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Restless leg syndrome in young children with orofacial cleft
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Abstracts / Sleep Medicine 14S (2013) e18–e92
Results: There were 11 men and 7 women in both groups. Mean age in PLMD groups was 50.00 an in control group it was 49.89 years (p = 0,492). PLMD patients had significantly higher BMI (27,69 vs. 23,84; p = 0,0047). There was no difference between the groups in values in mean systolic blood pressure during the night (123,5 mmHg vs 121.66 mmHg, p = 0,369) and during sleep (122,0 vs.121,11, p = 0,433). No difference was found in mean values of diastolic blood pressure during the night (77.66 vs. 75.15, p = 0,242) and during the sleep (77.16 vs. 74.61, p = 0,239). Conclusion: We have found that periodic limb movement disorder does not imfluence significantly values of nocturnal blood pressure compared with another sleep disorders. http://dx.doi.org/10.1016/j.sleep.2013.11.081
Restless leg syndrome in young children with orofacial cleft M. Moraleda-Cibrián 1, S. Edwards 2, S. Buchman 3, S. Kasten 3, S. Warschausky 4, L. O’Brien 1 1 University of Michigan, Sleep Disorders Center, United States 2 University of Michigan, Oral & Maxillofacial Surgery, United States 3 University of Michigan, Department of Surgery, United States 4 University of Michigan, Department of Physical Medicine and Rehabilitation, United States
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 P0.33 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 5.01.3 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. http://dx.doi.org/10.1016/j.sleep.2013.11.082
Disease burden in patients with restless legs syndrome compared with an apnea and a control cohort K. Morin 1, L. Makaroff 2, K. Moran 3, S. Thieffry 1 1 UCB Inc., United Kingdom 2 UCB Pharma, United Kingdom 3 UCB, United Kingdom
Introduction: The objective of this study was to characterize demographics and disease burden for patients with restless legs syndrome (RLS) compared with an apnea and a control cohort. Materials and methods: This retrospective, longitudinal, observational cohort study compared patient demographics, comorbidities, and prescription drug use in a prevalent cohort of RLS patients compared with an apnea and a control cohort. The study examined data from 1 year prior to index date (first ICD-9 diagnosis for RLS during time period 1/1/10 to 7/31/11) through 1 year post-index date in a US claims database. Prevalent RLS patients were identified by at least 2 RLS diagnoses with 2nd diagnosis any time pre- or 1 year postindex date. In a subset of incident RLS patients (no RLS diagnosis in pre-index period) prior sleep disorders and use of sleep aids was also determined. Results: 7,773 prevalent RLS patients were matched 1:1 to apnea and control patients. Mean age of RLS patients was 61.4 years and 73% were female. There were 2,857 incident RLS cases. Due to matching, there was no significant difference in age or sex between cohorts. In the post-index period the prevalence of the most common comorbidities for RLS vs apnea patients was as follows: hypertension (46.9 vs 49.9%), pain (39.8 vs 29.0%), fatigue (17.7 vs 16.7%), anxiety (17.1 vs 8.1%), thyroid disease (16.8 vs 16.5%), depression (14.1 vs 7.4%), anemia (11.0 vs 7.2%), and peripheral neuropathy (10.7 vs 3.2%). Rates of pain, fatigue, anxiety, depression, anemia and peripheral neuropathy were higher (P<0.001) in RLS patients, while hypertension was higher (P < 0.0001) in apnea patients. All comorbidities were more common (P<0.0001) in the RLS cohort than the control cohort. Unspecified insomnia in the incident population affected RLS patients (9.4%) more often (P < 0.0001) than apnea (4.6%) or control (1.9%) patients. More incident RLS patients required a hypnotic agent during the pre-index period than apnea or control patients (P<0.0001, RLS vs either). RLS patients used more opioid analgesics, dopamine precursors, benzodiazepines, dopamine agonists, anti-inflammatory agents, anticonvulsants, antidepressants, and anxiolytics than apnea patients or controls. Conclusion: RLS was associated with hypertension, pain, anxiety, depression, anemia, and peripheral neuropathy, and was correlated with the utilization of several medications to control these conditions. This observational study suggests that unspecified insomnia may be an early symptom of RLS. Acknowledgements: This study was supported by UCB Pharma. http://dx.doi.org/10.1016/j.sleep.2013.11.083
