{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T15:45:39Z","timestamp":1763480739709,"version":"build-2065373602"},"reference-count":36,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T00:00:00Z","timestamp":1716854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Introduction: Children born prematurely (&lt;37 weeks\u2019 gestation) are at increased risk of perinatal complications, comorbidities, and iron deficiency. Iron deficiency is associated with restless legs syndrome and periodic limb movement disorder. In this study, we assessed the prevalence of restless sleep disorder (RSD) and elevated periodic limb movements during sleep (PLMS) in children born prematurely who underwent polysomnography. Methods: A retrospective chart review of sleep studies was conducted in children aged 1\u201318 years (median age 4 years) with a history of premature birth. Children with genetic syndrome, airway surgery, or tracheostomy were excluded. Three groups were compared: children with PLMS index &gt;5, children with RSD, and children with neither elevated PLMS index nor RSD. Results: During the study, 2577 sleep studies were reviewed. Ninety-two studies fit our criteria and were included in the analysis. The median age at birth was 31 weeks, and the interquartile range (IQR) was 27\u201334 weeks. A total of 32 (34.8%) children were referred for restless sleep and 55 (59.8%) for snoring. After polysomnography, 18% were found to have a PLMS index &gt;5\/h, and 14% fit the criteria for restless sleep disorder (RSD). There were no statistically significant differences in PSG parameters among the children with RSD, PLMS, and the remaining group, except for lower obstructive apnea\/hypopnea index (Kruskal\u2013Wallis ANOVA 8.621, p = 0.0135) in the RSD group (median 0.7, IQR 0.3\u20130.9) than in the PLMS (median 1.7, IQR 0.7\u20133.5) or the non-RSD\/non-PLMS (median 2.0, IQR 0.8\u20134.5) groups. Conclusions: There was an elevated frequency of RSD and elevated PLMS in our cohort of children born prematurely. Children born prematurely are at higher risk of iron deficiency which can be a contributor factor to sleep -related movement disorders. These results add new knowledge regarding the prevalence of RSD and PLMS in these children.<\/jats:p>","DOI":"10.3390\/children11060658","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T07:38:39Z","timestamp":1716881919000},"page":"658","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Polysomnographically Defined Restless Sleep Disorder and Periodic Limb Movements during Sleep in Children Born Prematurely"],"prefix":"10.3390","volume":"11","author":[{"given":"Lourdes M.","family":"DelRosso","sequence":"first","affiliation":[{"name":"University of California San Francisco, 155 N. Fresno St, Fresno, CA 93701, USA"},{"name":"Seattle Childrens Hospital, Seattle, WA 98105, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hovig","family":"Artinian","sequence":"additional","affiliation":[{"name":"University of California San Francisco, 155 N. Fresno St, Fresno, CA 93701, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6662-2281","authenticated-orcid":false,"given":"Maria P.","family":"Mogavero","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, 20127 Milan, Italy"},{"name":"Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2207-1398","authenticated-orcid":false,"given":"Oliviero","family":"Bruni","sequence":"additional","affiliation":[{"name":"Department of Developmental and Social Psychology, Sapienza University, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manisha","family":"Witmans","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alberta, Edmonton, AB T6G 1C9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Anne","family":"Tablizo","sequence":"additional","affiliation":[{"name":"University of California San Francisco, 155 N. Fresno St, Fresno, CA 93701, USA"},{"name":"Department of Pediatrics, Division of Pediatric Pulmonary and Sleep Medicine, Stanford University, Palo Alto, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2124-7824","authenticated-orcid":false,"given":"Michelle","family":"Sobremonte-King","sequence":"additional","affiliation":[{"name":"Seattle Childrens Hospital, Seattle, WA 98105, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6937-3065","authenticated-orcid":false,"given":"Raffaele","family":"Ferri","sequence":"additional","affiliation":[{"name":"Sleep Research Centre, Department of Neurology IC, Oasi Research Institute-IRCCS, 94018 Troina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.siny.2018.09.001","article-title":"Epidemiology of late preterm and early term births\u2014An international perspective","volume":"24","author":"Delnord","year":"2019","journal-title":"Semin. Fetal