What causes restless legs syndrome? Why do so many people have it?

Do kids get RLS? Why do children get RLS? Listen to this on NPR JR

When Brain Shuts Down, Legs Kick into Overdrive

 by David Kestenbaum

It's maddening to have a feeling that you can't explain. When I was a kid on long car rides, I would sometimes experience a strange sensation in my legs. I felt like I had to move my legs. When I did, the feeling would go away for a few seconds but then come back.

It struck at the worst times — my legs kept me awake when I was tired and needed to sleep. As an adult, the feeling periodically comes back to haunt me, during a slow movie, on airplane rides, or having a late drink at a bar...

I had no idea what this was until a few years ago when I found a Web site about something called Restless Legs Syndrome (RLS). I had that eureka moment people must have when they find out that what ails them has a name. "Yes!" I thought, "THIS IS WHAT I HAVE!"

My case is fairly tame. People with severe forms of Restless Legs Syndrome are sleep deprived and miserable.

Jumping Legs

The number of people affected by RLS is somewhat uncertain, but one large study found that almost 8 percent of people in the United States have experienced restless legs sometime in the past year. Three percent are bothered by it two or more times a week. And "bothered" probably isn't the right word — the study categorizes these people as experiencing "moderate or extreme distress."

People with RLS sometimes describe a "tugging" or "creepy crawly" sensation. Until recently, an average physician was unlikely to know what it was.

There are some early references to what appears to be RLS in the scientific literature. An English physician named Thomas Willis wrote a description in 1683:

"Wherefore to some, when being in bed they betake themselves to sleep, presently in the arms and legs. Leaping and contractions of the tendons and so great a restlessness and tossing of the members ensure, that the diseased are no more able to sleep, than if they were in the place of the greatest torture!"

.....Earley has a pet theory that RLS may be the body's way of reacting to reduced iron in the brain and saying, in essence, "Go get some iron!"

"5,000 or 10,000 years ago, the major source of iron was meat," he says. "So the guy out running around... was more likely to find meat and iron than the other guy sitting warmly in his cave keeping comfortable."

Studies indicate the RLS is more common in people from Scandinavia and northern Europe. Earley jokes that this could explain the trips taken by the Vikings.

"What could possibly possess a bunch of guys to get in a boat in the middle of winter and row across the Atlantic," he says, "other than a bad case of restless legs!".....

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Common issues that hurt your sleep

This article discusses common issues that hurt people's sleep, and tells you what to do about them.

You might remember a time when you could drift off to sleep in an instant and remain in a state of blissful slumber well past lunchtime the next day. Now your sleep is more likely to be lighter and more fitful, and when you wake up in the morning you don't always feel refreshed.

A lack of good-quality sleep could be a natural consequence of changing sleep-wake patterns after menopause. It's also likely that the issue is physical--and fixable. Many conditions can disrupt your rest, and they can be treated. It's important to address these issues. Lack of sleep does more than make you drowsy. Chronic insomnia has been linked to a variety of health problems, including obesity, high blood pressure, heart disease, diabetes and depression.

Go through this list to see whether you might have one of these sleep-stealing conditions. Also check your medicine cabinet. Some medications, including corticosteroids, beta blockers, cold and flu remedies, and certain antidepressants also can interfere with sleep.

1. Sleep apnea

The conventional image of sleep apnea is of the overweight man who snores, but women of any size can also develop these repeated pauses in breathing while they sleep.

"A woman who has a narrow jaw or a change in muscle tone can get apnea," says Dr. Julia Schlam Edelman, clinical instructor in obstetrics and reproductive biology at Harvard Medical School and author of "Successful Sleep Strategies for Women and Menopause Matters: Your Guide to a Long and Healthy Life." Either of these anatomical issues can block oxygen from reaching your lungs (and subsequently the rest of your body) while you sleep. Snoring might not be your main symptom if you do have sleep apnea, but you will notice that you're especially sleepy during the day.

