Sleep disturbances in children and adolescents with iron deficiency: Questionnaire-based and actigraphic findings.
Level 4 - case-series / case-control
Single-center observational study comparing pediatric patients against historical control datasets with an uncontrolled follow-up subgroup
PubMed 42456436 · doi:10.1016/j.sleep.2026.109131
What was done
In a single-center pilot observational study, 31 children with iron deficiency (with or without anemia) underwent clinical and laboratory assessment alongside caregiver-reported sleep evaluation using the Sleep Disturbance Scale for Children (SDSC) and restless legs syndrome (RLS)-oriented items. Sixteen completed home actigraphy, and 8 had follow-up assessments after routine iron treatment. Baseline findings were compared with historical datasets of healthy controls without reported sleep disturbances.
What was found
Compared with healthy controls, the iron-deficient group had higher SDSC total scores (43.97 ± 9.63 vs 34.61 ± 7.50; p < 0.001), with significant elevations in difficulty initiating and maintaining sleep, sleep-wake transition disorders, and sleep hyperhidrosis subscales. Plausible RLS-related symptoms occurred in 10 of 31 children (32.25%). Actigraphy demonstrated shorter sleep duration, lower sleep efficiency, longer wake after sleep onset, and greater fragmentation (exact numerical values not reported). Parent-reported restlessness improved following iron treatment, but actigraphic parameters showed only partial normalization.
Why it matters
This study provides objective and subjective evidence connecting pediatric iron deficiency to restless and fragmented sleep, supporting routine sleep evaluation and iron-status screening in affected children.
Limits
The sample size was very small (n = 31 total, n = 16 for actigraphy, n = 8 for post-treatment follow-up). The study used historical controls rather than concurrent controls, iron status was unknown for the questionnaire control group, and the treatment phase lacked a control arm.
Cited by
- supports Low iron or ferritin levels cause sleep disruption.