Neonatal Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.puhe.2014.03.010","article-title":"Outcomes in preterm infants","volume":"128","author":"Platt","year":"2014","journal-title":"Public Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.clp.2017.01.003","article-title":"Long-Term Impact of Preterm Birth: Neurodevelopmental and Physical Health Outcomes","volume":"44","author":"Luu","year":"2017","journal-title":"Clin. Perinatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/S1474-4422(08)70073-5","article-title":"Preterm birth and the developing brain","volume":"7","author":"Ment","year":"2008","journal-title":"Lancet Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/S0140-6736(08)60380-3","article-title":"Neurodevelopmental disabilities and special care of 5-year-old children born before 33 weeks of gestation (the EPIPAGE study): A longitudinal cohort study","volume":"371","author":"Larroque","year":"2008","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s12519-019-00240-8","article-title":"Sleep and prematurity: Sleep outcomes in preterm children and influencing factors","volume":"15","author":"Gogou","year":"2019","journal-title":"World J. Pediatr. WJP"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"463","DOI":"10.3389\/fphys.2019.00463","article-title":"Iron Metabolism and Brain Development in Premature Infants","volume":"10","author":"Wang","year":"2019","journal-title":"Front. Physiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1542\/peds.2007-0540","article-title":"Very low birth weight increases risk for sleep-disordered breathing in young adulthood: The Helsinki Study of Very Low Birth Weight Adults","volume":"120","author":"Paavonen","year":"2007","journal-title":"Pediatrics"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.1093\/ije\/dyz075","article-title":"Preterm birth and risk of sleep-disordered breathing from childhood into mid-adulthood","volume":"48","author":"Crump","year":"2019","journal-title":"Int. J. Epidemiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e13813","DOI":"10.1111\/jsr.13813","article-title":"Periodic leg movements during sleep and iron status in infants with prematurity, Down syndrome and Prader\u2013Willi syndrome","volume":"32","author":"DelRosso","year":"2023","journal-title":"J. Sleep Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"zsab092","DOI":"10.1093\/sleep\/zsab092","article-title":"Scoring of large muscle group movements during sleep: An International Restless Legs Syndrome Study Group position statement","volume":"44","author":"Ferri","year":"2021","journal-title":"Sleep"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.sleep.2020.08.011","article-title":"Consensus diagnostic criteria for a newly defined pediatric sleep disorder: Restless sleep disorder (RSD)","volume":"75","author":"DelRosso","year":"2020","journal-title":"Sleep Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"101406","DOI":"10.1016\/j.smrv.2020.101406","article-title":"Restless sleep in children: A systematic review","volume":"56","author":"DelRosso","year":"2021","journal-title":"Sleep Med. Rev."},{"key":"ref_14","unstructured":"Berry, R.B., Quan, S.F., Abreu, A.R., Bibbs, M.L., DelRosso, L., Harding, S.M., Mao, M.-M., Plante, D.T., Pressman, M.R., and Troester, M.R. (2020). The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, Version 2.6, American Academy of Sleep Medicine."},{"key":"ref_15","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, Erlbaum. [2nd ed.]."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.sleep.2016.02.009","article-title":"Periodic limb movements and restless legs syndrome in children with a history of prematurity","volume":"30","author":"Cielo","year":"2017","journal-title":"Sleep Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"115","DOI":"10.5387\/fms.2022-21","article-title":"Risk factors for anemia of prematurity among 30-35-week preterm infants","volume":"69","author":"Kitaoka","year":"2023","journal-title":"Fukushima J. Med. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/BF03033574","article-title":"Brain iron deficiency and excess; cognitive impairment and neurodegeneration with involvement of striatum and hippocampus","volume":"14","author":"Youdim","year":"2008","journal-title":"Neurotox. