Restless Sleep Prevalent in Children with Underlying Health Conditions

This systematic review assessed the prevalence of restless sleep in children, documented the association of restless sleep with other conditions, and summarized the existing evidence regarding whether restless sleep should be considered a distinct sleep disorder.

Children with a number of underlying conditions have a higher than average prevalence of restless sleep according to a study to be published in Sleep Medicine Reviews.

Restless sleep is a common pediatric sleep complaint. The researchers conducted a literature review to determine the prevalence of restless sleep in children with various medical conditions, from sleep apnea to Down syndrome. They also wanted to assess restless sleep coverage in pediatric medical literature.

The researchers’ literature search used the PubMed, EMBASE (including the Cochrane library), and Scopus electronic databases through October 9, 2019. Search term: “restless sleep.” They excluded studies in adults and animals, in languages other than English, and with less than 5 participants, among other criteria. They retrieved 117 articles for review.

Of the 19 studies that mentioned restless sleep in children with sleep-disordered breathing, 5 reported the condition as highly prevalent. Restless sleep prevalence was higher in children with sleep apnea than in children with other sleep-disordered breathing conditions.

The 7 studies that involved children undergoing adenotonsillectomy for sleep-disordered breathing reported prevalence between 37.7% and 91%.

All respiratory disorders included in the study showed a prevalence of restless sleep. It was found to affect up to 83.5% of children with poorly controlled asthma.

Restless sleep was also reported in children with epilepsy (64.3%) and in 67.8% of children evaluated in psychiatric clinics. Restless sleep was also significantly associated with bipolar mood disturbance and with an anxiety-affective disorder or conduct disorder, the researchers found.

“Restless sleep can be perceived by the parent or caregiver in association with other conditions and can be improved after treating the underlying medical or sleep disorders,” the researchers concluded.

“Primary restless sleep disorder has been described as a new diagnostic category with specific criteria for its identification.”


DelRosso L, Picchietti DL, Spruyt K, et al, on behalf of the International Restless Legs Syndrome Study Group (IRLSSG). Restless sleep in children: A systematic review. Sleep Med Rev. Volume 56, 2021,101406, ISSN 1087-0792.