OD12 Treatment options and mechanisms in pediatric RLS

Summary

Pediatric RLS is increasingly recognized as a sleep-related sensorimotor disorder, often comorbid to several neurodevelopmental syndromes such as ADHD and autism spectrum disorders. Few guidelines address the treatment of pediatric RLS despite its often-devastating impact on children ́s emotional life and academic performance.

The role of dopaminergic agents warrants clarification in this age spectrum. Potential side effects and long-term consequences require assessment prior to starting treatment.

The role of iron supplementation is instead more widely accepted and corroborated by the extant literature. No major side effects are ascribed to this treatment option, which appears to address both sensory symptoms and sleep impairment, also in the context of the recently described Restless Sleep Disorder.

Clinical sleep disturbances such as chronic sleep-onset and sleep-maintenance problems often precede a diagnosis of definite RLS by up to 11.6 years in children and adolescents. Hence, special attention to manifestations of insomnia can aid in detecting RLS in children who are unable to describe its symptoms and is pivotal in order to correctly orient treatment options.

Lastly, the challenge of treating children with neurodevelopmental/ psychiatric disorders that require additive therapeutic planning will be explored. In particular, the need to discard several drugs employed to treat their primary disorder should be recognized and encouraged.

Little is known on the common practice for the treatment of pediatric RLS. Hence clarifications and elucidations regarding this topic are of primary importance for the community of pediatric sleep experts.

Learning Objectives

Upon completion of this CME activity, participants should be able to:

• Recognize and treat dopaminergic imbalance in pediatric RLS
• Identify the development of RLS in its early stages in pediatric patients that are unable to describe RLS symptoms
• Recognize and treat iron deficiency in restless sleep and pediatric RLS
• Explain how to recognize and treat RLS within pediatric neurodevelopmental and psychiatric disorders

Target Audience

Sleep scientists and sleep physicians, pediatricians, pediatric neurologists, psychiatrists, nurses and psychologists, pharmacologists

Chair

Rosalia Silvestri (Italy)

Dopaminergic drugs: Efficacy, limitations, and concerns

Arthur Walters (United States)

Insomnia as an early manifestation of RLS: How do we treat it?

Oliviero Bruni (Italy)

The role of iron supplementation in restless sleep and pediatric restless legs syndrome

Rosalia Silvestri (Italy)

Benefits of treating RLS-comorbid neurodevelopmental/psychiatric disorders

Osman Ipsiroglu (Canada)