Periodic limb movement disorder of sleep in children.
To characterize periodic limb movement disorder (PLMD) in a cohort of prepubertal children we examined sleep-related identifiable differences between children with PLMD and attention-deficit/hyperactivity disorder (ADHD), PLMD alone, and age-matched controls. Children were selected from a chart review of all children referred to a pediatric sleep medicine center and from a community survey of 5-7-year-old-children. Polysomnography (PSG) and parental report data from all children identified as having periodic limb movement index (PLMI) >5 were reviewed and compared with a cohort of age-matched controls. A total of 8.4% of children in the clinic-referred sample, and 11.9% of the children recruited from the community had PLMI >5. Of those, 44.4% were identified as having ADHD. Children with PLMD had significantly lower percentage of rapid eye movement (REM) than control children (P < 0.001). Children in the PLMD/ADHD group had a significantly greater number of arousals associated with PLM (PLMa) than children with PLMD only (P < 0.05). While a relationship between ADHD and PLMD was observed, it was weaker than previous reports (Chervin, R. D. et al. Sleep, 2002; 25: 213; Chervin, R. D. and Archbold, K. H. Sleep, 2001; 24: 313; Picchietti et al. J. Child Neurol., 1999; 13: 588; Picchietti et al. Mov. Disord., 1999; 14: 1000; Picchietti and Walters Sleep, 1999; 22: 297). Children in the PLMD/ADHD group were more likely to have PLMas than were children with PLMD only. We postulate that rather than a direct relationship between ADHD and PLMD, this link may be mediated by the presence of reduced REM sleep and more importantly by the sleep fragmentation associated with PLM-induced arousals.
Crabtree
Valerie McLaughlin
VM
Kosair Children's Hospital Research Institute, Division of Pediatric Sleep Medicine, Department of Pediatrics, University of Louisville School of Medicine, 571 S. Preston Street, Louisville, KY 40202, USA.
Ivanenko
Anna
A
O'Brien
Louise Margaret
LM
Gozal
David
D
D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D020189:Nocturnal Myoclonus Syndrome / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D017286:Polysomnography / Q000379:methods; D012720:Severity of Illness Index; D012892:Sleep Deprivation / Q000175:diagnosis / Q000209:etiology; D012895:Sleep, REM / Q000502:physiology; D011795:Surveys and Questionnaires