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ISSN (Print): 1574-8855
ISSN (Online): 2212-3903

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Review Article

Sleep and Sleep Disorders in Tourette Syndrome: What is Known and What is Still Unknown

Author(s): Arie Oksenberg*

Volume 15, Issue 2, 2020

Page: [124 - 131] Pages: 8

DOI: 10.2174/1574885514666191121142555

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Abstract

Background: Most of the patients with Tourette Syndrome (TS) present additional comorbidities. Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive-Compulsive Disorder (OCD) are the most common. Sleep Disorder has been suggested also as common comorbidity.

Objective: To review the literature on sleep characteristics and sleep disorder in patients with Tourette Syndrome (TS), with emphasis on the contribution of specific co-morbidities to the severity of impaired sleep and life quality of the patients.

Results: In general, sleep problems are not frequent at the age when tics appear which are estimated to affect about 10 % of these children. In severe cases, tics appear in all sleep stages. In a large study, the prevalence of sleep problems was 17.8% but was 12 % in “TS-only” (9.4% in children and 7.5 in adults) compared to 22% in children and 18% in adults with TS+ADHD. Unfortunately, in most of the studies, the characteristics of these “sleep problems” are not defined. In spite of the scarcity of data, the two main sleep disorders in TS patients are insomnia and parasomnias. Although much more data is needed, many TS subjects are sleep deprived (which exacerbate the tics) and may suffer from excessive daytime sleepiness, which negatively affects normal functioning.

Conclusions: Although the literature is not conclusive, children and adolescents with TS appear to suffer more from sleep disturbances and sleep disorders than age-matched controls. Not all patients have tics during sleep, but in severe cases, tics may appear in all sleep stages. It is clear that when patients present both TS and ADHD, (a very common condition), the sleep difficulties are related mainly to ADHD. Much more research is warranted in all aspects of sleep and sleep disorders in TS.

Keywords: Tourette, tics, sleep, sleep disorders, motor disorders, neurology.

