Advertisement

Sleep Disorders in Children With Tourette Syndrome

      Abstract

      Background

      The objective of this study was to determine the frequency, nature, and impact of sleep disorders in children and adolescents with Tourette syndrome and to raise awareness about their possible inclusion as a Tourette syndrome comorbidity.

      Methods

      Using a prospective questionnaire, we interviewed 123 patients of age ≤21 years with a confirmed diagnosis of Tourette syndrome. Each completed questionnaire was then reviewed in accordance with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria for categorization to a form of sleep disorder.

      Results

      Of the 123 patients with Tourette syndrome, 75 (61%) had comorbid attention deficit hyperactivity disorder and 48 (39%) had Tourette without attention deficit hyperactivity disorder. The sleep problems observed included problems in the nature of sleep, abnormal behaviors during sleep, and impact of sleep disturbances on quality of life. Within these cohorts, 31 (65%) of the 48 Tourette-only patients and 48 (64%) of the 75 Tourette + attention deficit hyperactivity disorder patients could fit into some form of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, coded sleep disorders. Of the 48 Tourette + attention deficit hyperactivity disorder patients with sleep disorders, 36 (75%) had insomnia signs, which could be explained by the co-occurrence of attention deficit hyperactivity disorder and high stimulant use. However, 10 (32%) of the 31 Tourette-only patients with sleep disorders had insomnia irrespective of attention deficit hyperactivity disorder or medication use.

      Conclusions

      Sleep problems are common in children with Tourette syndrome irrespective of comorbid attention deficit hyperactivity disorder, justifying their inclusion as a comorbidity of Tourette syndrome.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Pediatric Neurology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • American Psychiatric Association
        Diagnostic and statistical manual of mental disorders.
        5th ed. American Psychiatric Publishing, Arlington, VA2013
        • Freeman R.D.
        • Tourette Syndrome International Database Consortium
        Tic disorders and ADHD: answers from a world-wide clinical dataset on Tourette syndrome.
        Eur Child Adolesc Psychiatry. 2007; 16: 15-23
        • Mol Debes N.M.
        • Hjalgrim H.
        • Skov L.
        Validation of the presence of comorbidities in a Danish clinical cohort of children with Tourette syndrome.
        J Child Neurol. 2008; 23: 1017-1027
        • Srour M.
        • Lespérance P.
        • Richer F.
        • Chouinard S.
        Psychopharmacology of tic disorders.
        J Can Acad Child Adolesc Psychiatry. 2008; 17: 150-159
        • Robertson M.M.
        Mood disorders and Gilles de la Tourette's syndrome: an update on prevalence, etiology, comorbidity, clinical associations, and implications.
        J Psychosom Res. 2006; 61: 349-358
        • Jankovic J.
        • Rohaidy H.
        Motor, behavioral and pharmacologic findings in Tourette's syndrome.
        Can J Neurol Sci. 1987; 14: 541-546
        • Allen R.P.
        • Singer H.S.
        • Brown J.E.
        • Salam M.M.
        Sleep disorders in Tourette syndrome: a primary or unrelated problem?.
        Pediatr Neurol. 1992; 8: 275-280
        • Kostanecka-Endress T.
        • Banaschewski T.
        • Kinkelbur J.
        • et al.
        Disturbed sleep in children with Tourette syndrome: a polysomnographic study.
        J Psychosom Res. 2003; 55: 23-29
        • Kirov R.
        • Kinkelbur J.
        • Banaschewski T.
        • Rothenberger A.
        Sleep patterns in children with attention-deficit/hyperactivity disorder, tic disorder, and comorbidity.
        J Child Psychol Psychiatry. 2007; 48: 561-570
        • Taylor E.
        Sleep and tics: problems associated with ADHD.
        J Am Acad Child Adolesc Psychiatry. 2009; 48: 877-878
        • Trajanovic N.N.
        • Voloh I.
        • Shapiro C.M.
        • Sandor P.
        REM sleep behaviour disorder in a child with Tourette's syndrome.
        Can J Neurol Sci. 2004; 31: 572-575
        • Stein M.A.
        • Mendelsohn J.
        • Obermeyer W.H.
        • Amromin J.
        • Benca R.
        Sleep and behavior problems in school-aged children.
        Pediatrics. 2001; 107: E60
        • Ohayon M.M.
        • Roberts R.E.
        • Zulley J.
        • Smirne S.
        • Priest R.G.
        Prevalence and patterns of problematic sleep among older adolescents.
        J Am Acad Child Adolesc Psychiatry. 2000; 39: 1549-1556
        • Meltzer L.J.
        • Johnson C.
        • Crosette J.
        • Ramos M.
        • Mindell J.A.
        Prevalence of Diagnosed Sleep Disorders in Pediatric Primary Care Practices.
        Pediatrics. 2010; 125: e1410-e1418
        • Erenberg G.
        The relationship between Tourette syndrome, attention deficit hyperactivity disorder, and stimulant medication: a critical review.
        Semin Pediatr Neurol. 2005; 12: 217-221
        • Overeem S.
        • van Nues S.J.
        • van der Zande W.L.
        • Donjacour C.E.
        • van Mierlo P.
        • Lammers G.J.
        The clinical features of cataplexy: a questionnaire study in narcolepsy patients with and without hypocretin-1 deficiency.
        Sleep Med. 2011; 12: 12-18
        • Stores G.
        Practitioner review: assessment and treatment of sleep disorders in children and adolescents.
        J Child Psychol Psychiatry. 1996; 37: 907-925
        • Cohrs S.
        • Rasch T.
        • Altmeyer S.
        • et al.
        Decreased sleep quality and increased sleep related movements in patients with Tourette's syndrome.
        J Neurol Neurosurg Psychiatry. 2001; 70: 192-197
        • Arana-Lechuga Y.
        • Sanchez-Escandón O.
        • de Santiago-Treviño N.
        • Castillo-Montoya C.
        • Terán-Pérez G.
        • Velázquez-Moctezuma J.
        Risperidone treatment of sleep disturbances in Tourette's syndrome.
        J Neuropsychiatry Clin Neurosci. 2008; 20: 375-376
        • Rivière J.B.
        • Xiong L.
        • Levchenko A.
        • et al.
        Association of intronic variants of the BTBD9 gene with Tourette syndrome.
        Arch Neurol. 2009; 66: 1267-1272
        • Chervin R.D.
        • Hedger K.
        • Dillon J.E.
        • Pituch K.J.
        Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problem.
        Sleep Med. 2000; 1: 21-32