Solution: See a specialist for a sleep study. You may be able to relieve apnea with a few lifestyle adjustments, such as sleeping on your side or losing weight. Your doctor might also suggest an oral appliance or a CPAP machine that blows air into your airways to keep them open at night.

2. Diet

What you eat can affect your sleep. Spicy foods can contribute to painful heartburn. Big meals leave you uncomfortably full, and over time can contribute to obesity--a well-known risk factor for sleep apnea. Too much caffeine could keep you wide awake, even if you finish your coffee in the morning.

"It takes six hours to clear half of the caffeine from your body. If you have enough caffeine, it's still in your body at 4 in the morning," says Dr. Edelman. And though a glass of wine or two with dinner will make you feel relaxed or even sleepy, it won't help you sleep. "You can fall asleep, but once you're asleep you can't sleep deeply," she says.

Solution: Eat dinner at least a couple of hours before bedtime, and keep the meal light. Avoid spicy, fatty foods, as well as alcohol and caffeine. Also, don't drink too many fluids before bed. Having to constantly get up to go to the bathroom can disrupt your sleep, too.

3. Lack of exercise

Sleep and exercise complement each other. Working out regularly can help you sleep better, and conversely, you're more likely to exercise if you get a good night's rest.

Solution: Exercise every day if you can, ideally in the morning. Doing a high-energy aerobic routine too close to bedtime can have the opposite of the intended effect, making you too energized to sleep. A gentle yoga stretch before bed probably won't hurt, though. It might even help you relax.

4. Pain

Arthritis aches or any other kinds of pain don't make for restful slumber. Conversely, a lack of sleep can increase your pain. Researchers believe that a lack of sleep may activate inflammatory pathways that exacerbate arthritis pain. Poor sleep can also make you more sensitive to the feeling of pain.

Solution: In addition to the pain remedies your doctor recommends, try using a heating pad or taking a warm bath before bed to soothe achy joints or muscles. Lying against a body pillow can put you in a more comfortable position while you sleep.

5. Restless legs syndrome

Women are twice as likely as men to have restless legs syndrome (RLS)--a condition that causes a creepy, crawly feeling and uncontrollable movements in the legs at night. It's often linked to hormonal changes early in life and during pregnancy, but RLS can continue as you get older. RLS isn't just miserably uncomfortable--researchers at Harvard have linked this condition to an increased risk for heart disease and depression in women.

Solution: Try simple interventions first. Exercise every day, take a hot bath before bed, massage your legs, and cut back on things that can make you jittery--like caffeine and tobacco. If these measures don't work, your doctor may recommend one of several medicines that reduce RLS symptoms--including ropinirole (Requip), pramipexole (Mirapex), rotigotine (Neupro), or gabapentin enacarbil (Horizant).

6. Depression

"Depression is a common compromiser of sleep, and it's much more common in women than in men," Dr. Edelman says. Women who are depressed may sleep more than usual, but their sleep isn't restful. Some of the antidepressants meant to counteract depression, particularly SSRIs, can also interfere with sleep.

Solution: See your primary care doctor, psychologist, psychiatrist, or therapist for help, which may include medications, talk therapy, or both. If your antidepressant seems to be keeping you awake, ask your doctor to switch you to another drug.

7. Stress

It's impossible to sleep when the weight of the day is pressing on you. Finding a sense of calm before bed isn't easy, especially when you can't unplug from the demands of your day.

Solution: Establish wind-down time. Do a quiet, relaxing activity before bed that doesn't involve a screen. Talk to a friend or family member, sew, or read a real book--not one on a backlit tablet device.

"Just allow yourself to have quiet time," Dr. Edelman adds. And don't sleep with your smartphone on your bedside table.

8. Poor sleep habits

Sometimes insomnia stems from long-ingrained behaviors, like staying up too late or engaging in stimulating activities before bed.

