{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:56:23Z","timestamp":1785405383087,"version":"3.56.0"},"reference-count":54,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T00:00:00Z","timestamp":1726012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"BC Children\u2019s Hospital Research Foundation","award":["KRZ75155"],"award-info":[{"award-number":["KRZ75155"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Iron deficiency (ID) and restlessness are associated with sleep\/wake-disorders (e.g., restless legs syndrome (RLS)) and neurodevelopmental disorders (attention deficit\/hyperactivity and autism spectrum disorders (ADHD; ASD)). However, a standardized approach to assessing ID and restlessness is missing. We reviewed iron status and family sleep\/ID history data collected at a sleep\/wake behavior clinic under a quality improvement\/quality assurance project. Restlessness was explored through patient and parental narratives and a \u2018suggested clinical immobilization test\u2019. Of 199 patients, 94% had ID, with 43% having a family history of ID. ADHD (46%) and ASD (45%) were common conditions, along with chronic insomnia (61%), sleep-disordered breathing (50%), and parasomnias (22%). In unadjusted analysis, a family history of ID increased the odds (95% CI) of familial RLS (OR: 5.98, p = 0.0002, [2.35\u201315.2]), insomnia\/DIMS (OR: 3.44, p = 0.0084, [1.37\u20138.64]), and RLS (OR: 7.00, p = 0.01, [1.49\u201332.93]) in patients with ADHD, and of insomnia\/DIMS (OR: 4.77, p = 0.0014, [1.82\u201312.5]), RLS\/PLMS (OR: 5.83, p = 0.009, [1.54\u201322.1]), RLS (OR: 4.05, p = 0.01, [1.33\u201312.3]), and familial RLS (OR: 2.82, p = 0.02, [1.17\u20136.81]) in patients with ASD. ID and restlessness were characteristics of ADHD and ASD, and a family history of ID increased the risk of sleep\/wake-disorders. These findings highlight the need to integrate comprehensive blood work and family history to capture ID in children and adolescents with restless behaviors.<\/jats:p>","DOI":"10.3390\/nu16183064","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T03:55:17Z","timestamp":1726026917000},"page":"3064","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Iron Deficiency and Restless Sleep\/Wake Behaviors in Neurodevelopmental Disorders and Mental Health Conditions"],"prefix":"10.3390","volume":"16","author":[{"given":"Osman S.","family":"Ipsiroglu","sequence":"first","affiliation":[{"name":"H-Behaviours Research Lab, BC Children\u2019s Hospital Research Institute, University of British Columbia, Vancouver, BC V5Z 4H4, Canada"},{"name":"Sleep\/Wake-Behaviour Clinic, Sleep Program BC Children\u2019s Hospital, Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3N1, Canada"},{"name":"Divisions of Developmental Pediatrics, Child and Adolescent Psychiatry, and Respirology, BC Children\u2019s Hospital, Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parveer K.","family":"Pandher","sequence":"additional","affiliation":[{"name":"H-Behaviours Research Lab, BC Children\u2019s Hospital Research Institute, University of British Columbia, Vancouver, BC V5Z 4H4, Canada"},{"name":"Sleep\/Wake-Behaviour Clinic, Sleep Program BC Children\u2019s Hospital, Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Hill","sequence":"additional","affiliation":[{"name":"H-Behaviours Research Lab, BC Children\u2019s Hospital Research Institute, University of British Columbia, Vancouver, BC V5Z 4H4, Canada"},{"name":"Sleep\/Wake-Behaviour Clinic, Sleep Program BC Children\u2019s Hospital, Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1141-2775","authenticated-orcid":false,"given":"Scout","family":"McWilliams","sequence":"additional","affiliation":[{"name":"H-Behaviours Research Lab, BC Children\u2019s Hospital Research Institute, University of British Columbia, Vancouver, BC V5Z 4H4, Canada"},{"name":"Sleep\/Wake-Behaviour Clinic, Sleep Program BC Children\u2019s Hospital, Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Braschel","sequence":"additional","affiliation":[{"name":"Clinical Research Support Unit, BC Children\u2019s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Edwards","sequence":"additional","affiliation":[{"name":"Division of Child and Adolescent Psychiatry, BC Children\u2019s Hospital, Department of Psychiatry, University of British Columbia, Vancouver, BC V6H 3N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Friedlander","sequence":"additional","affiliation":[{"name":"Division of Child and Adolescent Psychiatry, BC Children\u2019s Hospital, Department of Psychiatry, University of British Columbia, Vancouver, BC V6H 3N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0251-0720","authenticated-orcid":false,"given":"Elizabeth","family":"Keys","sequence":"additional","affiliation":[{"name":"School of Nursing, University of British Columbia (Okanagan), Kelowna, BC V1V 1V7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8401-9136","authenticated-orcid":false,"given":"Calvin","family":"Kuo","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6300-5381","authenticated-orcid":false,"given":"Marion Suzanne","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"},{"name":"BC Children\u2019s Hospital Research Institute, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"},{"name":"Pacific Autism Family Network, Richmond, BC V7B 1C7, 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Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,11]]},"reference":[{"key":"ref_1","unstructured":"National Research Council (US) Committee on Diet and Health (1989). 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