Daytime dysfunction in children with restless legs syndrome.

We investigated daytime dysfunction in children with restless legs syndrome (RLS) and the effects of treatment primarily with iron supplements on RLS symptoms and daytime dysfunction. We recruited 25 children with RLS (male:female=6:19, mean age at study onset: 12.3 years) for this prospective study, assessing their demographics, symptomatic characteristics, serum ferritin levels, and daytime functioning using the ADHD Rating Scale IV (ADHD-RS-IV), the Pediatric Symptom Checklist (PSC), and the Pediatric Quality of Life Inventory (PedsQL™). Children with RLS were compared with 28 controls (male:female=10:18, mean age: 13.2 years) on these measures, pre- and post-treatment. Before treatment, ADHD-RS-IV (all ps<0.05) and PSC scores (p<0.05) were significantly higher and PedsQL™ scores (all ps<0.05) significantly lower in the RLS group than in the control group. Eight and one of the RLS group had abnormally high PSC and ADHD-RS-IV scores, respectively. Following treatment, participants' daytime function had improved to levels similar to those of controls. Sixteen out of twenty-three cases were successfully treated primarily with iron supplement. Some children with RLS have daytime dysfunction; however, this can be treated with iron supplements.

The factors associated with preferences for napping and drinking coffee as countermeasures for sleepiness at the wheel among Japanese drivers.

OBJECTIVE: We explored differences between professional and non-professional drivers in terms of the factors associated with preferences for generally accepted, effective countermeasures for sleepiness at the wheel--i.e., napping and drinking coffee. METHODS: We performed a cross-sectional questionnaire survey. Data from professional (n = 716) and non-professional (n = 3365) drivers were used for analyses. RESULTS: The results showed that professional drivers experienced drowsy driving and traffic accidents due to falling asleep more often than non-professional drivers. Multiple logistic regression analyses showed that variables which may act as aggravating factors for sleepiness (i.e., engagement in shift-work and insufficient sleep) were associated with preferences for these countermeasures among non-professional drivers. In contrast, among professional drivers, being male and having experienced traffic accidents due to drowsy driving were associated with a preference for napping, while longer annual driving distances and shorter periods after the acquisition of driving licenses were associated with drinking coffee. CONCLUSION: Our results suggest that non-professional drivers are likely to take these effective countermeasures when they feel or have the potential to experience sleepiness at the wheel. However, this tendency was not observed in professional drivers, and it is speculated that they do not use naps as a countermeasure until they have experienced traffic accidents due to drowsy driving. Sleep education for professional drivers and their employers is desirable for preventing drowsy driving-related traffic accidents.

Possible mechanism of secondary narcolepsy with a long sleep time following surgery for craniopharyngioma.

A 19-year-old woman suffered from severe excessive daytime sleepiness accompanied with long sleep episodes both in the daytime and nighttime and frequent episodes of cataplexy shortly after the removal of craniopharyngioma in the intrasellar space. Multiple sleep latency test showed a typical finding of narcolepsy, and cerebrospinal fluid orexin concentration was below the narcolepsy cut-off value. MRI-tractography showed a clear lack of neuronal fiber connections from the hypothalamus to the frontal lobe. SPECT using (123)I-IMP showed frontal hypoperfusion. These connection damages could have been responsible for the occurrence of narcolepsy-like symptoms and long daytime sleep episodes in this case.