Chervin Ronald D, Archbold Kristen Hedger, Dillon James E, Pituch Kenneth J, Panahi Parviz, Dahl Ronald E, Guilleminault Christian
Sleep Disorders Center, Department of Neurology, University of Michigan, Ann Arbor, USA.
Sleep. 2002 Mar 15;25(2):213-8.
Attention-deficit/hyperactivity disorder (ADHD) has shown associations with restless legs syndrome (RLS) and periodic leg movements during sleep (PLMS) among small samples of referred children, but whether RLS or PLMS are common more generally among hyperactive children has not been well studied.
Cross-sectional survey.
Two university-affiliated but community-based general pediatrics clinics.
N=866 children (469 boys), aged 2.0 to 13.9 years (mean 6.8+/-3.2 years), with clinic appointments.
N/A.
A validated Pediatric Sleep Questionnaire assessed for PLMS (a 6-item subscale), restless legs, growing pains, and several potential confounds of an association between behavior and PLMS or RLS. Parents also completed two common behavioral measures, a DSM-IV-derived inattention/hyperactivity scale (IHS) and the hyperactivity index (HI, expressed as a t-score) of the Conners' Parent Rating Scale.
Restless legs were reported in 17% (95% C.I. [15, 20]) of the subjects. Positive HI scores (>60) were found in 13% [11, 16] of all subjects, 18% [12, 25] of children with restless legs, and 11% [9, 14] of children without restless legs (chi-square p<0.05). Odds ratios between HI>60 and each of the following were: a one-s.d. increase in the overall PLMS score, 1.6 [1.4, 1.9]; restless legs, 1.9 [1.1, 3.2]; and growing pains, 1.9 [0.9, 3.6] (all age and sex-adjusted). Results were similar for high IHS scores (>1.25). The associations between each behavioral measure and the PLMS score retained significance after statistical adjustment for sleepiness, snoring, restless sleep in general, or stimulant use.
Inattention and hyperactivity among general pediatric patients are associated with symptoms of PLMS and RLS. If either condition contributes to hyperactivity, the magnitude of association suggests an important public health problem.
在转诊儿童的小样本中，注意缺陷多动障碍（ADHD）已显示出与不安腿综合征（RLS）及睡眠期周期性腿动（PLMS）有关，但在多动儿童中RLS或PLMS是否更普遍尚未得到充分研究。
横断面调查。
两家大学附属医院但基于社区的普通儿科诊所。
N = 866名儿童（469名男孩），年龄2.0至13.9岁（平均6.8±3.2岁），前来诊所就诊。
无。
使用经过验证的儿科睡眠问卷评估PLMS（一个6项分量表）、不安腿、生长痛以及行为与PLMS或RLS之间关联的几个潜在混杂因素。家长还完成了两项常见的行为测量，一项基于《精神疾病诊断与统计手册》第四版（DSM-IV）得出的注意力不集中/多动量表（IHS）以及康纳斯父母评定量表的多动指数（HI，以t分数表示）。
17%（95%置信区间[15, 20]）的受试者报告有不安腿。所有受试者中13%[11, 16]的HI得分呈阳性（>60），有不安腿的儿童中为18%[12, 25]，无不安腿的儿童中为11%[9, 14]（卡方检验p<0.05）。HI>60与以下各项之间的比值比为：PLMS总分每增加一个标准差，为1.6[1.4, 1.9]；不安腿，为1.9[1.1, 3.2]；生长痛，为1.9[0.9, 3.6]（均经年龄和性别调整）。高IHS得分（>1.25）的结果相似。在对嗜睡、打鼾、一般睡眠不安或使用兴奋剂进行统计调整后，每种行为测量与PLMS得分之间的关联仍具有显著性。
普通儿科患者的注意力不集中和多动与PLMS及RLS症状有关。如果这两种情况中的任何一种导致多动，关联程度表明这是一个重要的公共卫生问题。