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1038\/sj.jp.7211178","article-title":"Iron status and neurobehavioral development of premature infants","volume":"24","author":"Eidelman","year":"2004","journal-title":"J. Perinatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.jpeds.2007.12.047","article-title":"The quality of the early motor repertoire in preterm infants predicts minor neurologic dysfunction at school age","volume":"153","author":"Bruggink","year":"2008","journal-title":"J. Pediatr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1016\/j.sleep.2012.05.011","article-title":"Iron deficiency anemia in infancy exerts long-term effects on the tibialis anterior motor activity during sleep in childhood","volume":"13","author":"Peirano","year":"2012","journal-title":"Sleep Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e2018286","DOI":"10.1590\/1984-0462\/2020\/38\/2018286","article-title":"Predictive Value of the General Movements Assessment in Preterm Infants: A Meta-Analysis","volume":"38","author":"Pires","year":"2020","journal-title":"Rev. Paul. Pediatr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"zsad129","DOI":"10.1093\/sleep\/zsad129","article-title":"Large Muscle Group Movements during Sleep in Healthy People: Normative Values and Correlation to Sleep Features","volume":"46","author":"Ibrahim","year":"2023","journal-title":"Sleep"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1049219","DOI":"10.3389\/fnut.2023.1049219","article-title":"Anemia in pregnancy and sleep of 6-month-old infants: A prospective cohort study","volume":"10","author":"Zhang","year":"2023","journal-title":"Front. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.sleep.2004.01.012","article-title":"Dopamine and iron in the pathophysiology of restless legs syndrome (RLS)","volume":"5","author":"Allen","year":"2004","journal-title":"Sleep Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.sleep.2021.08.030","article-title":"Clinical efficacy and safety of intravenous ferric carboxymaltose treatment of pediatric restless legs syndrome and periodic limb movement disorder","volume":"87","author":"DelRosso","year":"2021","journal-title":"Sleep Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e29088","DOI":"10.7554\/eLife.29088","article-title":"The effect of perinatal brain injury on dopaminergic function and hippocampal volume in adult life","volume":"6","author":"Bloomfield","year":"2017","journal-title":"eLife"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.sleep.2021.10.025","article-title":"Morphological analysis of the brain subcortical gray structures in restless legs syndrome","volume":"88","author":"Mogavero","year":"2021","journal-title":"Sleep Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1097\/01.pep.0000229969.02895.d6","article-title":"Comparison of active motor items in infants born preterm and infants born full term","volume":"18","author":"Cameron","year":"2006","journal-title":"Pediatr. Phys. Ther."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1093\/cercor\/bhm180","article-title":"Mapping the early cortical folding process in the preterm newborn brain","volume":"18","author":"Dubois","year":"2008","journal-title":"Cereb. Cortex"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1002\/lary.29473","article-title":"Prematurity: A Prognostic Factor for Increased Severity of Pediatric Obstructive Sleep Apnea","volume":"131","author":"Jaleel","year":"2021","journal-title":"Laryngoscope"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2030","DOI":"10.1002\/lary.23999","article-title":"Children with a history of prematurity presenting with snoring and sleep-disordered breathing: A cross-sectional study","volume":"123","author":"Manuel","year":"2013","journal-title":"Laryngoscope"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.5664\/jcsm.6728","article-title":"Sleep Characteristics and Temperament in Preterm Children at Two Years of Age","volume":"13","author":"Caravale","year":"2017","journal-title":"J. Clin. Sleep Med. JCSM"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"5687","DOI":"10.1113\/JP274950","article-title":"Waking up too early\u2014The consequences of preterm birth on sleep development","volume":"596","author":"Bennet","year":"2018","journal-title":"J. Physiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"201","DOI":"10.5664\/jcsm.26819","article-title":"The visual scoring of sleep and arousal in infants and children","volume":"3","author":"Gozal","year":"2007","journal-title":"J. Clin. Sleep Med. JCSM"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/j.sleep.2010.11.011","article-title":"Normative values of polysomnographic parameters in childhood and adolescence: Quantitative sleep parameters","volume":"12","author":"Scholle","year":"2011","journal-title":"Sleep Med."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/6\/658\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:49:33Z","timestamp":1760107773000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/6\/658"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,28]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["children11060658"],"URL":"https:\/\/doi.org\/10.3390\/children11060658","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2024,5,28]]}}}