Restless leg syndrome in young children with orofacial cleft

Abstract

Introduction Periodic limb movements (PLMs) and Restless Leg Syndrome (RLS) are related conditions which are increasingly being recognized in children. The prevalence of PLMs is believed to be approximately 8–12% in childhood although it occurs in up to 25% of children with attention- deficit/hyperactivity disorder. Children with orofacial clefts are at increased risk of behavioral difficulties, including inattention and hyperactivity. However, no study has investigated the prevalence of PLMs or RLS in these children and the association with behavioral morbidity. The goal of the current study, therefore, was to investigate the frequency of PLMs and RLS in young children with orofacial cleft and to determine the relationship to inattentive and hyperactive behaviors. Materials and methods Families of children aged 2–6 years with orofacial clefts were invited to participate. All families completed the Pediatric Sleep Questionnaire (PSQ) which included the following subscales: PLMS (6-items), snoring and sleepiness (4 items each). A total score ⩾ 0.33 on any subscale indicated a positive screen. Items about RLS and growing pains were also analyzed separately. In addition, families completed the Conners Early Childhood Assessment questionnaire which included several behavioral domains including hyperactivity/inattention. Results Thus far 36 children have been enrolled. Mean age was 5.0 ± 1.3 years, 53% were boys and 61% Caucasian. Overall 19% of children screened positive for PLMs and a positive response to the RLS and growing pains items was reported in 15% and 12% of children respectively. Children with PLMs had a higher sleepiness score than those without (0.32 vs. 0.06; p = 0.008). Those with RLS, compared to children without, tended towards a higher sleepiness score (0.25 vs. 0.09; p = 0.18), as did those with growing pains (0.25 vs. 0.07; p = 0.12). There were no associations between PLMs or RLS with snoring scores (0.25 vs. 0.21; p = 0.75 and 0.20 vs. 0.21; p = 0.97 respectively). Children with PLMs had higher inattention/hyperactivity scores than those without (66.7 ± 17.0 vs. 53.9 ± 13.5; p = 0.039), as did children with RLS (70.4 ± 19.1 vs. 54.1 ± 13.6; p = 0.026). Conclusion Daytime sleepiness and inattentive/behavioral problems are associated with symptoms of PLMs and RLS in young children with orofacial cleft. Screening for such sleep problems may be important in this pediatric population. Acknowledgements Dr. Moraleda-Cibrian is supported in part by Fundacio Universitaria Agusti Pedro i Pons.