Solution: Follow a few basic sleep hygiene strategies. Go to bed and wake up at the same times each day. Keep your bedroom cool, dark, and comfortable. Use your bed for sleep and sex only. If you can't fall asleep within 15 minutes, get up and leave the bedroom. Read or do another quiet activity for 15 to 20 minutes until you get sleepy.

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Brain impairment and Restless Legs Syndrome

Those who have Restless Legs Syndrome also seem to have implicated early brain development.

In a study published online in Genome Research, researchers of the Helmholtz Zentrum München und the Technische Universität München have demonstrated that a common genetic variant associated with Restless Legs Syndrome (RLS) alters the expression of a critical gene during fetal development of the brain. This leads to alterations of the developing forebrain indicating an anatomical region involved in RLS.

Restless Legs Syndrome (RLS), a neurological disorder characterized by unpleasant sensations in the legs and the urge to move them, is not caused by a single genetic defect, but rather is a complex disorder influenced by many genetic and environmental components. Previously, researchers identified genetic variants in RLS patients; however, how these variants, each of which only has a small effect, contributed to RLS was unclear.

MEIS1 gene variant leads to altered development of the brain

In this new study, authors from the Helmholtz Zentrum München (HMGU) and Technische Universität München as well as the Stanford Center for Sleep Medicine and Sciences demonstrate how one of these variants may contribute to RLS. The RLS-associated variant is located in a non-coding region of the MEIS1 gene and led to decreased ability to activate gene expression. Specifically, the authors observed the reduced gene expression in the future basal ganglia in the forebrain. "Here we have pinpointed down to an anatomical region for RLS," says lead author of the study, Prof. Juliane Winkelmann from HMGU, who is currently doing research at the Stanford University.

"The RLS-associated variant is located in an intron of MEIS1, a transcription factor involved in organ development and maintenance. The risk variant binds more strongly to the transcriptional regulator CREB1, which may lead to the reduced MEIS1 expression," explains Prof. Dr. Wolfgang Wurst from HMGU. Furthermore, screening analyses in animal models with reduced MEIS1 expression, conducted by the Institute of Experimental Genetics at the HMGU, led by Prof. Dr. Martin Hrabě de Angelis, showed hyperactivity, which resembles the human condition of RLS.

Reduced gene activity predisposition for RLS

Interestingly, the non-coding region only seems to be active during early brain development, suggesting that RLS, which is associated with aging, may have fetal origins. "Minor alterations in the developing forebrain during early embryonic development are probably leading to a predisposition to RLS," Winkelmann said. "Later in life, during aging, and together with environmental factors, these may lead to the manifestation of the disease."

In further studies researchers aim to investigate the affected cells in the forebrain. Based on their findings new treatment strategies for RLS may be developed.

This study provides one of the first in-depth examinations of a genetic variant identified in a genome-wide association study, which examines many individuals for genetic variants that are linked to a trait. Although many variants are often reported in these studies, it has been difficult understand how variants contribute to disease because they often lie in non-coding regions of the genome and have small effect sizes. This work also reveals that combinatorial use of multiple approaches will be likely required to unravel the physiological causes most of human diseases.

Read more here

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What may be keeping you up at night?

This article discusses the common issues that keep people from getting a good night's sleep, such as insomnia, sleep apnea, narcolepsy, restless leg syndrome, and periodic limb disorder.

The illusive good night’s sleep. According to the National Center for Sleep Disorders Research at the National Institutes of Health, it’s a national problem. Between stress, problems with your sleeping environment and any number of disorders, 30 to 40 percent of the U.S. adult population reports experiencing symptoms of insomnia each year.

We talked to Marcy Guido-Posey, registered polysomnographic technologist and registered sleep technologist who is a coordinator at Holy Spirit Sleep Centers, and Beverly Azemar, certified nurse practitioner at Penn State Hershey Sleep Research and Treatment Center in Hummelstown, to get the skinny on what’s keeping you from a blissful eight hours.

Insomnia

“Insomnia is defined as the inability to fall asleep, stay asleep or both,” Guido-Posey said. It can lead to impaired daytime functioning.