Abstracts / Sleep Medicine 14S (2013) e18–e92
Results: There were 11 men and 7 women in both groups. Mean age in PLMD groups was 50.00 an in control group it was 49.89 years (p = 0,492). PLMD patients had significantly higher BMI (27,69 vs. 23,84; p = 0,0047). There was no difference between the groups in values in mean systolic blood pressure during the night (123,5 mmHg vs 121.66 mmHg, p = 0,369) and during sleep (122,0 vs.121,11, p = 0,433). No difference was found in mean values of diastolic blood pressure during the night (77.66 vs. 75.15, p = 0,242) and during the sleep (77.16 vs. 74.61, p = 0,239). Conclusion: We have found that periodic limb movement disorder does not imfluence significantly values of nocturnal blood pressure compared with another sleep disorders. http://dx.doi.org/10.1016/j.sleep.2013.11.081
Restless leg syndrome in young children with orofacial cleft M. Moraleda-Cibrián 1, S. Edwards 2, S. Buchman 3, S. Kasten 3, S. Warschausky 4, L. O’Brien 1 1 University of Michigan, Sleep Disorders Center, United States 2 University of Michigan, Oral & Maxillofacial Surgery, United States 3 University of Michigan, Department of Surgery, United States 4 University of Michigan, Department of Physical Medicine and Rehabilitation, United States
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 P0.33 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 5.01.3 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. http://dx.doi.org/10.1016/j.sleep.2013.11.082
Disease burden in patients with restless legs syndrome compared with an apnea and a control cohort K. Morin 1, L. Makaroff 2, K. Moran 3, S. Thieffry 1 1 UCB Inc., United Kingdom 2 UCB Pharma, United Kingdom 3 UCB, United Kingdom
Introduction: The objective of this study was to characterize demographics and disease burden for patients with restless legs syndrome (RLS) compared with an apnea and a control cohort. Materials and methods: This retrospective, longitudinal, observational cohort study compared patient demographics, comorbidities, and prescription drug use in a prevalent cohort of RLS patients compared with an apnea and a control cohort. The study examined data from 1 year prior to index date (first ICD-9 diagnosis for RLS during time period 1/1/10 to 7/31/11) through 1 year post-index date in a US claims database. Prevalent RLS patients were identified by at least 2 RLS diagnoses with 2nd diagnosis any time pre- or 1 year postindex date. In a subset of incident RLS patients (no RLS diagnosis in pre-index period) prior sleep disorders and use of sleep aids was also determined. Results: 7,773 prevalent RLS patients were matched 1:1 to apnea and control patients. Mean age of RLS patients was 61.4 years and 73% were female. There were 2,857 incident RLS cases. Due to matching, there was no significant difference in age or sex between cohorts. In the post-index period the prevalence of the most common comorbidities for RLS vs apnea patients was as follows: hypertension (46.9 vs 49.9%), pain (39.8 vs 29.0%), fatigue (17.7 vs 16.7%), anxiety (17.1 vs 8.1%), thyroid disease (16.8 vs 16.5%), depression (14.1 vs 7.4%), anemia (11.0 vs 7.2%), and peripheral neuropathy (10.7 vs 3.2%). Rates of pain, fatigue, anxiety, depression, anemia and peripheral neuropathy were higher (P<0.001) in RLS patients, while hypertension was higher (P < 0.0001) in apnea patients. All comorbidities were more common (P<0.0001) in the RLS cohort than the control cohort. Unspecified insomnia in the incident population affected RLS patients (9.4%) more often (P < 0.0001) than apnea (4.6%) or control (1.9%) patients. More incident RLS patients required a hypnotic agent during the pre-index period than apnea or control patients (P<0.0001, RLS vs either). RLS patients used more opioid analgesics, dopamine precursors, benzodiazepines, dopamine agonists, anti-inflammatory agents, anticonvulsants, antidepressants, and anxiolytics than apnea patients or controls. Conclusion: RLS was associated with hypertension, pain, anxiety, depression, anemia, and peripheral neuropathy, and was correlated with the utilization of several medications to control these conditions. This observational study suggests that unspecified insomnia may be an early symptom of RLS. Acknowledgements: This study was supported by UCB Pharma. http://dx.doi.org/10.1016/j.sleep.2013.11.083