described. Children may describe these sensations as “got to move, wiggle or kick.” These sensations usually occur at bedtime but can occur at other times of leg inactivity.
- Urge to move legs: To relieve leg discomfort, children and adolescents have an uncontrollable urge to move their legs, especially when resting, such as when sitting or lying down.
- Sleep disruption: Additional time is often needed to fall asleep because of the urge to move the legs to relieve the discomfort. Sometimes staying asleep may also be difficult.
- Bedtime behavior problems: Because children have a hard time falling asleep, they may not always stay in bed and sometimes need to get out of bed to stretch their legs to relieve discomfort.
- Daytime sleepiness: Problems with falling asleep and staying asleep may result in daytime sleepiness.
- Behavior and school performance problems: Again, due to sleep disruption, problems may emerge in the child’s academic performance or in daytime behavior (irritability, moodiness, difficulty concentrating, hyperactivity, etc).