Restless sleep disorder in children with attention deficit-hyperactivity disorder

STUDY OBJECTIVES: Restless sleep is a very common parental complaint in children with attention deficit-hyperactivity disorder (ADHD), but restless sleep has been seen in association with other comorbidities such as restless legs syndrome and obstructive sleep apnea. Restless sleep disorder (RSD) needs to be identified from other disorders when evaluating children with ADHD. In this study we aim to identify the prevalence of RSD in children with ADHD referred to our sleep center.

METHODS: This is a retrospective study of children with ADHD who underwent polysomnography. The following diagnostic and descriptive data were obtained for each patient: age, sex, presence/absence of RSD, other sleep disorders, psychiatric comorbidities, and medications. RSD was diagnosed per diagnostic criteria.

RESULTS: There were sixty-six children with ADHD. All of them underwent PSG, 17 of whom were females and 49 males. Mean age was 11.6 years (±3.6 SD). The complaint of restless sleep was reported by the parents of 54 (81.1%) of children; however only six of them (9.1%) were diagnosed with RSD. 71% had obstructive sleep apnea and 19.7% had restless legs syndrome. A significant number of patients had psychiatric comorbidities and were on various medications.

CONCLUSIONS: Although restless sleep is a common complaint reported in 81.1% of children with ADHD, only 9.1% had RSD. Most causes of restless sleep are secondary and associated with other sleep disorders, psychiatric comorbidities, or medication use.