ferritin and sleep disturbance

we are experimenting with display styles that make it easier to read articles in pmc. you may notice problems with the display of certain parts of an article in other ereaders. ingram dg, al-shawwa b. serum ferritin in the pediatric sleep clinic: what’s normal anyway? we read with great interest the study by dr. rosen and colleagues in a recent issue of the journal of clinical sleep medicine.1 they examined the effect of iron therapy in children who had restless legs syndrome (rls) and serum ferritin levels less than 50 ng/ml (which they defined as biochemical evidence of iron deficiency). in pediatric sleep medicine, we routinely measure serum ferritin levels as a surrogate of iron stores in the body when assessing children with rls, periodic limb movement disorder (plmd), or simply self-reported restless sleepers.2 this last category is also an area of active research, with dr. delrosso characterizing a proposed new diagnostic category of “restless sleep disorder,”3 in which children who do not qualify for the diagnosis of rls/plmd but who have self-reported restless sleep and daytime consequences may respond to iron supplementation. so, are children who present to a pediatric sleep center actually different in terms of their ferritin levels compared to those children in the general population?




these levels correspond very closely to general population levels found in national surveys,4 as astutely mentioned in dr. rosen’s introduction. clearly, if we were to define iron deficiency as less than 50 ng/ml, most children in the united states would fall into that category. one possibility is serum ferritin does not accurately reflect brain iron stores, and therefore will not reflect the resulting symptoms. this is supported by prior studies demonstrating significant differences in cerebrospinal fluid ferritin level but not in serum ferritin levels between adults with or without rls.5,6 finally, we suggest care be taken with the terminology we use when discussing ferritin levels with our patients and families. although following a serum ferritin level in a given patient with rls/plmd may be helpful to ensure that they are not becoming iron overloaded with supplementation, the data do not substantiate it as a predictor of clinical improvement. all authors have seen and approved the final manuscript. otherwise, the authors have no financial interests or conflicts of interested relevant to this manuscript.

as a sleep coach, i often see clients only after they have tried everything under the sun with no luck. a third client had a 7-month-old who couldn’t tolerate not nursing through the entire night and would scream if mom even tried to move away or unlatch. ferritin refers to the iron storage capacity in the blood. some children start off with potentially lower levels of ferritin as a result of gestation, early cord clamping, or other physiological issues that can reduce how iron is absorbed by the gut. when ferritin starts to run low, it causes a cascade of effects in the body. older children with rls will say that their legs feel “twitchy” or “jumpy” and they can’t get comfortable. low ferritin makes bedtime and nighttime incredibly difficult. we think a child just can’t settle, but in fact, they are really and truly desperately uncomfortable. in infants and toddlers, we only have behaviors to go on. [children in a bed] they take a long time to go to sleep.

as a parent, it seems like they just can’t get comfortable. (i.e., baby screams if nursing stops or parent tries to move away) if your child has a food intolerance (e.g., milk, wheat), they may be more prone to low ferritin since gut inflammation can hinder iron absorption. mom had low iron in pregnancy or either parent had a history of low iron/ferritin or either parent has restless legs syndrome. the usual lower threshold for “normal” ferritin is considered too low when it comes to sleep. if your child is having significant sleep issues and the score comes back on what the pediatrician might say is “the lower end of normal,” consult a sleep doctor to be sure. ferritin levels can take months to come up to the higher threshold, however, you should see improvement in sleep behaviors within a few weeks. iron’s role in paediatric restless legs syndrome: a review. sleep alterations and iron deficiency anemia in infancy. early manifestations of restless legs syndrome in childhood and adolescence. sleep medicine, 9(7), 770–781.

in pediatric sleep medicine, we routinely measure serum ferritin levels as a surrogate of iron stores in the body when assessing children low ferritin and sleep problems can cause issues in children and sleep. if you suspect this is why your child isn’t sleeping, read this! conclusions. sleep problems are common, and this study suggests an association between low serum ferritin levels and sleep disturbances., related symptoms, related symptoms, related conditions, low ferritin and sleep apnea, iron deficiency and sleep problems.

serum ferritin levels were inversely correlated to swtd scores (p = 0.043). conclusion: serum ferritin levels <45 microg/l might indicate a risk for sleep wake transition disorders, including abnormal sleep movements, in children with adhd. common ones include insomnia, narcolepsy, sleep apnea, low ferritin levels (a protein used to carry iron in the blood) have also been serum ferritin levels <45 µg/l might indicate a risk for sleep wake transition disorders, including abnormal sleep movements, in children with our study shows that 54.5% of children is our sleep center respond to oral iron supplementation with improvement in ferritin levels. responders were found to, ferritin baby sleep, ferritin low, how much sleep does an anemic person need, low ferritin symptoms, what is considered a dangerously low ferritin level, ferritin level in child, iron deficiency in toddlers and sleep, low ferritin anxiety, iron for insomnia, ferritin supplement.

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