Sleep experts define pediatric sleep condition, iron deficiency likely culprit

“For years we saw children whose parents were concerned that something was wrong because they moved a lot in their sleep, but the diagnosis and tools we had were unable to identify abnormalities. We would tell those families that nothing was wrong. Parents would insist, ”explains Dr. Lourdes DelRosso, Seattle Children’s pediatric sleep specialist. “Finally, I contacted a movement disorders expert and together we designed the study to be able to see and assess the movements at night.”

Together with an international panel of sleep experts, DelRosso led the charge in defining a new sleep disorder in children they call restless sleep disorder or RSD.

The description and medical definition of RSD is detailed in an article published in Sleep Medicine, which provides a new tool to help more children challenged by restless sleep.

To get there, the panel of ten sleep experts agreed on 16 consensus questions to guide the development of diagnostic criteria. The questions addressed issues such as evidence, frequency and duration criteria for RSD, the age of RSD patients, and areas for future research.

The authors agreed that RSD occurs in children aged 6-18 years and can lead to disturbances in attention, mood and behavioral problems and other problems at home and at school due to poor sleep quality.

DelRosso said parents often characterize their children’s behavior as struggling in their sleep or thrashing in bed.

Iron

Fortunately, parents may be able to solve their children’s sleep problems by simply supplementing them with iron.

DelRosso explained that iron is a cofactor of dopamine synthesis in the brain and it is believed that iron helps with dopamine and dopamine in turn aids in the movements that make for a more restful sleep.

“There is a lot of evidence to suggest a link between movement disorders and iron deficiency in the brain,” said DelRosso. “In children with RSD, we recommend monitoring their protein levels needed to store iron, called ferritin, and if they are low, start supplementing with iron.”

For their study, DelRosso said they measured their subjects’ ferritin levels, which is a marker of iron stores in the rest of the body.

According to their findings, ferritin levels were between 14 and 20.

“While they were normal, they were in the low range of normal. At these levels, some studies have shown that there is already a non-anemic iron deficiency, ”she explained.

Sleep and immune health

DelRosso said she cannot stress enough the importance of sleep in everyone, especially in a child’s growing and developing brain.

“In studies into sleep deprivation, we see how sleep deprivation adversely affects the immune system. There is a study on the flu vaccine that shows that people who were sleep deprived the week before they got the vaccine did not develop as good an antibody level as people who slept well. immune system and makes us more vulnerable to infections. “

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Source: sleep medicine

2020 November; 75: 335-340. doi: 10.1016 / j.sleep.2020.08.011

“Consensus Diagnostic Criteria for a Newly Defined Pediatric Sleep Disorder: Restless Sleep Disorder (RSD)”

Authors: L. DelRosso et al.

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