“When people have trouble sleeping it’s insomnia, which is a symptom and not a disease,” Azemar said. Insomnia symptoms fall into three categories:

• Transient: lasting less than one week

• Short-term: lasting one to three weeks

• Chronic: lasting one month or longer

Sleep apnea

“Sleep apnea is a decrease or total cessation of airflow during sleep,” Guido-Posey said. “Often you will hear loud, rhythmic snoring, followed by a period of silence that ends with a loud snort or gasp as breathing resumes, then stops again. This pattern repeats itself over and over.”

According to the American Sleep Apnea Association, sleep apnea occurs most frequently in men, particularly African Americans and Hispanics. It affects more than 18 million Americans. The three types of sleep apnea are:

• Obstructive sleep apnea: caused by a blockage in the airways

• Central sleep apnea: “That is when the airway is not blocked, but the brain fails to signal the respiratory muscles to breathe,” Azemar said.

• Mixed: a combination of obstructive and central sleep apnea

Narcolepsy

Narcolepsy is the chronic neurological disorder often depicted in movies by characters falling asleep suddenly during daily activities, which isn’t far from the truth. Excessive daytime sleepiness is the main symptom of narcolepsy and happens because the brain isn’t able to regulate the body’s sleep-wake cycle.

It is estimated that up to 200,000 Americans suffer from narcolepsy. It affects men and women equally. While there is no cure, treatment can involve stimulants, antidepressants and other types of prescription medication. Symptoms include:

• Cataplexy: a sudden loss of muscle control

• Sleep paralysis: the brief inability to talk or move while falling asleep or when waking up

• Hypnagogic hallucinations: scary dreams when falling asleep

• Automatic behavior: performing routine tasks without awareness, or even memory, of performing them

Restless Legs Syndrome

Willis-Ekbom disease, or restless legs syndrome, is a neurological disorder. Its hallmark is a tingling sensation in the legs or arms that results in an irresistible urge to move. The sensation varies from person to person with patients describing a creeping, crawling, or electric feeling, according to the National Sleep Foundation.

RLS is estimated to affect 7 to 10 percent of Americans. Treatments include dopaminergic agents or anticonvulsants combined with behavioral techniques.

Periodic Limb Movement Disorder

PLMD is basically RLS while you’re asleep, explained Guido-Posey. The disorder is characterized by repetitive movements such as twitching or jerking every 20 to 40 seconds. Like sleep apnea, it is often recognized first by bed partners.

PLMD isn’t considered to be a serious medical condition, but it can be a contributing factor in insomnia. The NSF recommends seeking treatment for PLMD when it’s accompanied by RLS and/or daytime sleepiness.

Symptom management with medication

Insomnia sufferers do have over-the-counter and prescription medication options to consider that may help them get a better night’s sleep. OTC drugs such as Benadryl and Tylenol PM can help with occasional sleeplessness, but the Mayo Clinic warns that they aren’t intended for long-term use.

Another issue with OTC sleep aids is the day-after hangover. “Many over-the-counter aids are antihistamines and they can also cause residual daytime drowsiness the next day,” Azemar said. She also warns that while they are fairly safe to use because they are over-the-counter, they can be abused.

Doctors can prescribe medication for their sleep-lacking patients. Common prescription brands of sleeping pills include the sedatives Ambien and Lunesta. These drugs work by relaxing patients and helping them fall asleep and stay asleep.

“When patients are prescribed a sleep aid, they are usually used for 1-2 weeks, but then again some patients need them longer. They just need to be followed and monitored to make sure they are effective and they’re getting the appropriate results,” Azemar said. Some prescription sleep aids help you fall asleep while others can be taken in the middle of the night to help you get back to sleep.

Patients are cautioned that use of prescription sleep aids can come with risks. Side effects can include dizziness, prolonged daytime sleepiness and weight gain. Use can also lead to an increased risk in nighttime falls in older adults.

