Abstract
BACKGROUND: Restless sleep disorder (RSD) is a pediatric movement disorder characterized by frequent large muscle movements during sleep. This disorder leads to disrupted sleep architecture and significant daytime impairments. Research has compared RSD with other conditions, such as restless legs syndrome (RLS) and periodic limb movement disorder (PLMD), to emerge as a distinct diagnostic entity. OBJECTIVES: This review aims to educate clinicians about the prevalence, pathophysiology, diagnostic challenges, and treatment options for RSD. METHODS: A comprehensive literature synthesis focused on studies investigating the clinical presentation, polysomnographic features, and therapeutic interventions for RSD. RESULTS: RSD affects approximately 7.7% of children referred to sleep clinics. It is characterized by large muscle movements, subtle changes in cyclic alternating pattern (CAP) rates, and heightened sympathetic activation. Iron deficiency is central to pathophysiology, and video-polysomnography (vPSG) is critical for diagnosis. Therapeutic options include oral and intravenous iron supplementation, but pharmacological treatments are limited. CONCLUSIONS: RSD is a distinct and impactful disorder that requires increased clinical awareness. Future research should focus on biomarkers, therapeutic strategies, and long-term implications to improve management.