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Could your child have Restless Sleep Disorder?

Tossing and turning at night isn’t uncommon whether you’re a child or an adult. But constant, fitful sleep in children could point to a concerning, but treatable sleep disorder.

Restless Sleep Disorder (RSD) is a newly defined pediatric sleep disorder characterized by persistent nighttime movements that not only disrupt sleep, but also cause significant day-time symptoms like sleepiness and irritability.

What is Restless Sleep Disorder?

Restless Sleep Disorder (RSD) is just what it sounds like: persistent nighttime movement of any part of body, especially the head, trunk, arms or legs.

The defining characteristic of RSD, however, is that apart from fitful sleep, children with RSD will have other symptoms that affect their waking hours. They may have trouble focusing at school, struggle with emotional or behavioral difficulties, display irritability or hyperactivity. Some of these symptoms may mimic ADHD, and it’s not uncommon for children with ADHD to also suffer from RSD.

If you suspect that your child might suffer from RSD or another type of sleep disorder, what should you do? The first step would be to address behaviors that affect quality of sleep — for example, limiting screens before bed, cutting out caffeine and practicing good sleep hygiene. If restless sleep continues after you’ve tried that, it’s time to speak to your child’s doctor.

Diagnosing Restless Sleep Disorder

To some degree, diagnosing RSD comes down to ruling out other disorders with similar symptoms as well as similar health consequences such as obstructive sleep apnea and periodic limb movement disorder (PLMD).

“Observing a restless sleeper is really common, but there are several diagnoses that this may represent,” says Dr. Vincent J. Gimino, MD, D-ABSM, FACCP, Sleep Medicine Director at Santiam Hospital & Clinics Sleep Medicine Clinic. “From five feet away restless sleep would look the same as PLMD in casual observation. But PLMD is a rhythmic, periodic movement of lower extremities — almost like a drum beat.”

Discerning the subtle differences and coming to a proper diagnosis requires an overnight sleep study.

Santiam Hospital & Clinics Sleep Medicine Clinic, where Dr. Gimino is director, is the only Willamette Valley center providing pediatric sleep medicine services down to age 12 months. As such, the practice is designed to put young patients at ease.

Children and their caregivers can tour the facility ahead of time to learn about the sleep study and see where they will spend the night. During the study, parents accompany children in-room at all times and are also provided sleeping accommodations.

Treating Restless Sleep Disorder

As is the case with obstructive sleep apnea and PLMD, the good news with RSD is that it’s treatable.

It’s not uncommon for children with RSD to have iron deficiencies, an important mineral that helps transmit brain signals, including those that stop restless legs.

“A child doesn’t have to be absolutely deficient in iron, it could be just on the lower end of normal,” says Dr. Gimino. “More often than not, we are recommending iron replacement for kids where labs fall within normal levels because data shows that patients should have more robust iron stores, more towards the higher normal level.”

In the absence of a diagnosis or while waiting for a sleep study, try adding iron-rich foods like spinach or iron-fortified cereals to your child’s diet. You can also ask your pediatrician about testing your child’s iron and ferritin levels.

Dr. Gimino cautions against simply adding iron supplements to a restless sleeper’s vitamin regime unless they are under a doctor’s supervision. “It is a mineral we need, but you can take too much,” he says.

If you suspect that your child might have a sleep disorder, start by talking with their pediatrician who can refer them to sleep study. Quality sleep is the foundation of our ability to grow and thrive, so if you’re concerned about your child, it’s worth starting the conversation.


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