Sleep Medicine and Psychophysiology (수면정신생리)

KOREAN ACADEMY OF SLEEP MEDICINE (대한수면의학회)
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Restless Legs Syndrome in Children and Adolescents with Type 1 Diabetes

제 1형 당뇨병 소아 청소년의 하지불안증후군

  • Yang, Woo Seok (Department of Psychiatry, Dong-A University Hospital) ;
  • Yoo, Jae Ho (Department of Pediatrics, Dong-A University Hospital) ;
  • Cheon, Sang-Myung (Department of Neurology, Dong-A University Hospital) ;
  • Kim, Seong Hwan (Department of Psychiatry, Dong-A University Hospital) ;
  • Choe, Byeong Moo (Department of Psychiatry, Dong-A University Hospital) ;
  • Kim, Woo Jin (Department of Psychiatry, Dong-A University Hospital) ;
  • Bang, Young Rong (Department of Psychiatry, Seoul National University Bundang Hospital) ;
  • Park, Jae Hong (Department of Psychiatry, Dong-A University Hospital)
  • 양우석 (동아대학교병원 정신건강의학과) ;
  • 유재호 (동아대학교병원 소아청소년과) ;
  • 천상명 (동아대학교병원 신경과) ;
  • 김성환 (동아대학교병원 정신건강의학과) ;
  • 최병무 (동아대학교병원 정신건강의학과) ;
  • 김우진 (동아대학교병원 정신건강의학과) ;
  • 방영롱 (분당서울대학교병원 정신건강의학과) ;
  • 박재홍 (동아대학교병원 정신건강의학과)
  • Received : 2015.04.30
  • Accepted : 2015.06.03
  • Published : 2015.06.30
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Abstract

Objectives: Restless legs syndrome (RLS) is a common sleep disorder in adults with diabetes. This study investigated the frequency of RLS and clinical correlations in children and adolescents with type 1 diabetes. Methods: This study included 55 consecutive patients (21 males, age $12.6{\pm}3.4years$) with type I diabetes that were regularly treated at the Department of Pediatric Endocrinology. RLS was diagnosed by intensive interviews which also included the Epworth Sleepiness Scale (ESS) and International RLS Rating Scale (IRLSRS). Patients also received neurological examinations and laboratory tests for diabetes, iron metabolism and renal function. Results: Thirteen patients (23.6%, 6 males) were compatible for the diagnostic criteria of RLS. None of the RLS patients showed abnormal findings in neurological evaluations and 7 patients had familial history of RLS. Demographic and laboratory findings were not different between the patients with or without RLS. The RLS group showed significantly increased ESS and IRLSRS scores. Conclusion: RLS was prevalent in children and adolescents with type 1 diabetes. The association between RLS and diabetes-related laboratory findings requires further investigation.

목 적 : 제 1형 당뇨병을 진단 받은 소아 청소년 환자들을 대상으로 RLS를 평가하고 RLS를 동반하는 환자군과 RLS를 동반하지 않은 환자군 간의 임상적 변인과 수면의 특성을 비교하고자 하였다. 방 법 : 소아 청소년과에서 제 1형 당뇨병으로 진단 받은 7세 이상 18세 이하의 소아 청소년 55명을 대상으로 면담, 설문조사, 임상학적 검사를 시행하였다. RLS 진단은 IRLSSG 진단기준을 따랐으며 설문은 Epworth sleepiness scale (ESS), International restless legs syndrome rating scale (IRLSRS)를 이용하였다. 결 과 : 55명의 대상자 중 RLS 빈도는 13명으로 23.6%였다. RLS 관련 변인으로 BMI, Hb, Iron, ferritin, TIBC, creatinine, GFR에서 두 군간에 유의한 차이는 없었다. RLS 환자 13명 중 RLS 가족력을 가진 환자는 7명으로, RLS가 없는 환자의 경우와 현저한 차이를 보였다. 수면의 특성을 조사한 결과 RLS를 동반한 환자군이 RLS를 동반하지 않은 군에 비해 ESS, IRLSRS 결과가 유의하게 높았다. 결 론 : 제 1형 당뇨병을 진단 받은 소아 청소년은 RLS가 흔히 동반되었다. 임상적으로 당뇨 소아 청소년의 RLS 동반여부와 수면의 질을 평가하여 치료하는 것이 필요하겠으며 향후 보다 많은 환자를 대상으로 보다 객관적인 방법을 이용한 연구가 진행되어야 할 것이다.

