Dental Sleep Blog

Restless Legs Syndrome in Children: Signs, Symptoms and Treatment Options

Posted by Premier Sleep Associates on Oct 23, 2018 2:59:41 PM

restless legs syndrome rls in children

Is your child restless in bed and tired during the daytime? When you go into their bedroom, do you see the sheets twisted up and the covers undone? Maybe they come into your room to complain of not being able to fall asleep or go back to sleep. They may say their legs are itchy or tickly. If so, it could be that your child is one of the approximate 2%-4% of children who may have Restless Leg Syndrome, according to The National Sleep Foundation. 


Known cases of RLS are rare in kids, but the real numbers may be higher due to misdiagnosis of the signs. In children, it’s easy for physicians to attribute discomfort, moodiness, fatigue, daytime sleepiness, and trouble performing in school to more common conditions like growing pains, attention deficit, insomnia, depression, or even dietary issues. And itchy legs can easily be written off as dry skin or an allergic reaction to detergents.


However, if you know what to look for, RLS is actually pretty easy to identify. In this article, you’ll learn how to spot the symptoms of Restless Leg in your child. The main thing you need to do is to ask your child questions and listen to the answers (if your child is verbal). Chances are, children with RLS are likely to have some awareness of what’s keeping them awake or uncomfortable.


If your child is nonverbal, behaviors like repeatedly getting out of bed, pacing in the evenings, kicking or moving the legs during sleep, tossing and turning, thrashing the sheets, or scratching at the legs may be an indicator that something is going on. If these symptoms are paired with dark circles under the eyes and other signs of exhaustion, you may be dealing with a sleep disorder. (If not RLS, then possibly pediatric sleep apnea or sleep disordered breathing.)


What Is Restless Leg Syndrome, Exactly?


Restless leg syndrome (RLS) is a neurological sensory disorder and a sleep disorder, also known as Willis-Ekbom Disease, that causes involuntary leg movements and discomfort, usually at night and during sleep.


Restless leg syndrome falls into two categories: primary RLS, which is more common and which is unrelated to any other health condition, and secondary RLS, which may have an underlying cause that can be treated.


Primary RLS tends to be hereditary and may be related to a protein deficit in the brain which affects how iron is processed by the body.  Secondary RLS may be a medication side effect or can be caused by another health condition such as anemia, kidney problems, or stress.


Both forms of RLS are sleep disorders that can diagnosed and treated by board-certified sleep specialists.


Is Restless Leg Harmful to Kids?


On its own, no. Restless Leg is not a danger to your child’s health; however, accumulated sleep deprivation or sleep debt as a result of this sleep disorder can be problematic over the long term.


Children with poor quality sleep may not stay in deep sleep long enough to release sufficient growth hormone to aid in their development. Studies show that fragmented sleep can lead to mood issues and a decrease in school performance. Attention deficit and hyperactivity symptoms may also arise.


Some of these same issues can also be true of kids with pediatric sleep disordered breathing and sleep apnea, the sleep disorders we help to treat in our office.


If your child shows symptoms like dark circles under the eyes, daytime sleepiness, bedwetting, night terrors, and mouth breathing, along with classic ADHD symptoms like difficulty concentrating, you may be looking at a sleep breathing issue instead of, or in addition to, the Restless Leg.


This is why seeing a board certified sleep specialist for a diagnosis is so important. A full exam, medical history, and possibly a polysomnography (overnight sleep study) can help you solve the mystery of your child’s evening restlessness and tiredness. It’s important to treat the true cause of your child’s symptoms, rather than mask them with unnecessary treatments that may not be helping.


What Are the Signs and Symptoms of RLS in Kids?


Children and adults with RLS tend to feel an itching, burning, or crawling feeling deep inside their legs, as if ants are wriggling inside them. Kids with RLS feel the only way they can get relief from these distracting and irritating sensations is to move their legs or get up and walk around. They may pace or run. Many describe an overpowering need to fidget or kick.


These symptoms, which tend to occur mainly in the evenings or when sitting still for prolonged periods, can vary from mildly irritating to agonizing. (With children, you may notice pronounced fidgeting when you ask them to sit still and do their homework in the evenings.)


Because RLS symptoms originate in the brain and nervous system and are sensory in nature, they can only be relieved by moving the legs (for example, by getting out of bed and walking around). Unfortunately, the symptoms return the moment the individual stops the movement.


As you can imagine, sleep is quite difficult when one’s nervous system demands movement. Your child may experience the following:


  • Itching, burning, or tickling inside the legs that gets no relief from scratching or from applying topical treatments
  • Inability to get comfortable in bed, which manifests as tossing and turning or changing sleep positions
  • Nighttime awakenings when sleep is fragmented by the unwanted leg movements


A Brief Video about Restless Leg


One of the best ways to understand what RLS is like is to hear about the condition directly from people who have it. Our colleague Lourdes DelRosso, MD at Seattle Children’s Hospital made a video to help raise visibility and understanding of this frustrating sleep disorder. You can watch it below:



What to Do If Your Child Has Restless Leg Syndrome


If your child shows any of the signs and symptoms of Restless Leg Syndrome, talk to your pediatrician. Your doctor’s office may refer you to a sleep specialist for additional exams and testing. Lab tests can rule out other causes that may require treatment, such as an iron deficiency or kidney problems. If your child does have primary RLS, treatment is possible through a combination of lifestyle modifications, relaxation techniques, and medication to control the symptoms.


Topics: restless legs syndrome in children

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