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RLS in Children

While the specific cause of RLS is still largely unknown, we do know that genes play an important role in many instances - a genetic basis of RLS is supported by studies reporting a positive family history in 63-92% of people with idiopathic RLS (i.e. where RLS is primary and not as a result of another medical condition).

It is increasingly clear that RLS can also occur in children. Here, the disease often results in symptoms and problems that are very similar to those of attention deficiency hyperactivity disorder (ADHD) and many children may receive this diagnosis.

Recent research by sleep specialists indicates that at least 25% of the children who have a diagnosis of ADHD may truly have Restless Legs Syndrome or Periodic Limb Movements or a combination of the two.

Like their adult counterparts, children with RLS tend to seek relief from their discomfort by moving their legs—often by fidgeting, stretching, walking, running, rocking or changing position in bed. Parents or healthcare providers may mistakenly also attribute the child’s discomfort to "growing pains." In a classroom setting, attempts to relieve the uncomfortable feelings of RLS may be viewed as inattentiveness, hyperactivity, or disruptive behaviour. 

Restless Legs Syndrome, however, is a real medical condition that calls for proper evaluation, diagnosis, and treatment. Unlike most adults with RLS, some children with RLS complain of the RLS sensations more during the day than at night.

Diagnosing RLS in children may be especially difficult, since it may be hard for a child to describe where it hurts, when and how often the symptoms occur, and how long symptoms last.

Children with RLS may sleep less well and thus are tired and hyperactive during the day. Further studies on the relationship between ADHD and RLS, as well as studies regarding safety and efficiency of dopamine therapy in children are urgently needed.

In the meantime, please take time to ensure your wider family are aware of RLS and the fact that it could impact on your children, grandchildren, nieces and nephews. Listen to your child's description of their symptoms and be conscious that they may in fact be describing RLS.

Children presenting symptoms suspected to be RLS should not be treated in primary care but instead should be referred to a Neurologist.

How Restless Legs Syndrome in Children is Treated

Treatment options for RLS can include any of the following:

- Adopt appropriate bedtime habits. The child or adolescent is only to get into bed and lay in bed when it is time to go to bed. Do not allow your child to get into bed and spend time reading, watching television, or playing any games.

- Say "No" to caffeine. Caffeine can make RLS worse, so avoid caffeinated products (eg, coffees, teas, colas, chocolates, and some medications).
- Supplement micronutrients. Have your physician check your child’s iron stores and if necessary, folic acid levels. Low levels of these substances can contribute to restless legs syndrome symptoms.
- Consider medication options. Your child’s doctor may discuss several different types of drugs as options. The simplest is iron or folate supplementation as mentioned above.
- Eliminate unnecessary medications. Talk to your doctor about other medications (both prescription and over-the-counter) and herbal products your child may be taking. They may be making RLS worse. Some of the types of products to discuss with your doctor include drugs to treat nausea, colds and allergies.
- Conduct a dietary review. Make sure your child is eating a healthy and well-balanced diet. You may wish to review this with the doctor.

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Resources for Professionals

Pediatric Restless Legs Syndrome diagnostic criteria: an update by the International Restless Legs Syndrome Study Group.

Early manifestations of Restless Legs Syndrome in childhood and adolescence.

Impact of Restless Legs Syndrome and iron deficiency on attention-deficit or hyperactivity disorder in children.

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