Keywords

References

  1. Allen R. Dopamine and iron in the pathophysiology of restless legs syndrome (RLS). Sleep Med 2004;5:385-391. https://doi.org/10.1016/j.sleep.2004.01.012
  2. Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 2003;4:101-119. https://doi.org/10.1016/S1389-9457(03)00010-8
  3. Allen RP, Walters AS, Montplaisir J, Hening W, Myers A, Bell TJ, et al. Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med 2005;165:1286-1292. https://doi.org/10.1001/archinte.165.11.1286
  4. Berger K, von Eckardstein A, Trenkwalder C, Rothdach A, Junker R, Weiland SK. Iron metabolism and the risk of Restless Legs Syndrome in an elderly general population - The MEMO-Study. J Neurol 2002;249:1195-1199. https://doi.org/10.1007/s00415-002-0805-2
  5. Bhowmik D, Bhatia M, Gupta S, Agarwal SK, Tiwari SC, Dash SC. Restless legs syndrome in hemodialysis patients in India: a case controlled study. Sleep Med 2003;4:143-146. https://doi.org/10.1016/S1389-9457(03)00005-4
  6. Caruso NC, Radovanovic B, Kennedy JD, Couper J, Kohler M, Kavanagh PS, et al. Sleep, executive functioning and behaviour in children and adolescents with type 1 diabetes. Sleep Med 2014;15:1490-1499. https://doi.org/10.1016/j.sleep.2014.08.011
  7. Cho YW, Na GY, Lim JG, Kim SH, Kim HS, Earley CJ, et al. Prevalence and clinical characteristics of restless legs syndrome in diabetic peripheral neuropathy: comparison with chronic osteoarthritis. Sleep Med 2013; 14:1387-1392. https://doi.org/10.1016/j.sleep.2013.09.013
  8. Cho YW, Lee JH, Son HK, Lee SH, Shin C, Johns MW. The reliability and validity of the Korean version of the Epworth sleepiness scale. Sleep Breath 2011;15:377-384. https://doi.org/10.1007/s11325-010-0343-6
  9. Dipankar Bhowmika, Manvir Bhatiab, Sanjay Guptaa, Sanjay K. Agarwala, Suresh C. Tiwaria, Suresh C. Dasha. Restless legs syndrome in hemodialysis patients in India: a case controlled study. Sleep Med 2003;4:143-146. https://doi.org/10.1016/S1389-9457(03)00005-4
  10. Hong SY, Lee JH, Cho YW. Quality of life in patients with restless legs syndrome in Korea: comparison with other chronic diseases. J Korean Neurol Assoc 2010;28:257-262.
  11. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991;14:540-545.
  12. Kim DY, Lee IK, Kim SY, Oh MH, Kim YC. A Case of idiopathic restless legs syndrome in a child. J Korean Child Neurol Soc 2004;12:247-51.
  13. Liborio AB, Santos JP, Minete NF, de Diogenes CA, Farias Lde A, de Bruin VM. Restless legs syndrome and quality of sleep in patients with glomerulopathy. BMC Nephrology 2013;14:113. https://doi.org/10.1186/1471-2369-14-113
  14. Merlino G, Valente M, Serafini A, Fratticci L, Del Giudice A, Piani A, et al. Effects of restless legs syndrome on quality of life and psychological status in patients with type 2 diabetes. The Diabetes Educator 2010;36:79-87. https://doi.org/10.1177/0145721709351252
  15. Moldenhauer F. Using in vitro prediction models instead of the rabbit eye irritation test to classify and label new chemicals: a post hoc data analysis of the international EC/HO validation study. Altern Lab Anim 2003;31:31-46.
  16. Ohayon MM, Roth T. Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res 2002;53:547-554. https://doi.org/10.1016/S0022-3999(02)00443-9
  17. Shin CH. Epidemiologic characteristics of type 1 diabetes in children aged 14 years or under in Korea, 1985-2000. Korean J Pediatr 2008;51:569-575. https://doi.org/10.3345/kjp.2008.51.6.569
  18. Walters AS, LeBrocq C, Dhar A, Hening W, Rosen R, Allen RP, et al. Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med 2003;4:121-132. https://doi.org/10.1016/S1389-9457(02)00258-7
  19. Wolkove N, Elkholy O, Baltzan M, Palayew M. Sleep and aging: 1. Sleep disorders commonly found in older people. CMAJ 2007;176:1299-1304. https://doi.org/10.1503/cmaj.060792
  20. Yang JG, Kim DH, Lee JH, Park KH, Jung KY, Shin WC, et al. The Reliability and Validity of the Korean Versions of the International Restless Legs Scale and the Restless Legs Syndrome Quality of Life Questionnaire. J Korean Neurol Assoc 2010;28:263-9.
  21. Zobeiri M, Shokoohi A. Restless leg syndrome in diabetics compared with normal controls. Sleep Disord 2014;2014:871751.

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