Bedtime Reads

The Discovery of a New Pediatric Sleep Disorder

By Lourdes DelRosso, MD

Recently, I was a member of a frequent movements during sleep and group of international sleep daytime symptoms as a consequence researchers who developed consensus of this poor sleep. Restless legs diagnostic criteria detailing a new syndrome (RLS) for instance, sleep disorder in manifests at bedtime children called with symptoms of Restless Sleep leg discomfort, but Disorder or RSD. children with RSD go With this new to sleep well, without discovery, we intend any problems. It’s to improve clinical just that once they practice and promote are asleep, they move further research. more than children without RSD and For years, sleep experts these movements have identified ‘restless interfere with sleep sleep’ as part of other quality and contribute sleep conditions that can cause sleep Lourdes DelRosso, MD to daytime symptoms. disruption or nocturnal awakenings RSD has been studied in comparison like obstructive sleep apnea or restless with other sleep disorders legs syndrome. However, recent showing individual and particular research in children has shown that characteristics. Initially, research on restless sleep can also be a primary children with RSD was started due disorder, not always associated with to the need to better understand another condition. how these children slept. Dr. Judith Owens, an author on the journal Adequate sleep is important for article, as well as the current President growth, memory, mental and of the International Pediatric Sleep physical health, social interactions, Association (IPSA) explains, “Parents safe alertness during the day and were concerned that children did not many other functions. We, as sleep get enough sleep at night because physicians, recommend and have they were “moving all night,” guidelines on how much sleep should “trashing the bed,” or “sleeping like someone get. But we do not only need a helicopter”—various terms used an adequate amount of sleep. We also by parents to characterize the sleep need good quality of sleep. This is the patterns of their children. Parents also main significance of RSD. It identifies noticed undereye dark circles, next-children with poor sleep quality, day fatigue, inability to concentrate

Bedtime Reads

Looking to learn even more? Each issue, we highlight one book about sleep.

In Sleep-Wrecked Kids: Helping Parents Raise Happy, Healthy Kids, One Sleep at a Time,

author and speech pathologist/myofunctional practitioner with 38 years of clinical experience, Sharon Moore will explain:

• The importance of sleep for kids • The good sleep formula • 7 tailored assessments to target sleep red flags • Simple environment and routine changes • How to address sleep disordered breathing, even before your kids are born • 20+ specialists who can help your kids sleep

—sleepwreckedkids.com

23 | January/February 2021

RSD continued from page 23

and sleepiness. We identified that there was no other explanation for the symptoms.”

Using sleep studies and other advanced technology, we on the research team were able to understand that children with RSD were moving a lot more than their counterparts. The movements occurred through the night, and were associated with other findings of sleep disruption. Prior to this team discovery, the International Restless Legs Syndrome Study Group assigned nine experts in sleep medicine to develop a pediatric consensus. The taskforce was chaired by Drs. Dan Picchietti and myself. Later, the taskforce invited another expert for a consensus of ten sleep physicians form various parts of the world. The current “consensus criteria for the diagnosis” was completed in June 2020. It published in Sleep Medicine journal on August 17, 2020. The world had a name for this sleep disorder in children.

TREATMENT

Current treatment for RSD is iron supplementation— both oral or IV—as we identified that iron supplementation improves sleep quality in children with RSD during our research. More studies continue to be done on children with RSD to help understand the syndrome better.

COMMON SYMPTOMS OF RSD IN CHILDREN (AGED 6-18)

• Ability to fall asleep is not usually compromised • During sleep, frequent movements can be observed • Frequent movements during sleep include repositioning of arms, legs or full body • Next day indications of lack of healthy sleep such as sleepiness, undereye dark circles, fatigue, inability to concentrate If you suspect that your child has RSD, please consult your physician or request a referral to a sleep expert. .................................................................................

Dr. DelRosso is an Associate Professor of Pediatrics and Associate Sleep Medicine Fellowship director at the University of Washington. She co-chairs the 2021 World Sleep Day.

24 | January/February 2021 Sleep & Stress continued from page 21

allow you to say "this is my time to worry and to think about all my problems." This reserved time to "worry" is the time to worry so when you get to bed, you can recognize that it is not the time to worry as you already had your reserved time to that during the day.

Many resources are now available online to help you and offer sleep tips for sleeping better. For example, you can visit sleeponitcanada.ca to find some of these tips. ..................................................................................

Dr. Bastien of the School of Psychology at Laval University in Quebec City, Canada has been working in the field of sleep for more than 30 years.

Less Sleep= More Negative Behaviors

Studies and surveys of American adults have made a clear pattern connecting sleep and symptoms of stress.

Less than 8 hours of quality sleep means…

More likely to feel overwhelmed

More likely to lose patience and/or yell

More feelings of irritability

More likely to forgo exercising

More likely to report high levels of stress