Sleep hygiene

One of the most important factors in a good night’s sleep is your hygiene. Sleep hygiene is the collection of practices necessary to developing a healthy sleep schedule.

Factors in sleep hygiene include:

• Creating a sleep-promoting environment

• Maintaining a regular sleep schedule

• Sticking to healthy eating habits

• Lowering your stress level

If you are maintaining healthy sleep hygiene and still experiencing insomnia or symptoms of a sleep disorder, talk to your doctor about scheduling a sleep study and treatment options.

Read more here

Pediatric Sleep Disorders

This article discusses all about pediatric sleep disorders and indicates when it is necessary to get help to treat them.

Bedwetting, sleepwalking, night terrors. Sleep disturbances that cause concern when seen in adults can actually be “part of the normal developmental process in children,” according to Dr. Kirk Watkins of the Intermountain Dixie Regional Sleep Disorder Center.

“In most instances, nothing is wrong with the child and they will grow out of it in time,” said Watkins.

But even things that are normal can be disruptive to families. When should you seek treatment for your child’s sleep disorder?

“When it begins to cause bigger problems,” said Watkins. He lists three examples:

• When it affects the safety of the child. For instance, if you find a sleepwalking child “on the next block walking down the middle of the street.”

• When it affects the child’s daytime function in terms of behavior, personality changes, or schoolwork.

• When lack of sleep disrupts regular family routines.

In those instances, “Pediatricians and family practice physicians have a lot of experience helping families deal with sleep disorders. They can reassure parents and help find the reason the child is aroused from sleep,” said Watkins.

When the usual methods fail, it may be time to seek help from a sleep specialist. According to Watkins, the three most common causes of parasomnia (abnormal or disruptive sleep disorders) in children he treats include:

• Obstructive sleep apnea. “Sleep apnea is not widely recognized in children because if a kid snores, the general practice is to perform a tonsillectomy. In about 65 percent of cases, it works. For the rest, it is really hard for anybody to objectively pick up from a child that excessive sleepiness is going on, so we often have to rely on other indicators. By middle school kids who snore will lose 1.5 grade points on average. They can cause social disturbances at home. A child with obstructive sleep apnea may be seen as always causing trouble, but is not typically defiant. Often they will sleep on their hands and knees with the rear end in the air. They may tear the entire bed apart at night. Mouth breathing at night in children who don’t have congestion during the day is also a classic symptom.

• Acid reflux at night. “Acid reflux is a significant pathology that should always be addressed. Again, it can be hard for a child to verbalize their symptoms, but if they had acid reflux as an infant and now wake up screaming every night, resuming treatment may help.”

• Restless leg syndrome. “Restless leg is the sleep disorder with the highest association with ADHD. Symptoms can be vague in children, and are sometimes described as ‘growing pains.’ Often restless leg is associated with iron deficiency that is easily treatable. If not, there are medications that while not well studied in children can sometimes be effective.”

Chronic sleep disorders in children can cover “the compendium of a parent’s worst nightmares,” acknowledged Watkins. “In most cases, however, they are very treatable.”

Read more here

Sleeping pills are not the only treatment worth considering for sleep problems

Millions of Americans might be overusing sleeping pills, which can pose health risks, a recent analysis by Consumer Reports Best Buy Drugs noted. Medication for insomnia can lead to side effects, dependency and even worse sleep problems when taken too often or in excessive doses. If you need help for short-term insomnia caused by travel or a stressful event, start with an over-the-counter sleep aid. If that doesn’t work, ask your doctor if you should try generic zolpidem. But everyone — especially those with chronic insomnia and people 55 or older — should first try these nondrug approaches:

Lifestyle changes. Behavior modification — such as changing sleep habits by getting up at the same time every day and avoiding naps — produced significant improvements for older adults with chronic insomnia, according to a 2011 study published in the Archives of Internal Medicine.

