Shandong University School of Public Health, No. 44, Wenhuaxi Rd, Lixia Dist. Jinan 250012, China.
Shandong University School of Public Health, Jinan, China.
J Clin Psychiatry. 2018 Jan/Feb;79(1). doi: 10.4088/JCP.16m11358.
Little is known about psychopathological features associated with restless legs syndrome (RLS) in pediatric populations. This study examined sleep duration, insomnia, and psychopathological profile associated with RLS in a large community sample of adolescents.
Participants included 11,831 adolescents from 3 counties of Shandong, China. Mean age of the participants was 15.0 (SD = 1.5) years, and 51% were boys. In November and December 2015, participants completed a structured questionnaire to assess sleep duration, sleep problems, behavioral/emotional problems, and hopelessness. RLS was assessed by the 2003 National Institutes of Health (NIH) Restless Legs Syndrome Diagnosis and Epidemiology Workshop criteria.
Of the sample, 9.5% met the 2003 NIH workshop criteria for RLS, and 2.2% had RLS at least 3 times per week. Compared with adolescents without RLS, adolescents with RLS < 3 times per week and those with RLS ≥ 3 times per week demonstrated significantly higher rates of insomnia symptoms (13.8%, 20.0%, and 36.4%, respectively; χ² = 117.84, P < .0001), internalizing (9.1%, 18.5%, and 34.1%; χ² = 238.84, P < .001) and externalizing (9.8%, 17.4%, and 34.1%; χ² = 193.87, P < .001) problems, and hopelessness (13.0%, 16.9%, and 27.8%; χ² = 54.10, P < .001). After adjusting for demographics and internalizing and externalizing problems, RLS ≥ 3 times per week was associated with a doubled risk of insomnia (OR = 2.05; 95% CI, 1.53-2.75). After adjusting for demographics, sleep duration, and insomnia, RLS ≥ 3 times per week was associated with a more than doubled risk of internalizing (OR = 2.65; 95% CI, 1.94-3.62) and externalizing problems (OR = 2.75; 95% CI, 2.02-3.74).
RLS is associated with increased risk of insomnia, hopelessness, and both internalizing and externalizing problems. Our findings suggest that clinicians need to assess RLS in adolescents with sleep and mental health problems.
关于小儿人群中不宁腿综合征（RLS）相关的精神病理学特征知之甚少。本研究在一个来自中国山东的三个县的大样本青少年人群中，调查了与 RLS 相关的睡眠持续时间、失眠和精神病理学特征。
参与者包括来自中国山东省三个县的 11831 名青少年。参与者的平均年龄为 15.0（SD=1.5）岁，其中 51%为男性。在 2015 年 11 月至 12 月期间，参与者完成了一份结构化问卷，以评估睡眠持续时间、睡眠问题、行为/情绪问题和绝望感。RLS 通过 2003 年美国国立卫生研究院（NIH）不宁腿综合征诊断和流行病学研讨会标准进行评估。
在样本中，9.5%符合 2003 年 NIH 研讨会 RLS 的标准，2.2%每周至少有 3 次 RLS。与没有 RLS 的青少年相比，每周 RLS ＜3 次和每周 RLS ≥3 次的青少年表现出更高的失眠症状发生率（分别为 13.8%、20.0%和 36.4%；χ²=117.84，P＜.0001）、内化问题（9.1%、18.5%和 34.1%；χ²=238.84，P＜.001）和外化问题（9.8%、17.4%和 34.1%；χ²=193.87，P＜.001），以及绝望感（13.0%、16.9%和 27.8%；χ²=54.10，P＜.001）。在调整人口统计学因素以及内化和外化问题后，每周 RLS≥3 次与失眠风险增加两倍相关（OR=2.05；95%CI，1.53-2.75）。在调整人口统计学因素、睡眠持续时间和失眠后，每周 RLS≥3 次与内化问题（OR=2.65；95%CI，1.94-3.62）和外化问题（OR=2.75；95%CI，2.02-3.74）的风险增加一倍以上相关。
RLS 与失眠、绝望感以及内化和外化问题的风险增加有关。我们的研究结果表明，临床医生需要在青少年出现睡眠和心理健康问题时评估 RLS。
