Restless legs syndrome in children and adolescents with attention-deficit/hyperactivity disorder: prevalence, mimic conditions, risk factors, and association with functional impairment

Maytinee Srifuengfung; Sontuss Bussaratid; Woraphat Ratta-Apha; Naratip Sanguanpanich; Tikumporn Hosiri

doi:10.1016/j.sleep.2020.05.037

Restless legs syndrome in children and adolescents with attention-deficit/hyperactivity disorder: prevalence, mimic conditions, risk factors, and association with functional impairment

Sleep Med. 2020 Sep:73:117-124. doi: 10.1016/j.sleep.2020.05.037. Epub 2020 Jun 4.

Authors

Maytinee Srifuengfung¹, Sontuss Bussaratid¹, Woraphat Ratta-Apha¹, Naratip Sanguanpanich¹, Tikumporn Hosiri²

Affiliations

¹ Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand. 2, Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand.
² Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand. 2, Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand. Electronic address: rlsthai@hotmail.com.

PMID: 32827883
DOI: 10.1016/j.sleep.2020.05.037

Abstract

Objectives: To determine the prevalence of restless legs syndrome (RLS) and RLS-mimic conditions, the risk factors for RLS, and whether RLS contributes to functional impairment in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).

Methods: ADHD children and adolescents were prospectively studied at the outpatient psychiatric clinic. A trained registered nurse used the 2012 Revised International Restless Legs Syndrome Study Group diagnostic criteria to diagnose RLS. Sociodemographic data and medical records were reviewed. Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) Thai version was used to identify association between RLS and 6 domains of function [family, school (learning), school (behavior), life skills, child self-concept, social activities, and risky activities].

Results: A total of 217 patients were included. Of those, 23 (11%) patients met the criteria for RLS, and 49 (23%) had RLS-mimic conditions. Those conditions included myalgia (30/49), habitual foot tapping (23/49), positional discomfort (20/49), leg ulcer/bruise (1/49), and arthralgia/arthritis (1/49). Binary logistic regression revealed first-degree relative having RLS symptom to be significantly associated with RLS in study patients (OR: 5.06, p < 0.01). Multivariate linear regression showed RLS to be independently associated with school (behavior) (Β = 1.18, p = 0.05) and life skills (Β = 2.36, p = 0.05) impairment.

Conclusions: RLS was found to be common in ADHD children and adolescents. RLS-mimic conditions were found in two-thirds of patients who previously met 4 essential RLS criteria. First-degree relative with RLS symptom was associated with RLS, and RLS was associated with functional impairment in the life skills and school (behavior) domains.

Keywords: ADHD; Functional impairment; Mimic; Prevalence; Restless legs syndrome; Risk factor.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Attention Deficit Disorder with Hyperactivity* / complications
Attention Deficit Disorder with Hyperactivity* / epidemiology
Child
Humans
Prevalence
Restless Legs Syndrome* / epidemiology
Risk Factors