Cognitive-behavioral therapy. Seeing a therapist who specializes in insomnia might help 70 to 80 percent of people with chronic insomnia, often providing a “cure.” (Pills treat the symptoms.) To find a sleep center where CBT is offered, call the American Academy of Sleep Medicine at 630-737-9700 or go to www.sleepcenters.org. Ask your insurer about coverage.

Exercise. A study of more than 3,000 adults, published in December in the journal Mental Health and Physical Activity, found that 150 minutes a week of moderate exercise, such as brisk walking, or 75 minutes a week of vigorous activity, such as running, improved sleep quality by as much as 65 percent.

Treat the causes. If you often have trouble sleeping or wake up tired, talk with your doctor about whether one of the conditions described below might be causing the problem.

Sleep apnea. Symptoms of this disorder include frequent, loud snoring. It can cause breathing to stop for 10 seconds or longer throughout the night, disrupting sleep and increasing the risk of high blood pressure, heart disease, mood and memory problems, and driving accidents. Shedding excess pounds can alleviate it in some cases. Avoiding alcohol, smoking and sedating medication can also help, as can sleeping on your side. In moderate and severe cases, the most effective treatment is continuous positive airway pressure, or CPAP, which involves using a mask that blows air into your throat to keep the airways open. Dental appliances that reposition the lower jaw and tongue might help in mild cases.

Restless legs syndrome. The condition, marked by a strong urge to move your legs, worsens in the evening and when you’re lying down, and is often accompanied by leg-jerking before sleep. To manage symptoms, take daily walks and avoid alcohol, caffeine and smoking. Before bedtime, do calf stretches, take a hot bath, massage your legs or do relaxation exercises.

Frequent nighttime urination. This is the No. 1 cause of insomnia among older adults, because aging bodies produce less of a hormone that enables people to retain fluid. But multiple bathroom calls might also signal uncontrolled diabetes, prostate enlargement, sleep apnea or a urinary tract infection, so talk with your doctor. Limit your consumption of liquids two hours before bedtime, especially alcohol, citrus juices and drinks with caffeine or artificial sweeteners.

Heartburn. If you experience a burning sensation in your chest two or more times a week, see your doctor. You might have gastroesophageal reflux disease, or GERD, which can inflame the lining of the esophagus and awaken you at night with heartburn, indigestion, coughing or choking. Minimize symptoms by eating small meals, not lying down for three hours after eating, avoiding fatty, spicy or acidic food, not smoking and losing excess weight.

Osteoarthritis. Cognitive-behavioral therapy improved both insomnia and arthritis pain in older patients in a 2009 study in the Journal of Clinical Sleep Medicine. And gentle yoga practiced about an hour before bedtime relieved sleep disturbance in women with osteoarthritis in a 2011 pilot study in the journal Sleep Medicine. Most important, lose extra weight and try to exercise regularly to reduce arthritis pain.

Nocturnal leg cramps. These painful muscle contractions, often in the calf and sometimes in the thighs or feet, commonly awaken older people. You might find relief by pulling the top of your foot toward your shin while extending your knee, massaging the affected leg or walking.

Hot flashes. More than half of menopausal women report chronic insomnia, primarily because of hot flashes that interrupt sleep and leave them drenched in sweat and shivering. To ease night sweats, lower the bedroom thermostat or use a fan; sleep on cotton sheets and wear cotton nightclothes; take a cool shower before bed; keep ice water at your bedside; and place a frozen ice pack under your pillow, turning the pillow often.

Emotional distress. Treatment for anxiety and depression generally involves psychotherapy aimed at changing thoughts and behavior that feed the problem, often paired with newer antidepressants such as fluoxetine (Prozac and its generic cousins) and sertraline (Zoloft, for example). If those pills worsen your insomnia, ask your doctor about switching the timing or the drug. Regular exercise can help ease both anxiety and depression.

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To Some Children, Sleep Does Not Come Easy

Sleep disorders are more prevalent among children than most people realize, according to two Central Illinois sleep medicine specialists.

