Children with Restless Legs

I sometimes read from fellow sufferers that they already suffered from restless legs when they were children. At the time, their complaints were often not seen as a form of RLS, but as growing pains. Or it was ‘just’ a busy kid.

Only later did it became clear that these children had to deal with some form of primary RLS at an early age. In many cases this form was probably hereditary. One or more family members also suffered from restless legs.

Restless legs in children can have various causes. It may also be more difficult to diagnose RLS in children, because children have more difficulty identifying exactly what is bothering them. Especially very young children.

Symptoms

It is quite difficult to describe exactly what restless legs are. That goes for adults, let alone children. Children may also describe RLS differently than an adult would.

I already wrote that children with restless legs are often seen as ‘just’ busy children. There is a truth in this. On average, children with ADHD suffer from restless legs more often than other children. PLMD (Periodic Limb Movement Disorder) is also more common in this group.

Conversely, children with RLS and/or PLMD have ADHD more often than other children. Can you still follow? Making a correct diagnosis is quite difficult, because disorders are confused with each other.

This problem also occurs with growing pains. The symptoms of restless legs and growing pains can be similar and do occur sometimes at the same time in children. In both, the symptoms are mainly felt in the late afternoon and early evening. One difference is that exercise does not help with growing pains, but it does with restless legs.

Diagnosis

RLS occurs in both boys and girls. In adults, more women than men have restless legs. This distinction does not exist in children.

As with adults, there is a variation in the extent to which children suffer from restless legs. It can range from mild to severe. A small proportion of children also experience symptoms in the arms.

Like adults, 80% of children have PLMD in addition to RLS.

RLS in children is often hereditary, but can also arise from something else (secondary RLS). Iron deficiency may be a factor.

Restless legs can also be a side effect of other diseases, such as polyneuropathy, thyroid disease, kidney disease and rheumatism. Medication use can also play a role. Think of antidepressants (SSRIs), antipsychotics and medicines for nausea and allergies.

To avoid confusing restless legs with other similar complaints, criteria have been established for diagnosing RLS in children. In addition, iron is often measured by means of blood tests. Sleep research provides more clarity about, among other things, brain activity, breathing and movement in the limbs at night.

Treatment

When treating children with restless legs, it is important to pay attention to a regular sleep pattern. It’s actually not that different from adults.

Make sure your child goes to bed around the same time every night and gets up around the same time in the morning. Make sure that at least an hour before going to sleep it is only doing things that bring relaxation. Turn off screens. Do not let your child drink caffeinated products such as coffee, tea and cola in the evening. Follow a fixed bed ritual with (small) children. Make sure that the children’s bedroom is cool and dark.

Sufficient physical activity and stretching exercises every day before going to sleep often reduce the symptoms of RLS in children. It can also be beneficial to massage your child’s legs in the evening. Feed your child a healthy and varied diet. Limit products that contain caffeine, such as coffee, tea, cola, energy drinks and (hot) chocolate.

If there is an iron deficiency, the child can take an iron supplement for a certain period. It is best to take it together with a product with vitamin C, for example orange juice.

Medication

Medicines are only prescribed for children when other measures are not sufficient. This is the same medication that adults receive, albeit in a different dose. Dopamine agonists are a possibility, as are anticonvulsants. With dopamine agonists there is a risk of augmentation.

It is not clear whether these drugs have different long-term adverse effects or side effects in children than in adults. Not much research has been done on this yet. Physicians are therefore often more reluctant to prescribe it to this target group.

Children with restless legs often suffer from this condition for life. Guidance of the child (and the parents) in dealing with this and accepting it is advisable.

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