Sometimes, sleep disorder symptoms in kids are misdiagnosed and treated as other health conditions, including behavior disorders, meaning the underlying problem isn't addressed.

Sometimes, an untreated sleep disorder exacerbates symptoms of another medical condition, including attention deficit hyperactivity disorder.

"Thirty to 40 percent of kids 9 to 12 years old have difficulty falling asleep or staying asleep at least three days a week," said Dr. David Koh, a pulmonologist and critical care physician with Illinois Heart & Lung Associates, part of Advocate Medical Group. Koh figures the prevalence among children younger than 9 is similar.

While those children have sleep problems that should be addressed, not all have a diagnosable sleep disorder. Dr. Humam Farah of OSF Critical Care, Pulmonary and Sleep Medicine, said 4 percent of children have a sleep disorder.

Koh, medical director of the Midwest Center for Sleep Medicine, said the increasing numbers are partly because of improved diagnoses but he also thinks that more children have sleep disorders than a generation ago.

Farah, medical director of the Sleep Center of Central Illinois, said increased obesity is one reason for the increase. Obesity results in fat in the upper airways. Narrowed airways interrupt breathing and sleep and decrease oxygen to the brain.

Some children inherit a sleep disorder, such as restless leg syndrome (RLS) and periodic limb movement disorder.

RLS is a neurological condition characterized by the irresistible urge to move the legs, according to the RLS Foundation. The urge to move the legs is often accompanied by unpleasant sensations in the legs that worsen during periods of rest or inactivity and at night.

Periodic limb movement disorder is a rhythmic twitching of the legs after falling asleep, Koh said.

Both conditions prevent deep sleep and wake people up at night.

While RLS is generally associated with older adults, 2 percent of children have the condition. When either parent has RLS, the prevalence among children increases to 16 percent, Koh said.

In addition, many children with RLS or periodic limb movement disorder also have low iron levels, Koh said.

RLS is worsened by stimulants such as caffeine or chocolate.

When people are sleep-deprived and stressed, that increases the body's desire for fatty foods. Increased consumption of fatty foods prompts weight gain.

Sometimes, increased stress on the cardiovascular system prompts the kidneys to produce more urine, resulting in bed-wetting.

But many parents don't recognize their child has a sleep disorder. Instead, they focus on the daytime symptoms of lack of sleep: irritability, declining academic performance, weight gain and a wet bed.

Some children with a sleep disorder are assumed to have a behavior disorder. Others are diagnosed with ADHD.

Indeed, some have ADHD with a sleep disorder. Thirty percent of children treated for ADHD have a diagnosable sleep disorder, Koh said. When those 30 percent of children are treated successfully for their sleep disorder, about half of them are able to be weaned off their ADHD medicine.

Children who have trouble falling asleep and staying asleep should be taken to their pediatrician, Koh and Farah said. The pediatrician may refer them for a sleep study. The two sleep centers in Bloomington perform overnight sleep studies.

Some children are diagnosed with sleep apnea, a common disorder in which a person has pauses in breathing or shallow breathing while sleeping. Sleep is interrupted. Left untreated, sleep apnea increases long-term risk of heart disease and stroke.

For children, a common treatment for sleep apnea is removing enlarged tonsils or adenoids.

Some children are treated with continuous positive airway pressure masks, which supply a steady stream of air through the nose or mouth during sleep, Farah said.

Weight loss is a key for overweight children, Farah said.

For children diagnosed with RLS or periodic limb movement disorder, medicine such as Mirapex can lessen the symptoms and improve sleep, Koh said. Iron supplements can help boost iron levels.

Sleep tips

Newborns need 16 to 18 hours of sleep a day, toddlers 6 months to 1 year old need 14 hours of sleep a day, children ages 1 to 3 need 12 hours of sleep a day, preschoolers need 11 to 12 hours of sleep, school-age children ages 5 to 13 need 9 to 10 hours of sleep a day and teenagers need 9 hours of sleep a day. Many children and teens don't get that much sleep. Here are tips for children to get a better night's sleep:

-- Don't have caffeine and limit chocolate, which are stimulants.

-- Don't eat a meal or exercise at least two hours before bedtime.

-- Try to go to bed and get up about the same time each day.

-- No videos (television, video games, computer games) within two hours of bedtime.

-- No electronics (televisions, computers, cellphones) in children's rooms at night.

-- For young children who are older than 6 months, make sure they fall asleep in the same position in which they will wake up. In other words, don't let them fall asleep in your arms. Instead, go through your bedtime routine (bath, bedtime story, etc.), then put them to bed, wish them good night and leave their room. If they get up and come into your room, direct them back to their room politely but unemotionally. They should learn to fall asleep on their own.

-- For children who want some light, dim nightlights are OK.

-- For older children, don't tell them "Go to sleep." You can't force someone to go to sleep. Instead urge them to go to bed and relax.

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Top 7 types of sleep disorders

Do you generally have trouble falling asleep even when you are dead tired? Do you often find yourself awake in the middle of the night, even though you went to bed exhausted?

If this is you, then you might just have some sort of a sleep disorder. Sleep disorders cause more than just sleepiness; they might have a deteriorating effect on your productivity, psychological and overall health. It is a must to understand them in detail. Today, Dr. Pulkit Sharma, Clinical Psychologist and Psychoanalytical Therapist at VIMHANS helps us understand the top 7 most common sleep disorders in detail.

Insomnia. People suffering from insomnia either have difficulty in sleep initiation, sleep continuation or both. It is a highly prevalent sleep disorder and can be transitional or primary. Transitional insomnia is a sleep disturbance caused due to stressful life circumstances and resolves once the stress is taken care of. Primary insomnia is poorly understood, long-term and is difficult to treat. Insomnia has an adverse impact on your mood, attention and concentration. Lifestyle changes and psychological treatments can help treat this condition.

Sleep Apnea. This condition is marked by difficulty in breathing while you are asleep. Either there is a rupture in breathing or the person's breath, in general, becomes superficial. This prevents the person from getting a deep rejuvenating sleep. It often leads to fatigue during daytime. This condition is manageable with a range of available treatments.

Periodic Limb Movement Disorder (PLMD). It is characterized by an involuntary movement of limbs while sleeping. People suffering from this condition have little awareness about it and often their close ones are the first to detect it. Stimulants such as alcohol and caffeine can worsen these symptoms. This condition is treatable by medicines used in the management of Parkinson's disease.

Restless Legs Syndrome. The individual experiences certain unusual sensations in their legs due to which they have an urge to move their legs constantly. Across individuals this condition varies in intensity. Symptoms may exacerbate temporarily during relaxation. Various pharmacological and non-pharmacological treatments are available.

Narcolepsy. People suffering from this condition feel extremely sleepy during daytime and drift into sleep during the waking hours. The individual may experience temporary freezing or paralysis during these sleep attacks. Antidepressants, special diets, lifestyle changes and psychological treatments are very helpful in this condition. Social support is essential as people may consider the person to be lazy.

Sleep Walking. A sleep walker performs tasks that people generally do when awake, while fast asleep. For instance - walking, getting ready, brushing teeth, going out of the house, etc. The person has no or limited insights into their behaviors during sleep and may get shocked when others tell them about it. Apart from certain biological factors, unconscious psychological processes, especially dissociation, contribute to sleep walking. This condition needs a thorough diagnosis and management as there may be a risk to the person's life.

Delayed sleep phase disorder. The person takes a lot of time to fall off to sleep and consequently finds it hard to get up on the scheduled time in morning. Once in a while such occurrences happen with everyone, but for people with this disorder this is almost a daily phenomenon. These people feel more alert at night than in the daytime. It commonly starts in childhood or adolescence and can be helped greatly with proper treatment.

Read more: http://timesofindia.indiatimes.com/life-style/health-fitness/health/Top-7-types-of-sleep-disorders/articleshow/12001463.cms