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Graphical Abstract

[1]
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing 2013.
[2]
Freeman RD, Fast DK, Burd L, Kerbeshian J, Robertson MM, Sandor P. An international perspective on Tourette syndrome: selected findings from 3,500 individuals in 22 countries. Dev Med Child Neurol 2000; 42(7): 436-47.
[http://dx.doi.org/10.1017/S0012162200000839 ] [PMID: 10972415]
[3]
Bloch MH, Leckman JF. Clinical course of Tourette syndrome. J Psychosom Res 2009; 67(6): 497-501.
[http://dx.doi.org/10.1016/j.jpsychores.2009.09.002] [PMID: 19913654]
[4]
Groth C, Mol Debes N, Rask CU, Lange T, Skov L. course of tourette syndrome and comorbidities in a large prospective clinical study. J Am Acad Child Adolesc Psychiatry 2017; 56(4): 304-12.
[http://dx.doi.org/10.1016/j.jaac.2017.01.010 ] [PMID: 28335874]
[5]
Ghosh D, Rajan PV, Das D, Datta P, Rothner AD, Erenberg G. Sleep disorders in children with Tourette syndrome. Pediatr Neurol 2014; 51(1): 31-5.
[http://dx.doi.org/10.1016/j.pediatrneurol.2014.03.017] [PMID: 24938137]
[6]
Kirov R, Becker A, Rothenberger A. Sleep in Tourette syndrome. Curr Dev Disord Rep 2014; 1: 252-9.
[http://dx.doi.org/10.1007/s40474-014-0028-0]
[7]
Allen RP, Singer HS, Brown JE, Salam MM. Sleep disorders in Tourette syndrome: a primary or unrelated problem? Pediatr Neurol 1992; 8(4): 275-80.
[http://dx.doi.org/10.1016/0887-8994(92)90365-6 ] [PMID: 1388416]
[8]
Budman CL, Bruun RD, Park KS, Olson ME. Rage attacks in children and adolescents with Tourette’s disorder: a pilot study. J Clin Psychiatry 1998; 59(11): 576-80.
[http://dx.doi.org/10.4088/JCP.v59n1103] [PMID: 9862602]
[9]
Freeman RD. Tic disorders and ADHD: answers from a world-wide clinical dataset on Tourette syndrome. Eur Child Adolesc Psychiatry 2007; 16(Suppl. 1): 15-23.
[http://dx.doi.org/10.1007/s00787-007-1003-7]
[10]
Lee WT, Huang HL, Wong LC, et al. Tourette syndrome as an independent risk factor for subsequent sleep disorders in children: a nationwide population-based case-control study. Sleep 2017; 40(3) doi: 10.1093/sleep/zsw072
[http://dx.doi.org/10.1093/sleep/zsw072] [PMID: 28364427]
[11]
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(2): 192-7.
[http://dx.doi.org/10.1136/jnnp.70.2.192] [PMID: 11160467]
[12]
Glaze DG, Frost JD Jr, Jankovic J. Sleep in Gilles de la Tourette’s syndrome: disorder of arousal. Neurology 1983; 33(5): 586-92.
[http://dx.doi.org/10.1212/WNL.33.5.586] [PMID: 6573576]
[13]
Mendelson WB, Caine ED, Goyer P, Ebert M, Gillin JC. Sleep in Gilles de la Tourette syndrome. Biol Psychiatry 1980; 15(2): 339-43.
[PMID: 6932227]
[14]
Ziemann U, Paulus W, Rothenberger A. Decreased motor inhibition in Tourette’s disorder: evidence from transcranial magnetic stimulation. Am J Psychiatry 1997; 154(9): 1277-84.
[http://dx.doi.org/10.1176/ajp.154.9.1277] [PMID: 9286189]
[15]
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(6): 561-70.
[http://dx.doi.org/10.1111/j.1469-7610.2007.01729.x] [PMID: 17537072]
[16]
Stephens RJ, Chung SA, Jovanovic D, et al. Relationship between polysomnographic sleep architecture and behavior in medication-free children with TS, ADHD, TS and ADHD, and controls. J Dev Behav Pediatr 2013; 34(9): 688-96.
[http://dx.doi.org/10.1097/DBP.0000000000000012 ] [PMID: 24247912]
[17]
Silvestri R, Raffaele M, De Domenico P, et al. Sleep features in Tourette’s syndrome, neuroacanthocytosis and Huntington’s chorea. Neurophysiol Clin 1995; 25(2): 66-77.
[http://dx.doi.org/10.1016/0987-7053(96)81034-3 ] [PMID: 7603414]
[18]
Kostanecka-Endress T, Banaschewski T, Kinkelbur J, et al. Disturbed sleep in children with Tourette syndrome: a polysomnographic study. J Psychosom Res 2003; 55(1): 23-9.
[http://dx.doi.org/10.1016/S0022-3999(02)00602-5 ] [PMID: 12842228]
[19]
Ricketts EJ, Rozenman M, Choy C, et al. Sleep sufficiency in pediatric and adolescent Tourette’s disorder: National survey of children’s health. J Dev Behav Pediatr 2018; 39(1): 72-6.
[PMID: 29095747]
[20]
Asarnow LD, McGlinchey E, Harvey AG. The effects of bedtime and sleep duration on academic and emotional outcomes in a nationally representative sample of adolescents. J Adolesc Health 2014; 54(3): 350-6.
[http://dx.doi.org/10.1016/j.jadohealth.2013.09.004 ] [PMID: 24225447]
[21]
Lo JC, Lee SM, Teo LM, Lim J, Gooley JJ, Chee MW. Neurobehavioral impact of successive cycles of sleep restriction with and without naps in adolescents. Sleep 2017; 40(2) 10.1093/sleep/zsw042.
[http://dx.doi.org/10.1093/sleep/zsw042] [PMID: 28364507]
[22]
Jankovic J, Rohaidy H. Motor, behavioral and pharmacologic findings in Tourette’s syndrome. Can J Neurol Sci 1987; 14(3): 541-6.
[http://dx.doi.org/10.1017/S0317167100038087] [PMID: 2890426]
[23]
Meltzer LJ, Johnson C, Crosette J, Ramos M, Mindell JA. Prevalence of diagnosed sleep disorders in pediatric primary care practices. Pediatrics 2010; 125(6): e1410-8.
[http://dx.doi.org/10.1542/peds.2009-2725 ] [PMID: 20457689]
[24]
Modafferi S, Stornelli M, Chiarotti F, Cardona F, Bruni O. Sleep, anxiety and psychiatric symptoms in children with Tourette syndrome and tic disorders. Eur J Paediatr Neurol 2016; 20(5): 696-703.
[http://dx.doi.org/10.1016/j.ejpn.2016.05.003 ] [PMID: 27228790]
[25]
Barabas G, Matthews WS, Ferrari M. Somnambulism in children with Tourette syndrome. Dev Med Child Neurol 1984; 26(4): 457-60.
[http://dx.doi.org/10.1111/j.1469-8749.1984.tb04471.x] [PMID: 6148287]
[26]
Comings DE, Comings BG. A controlled study of Tourette syndrome. VI. Early development, sleep problems, allergies, and handedness. Am J Hum Genet 1987; 41(5): 822-38.
[PMID: 3479017]
[27]
Champion LM, Fulton WA, Shady GA. Tourette syndrome and social functioning in a Canadian population. Neurosci Biobehav Rev 1988; 12(3-4): 255-7.
[http://dx.doi.org/10.1016/S0149-7634(88)80054-X] [PMID: 3226650]
[28]
de Almeida CMO, Pachito DV, Sobreira-Neto MA, Tumas V, Eckeli AL. Pharmacological treatment for REM sleep behavior disorder in Parkinson disease and related conditions: A scoping review. J Neurol Sci 2018; 393: 63-8.
[http://dx.doi.org/10.1016/j.jns.2018.08.008 ] [PMID: 30118919]
[29]
Stores G. Rapid eye movement sleep behaviour disorder in children and adolescents. Dev Med Child Neurol 2008; 50(10): 728-32.
[http://dx.doi.org/10.1111/j.1469-8749.2008.03071.x] [PMID: 18834385]
[30]
Trajanovic NN, Shapiro CM, Sandor P. REM sleep behavior disorder in patients with Tourette’s syndrome. Sleep Res 1997; 26: 524.
[31]
Trajanovic NN, Voloh I, Shapiro CM, Sandor P. REM sleep behaviour disorder in a child with Tourette’s syndrome. Can J Neurol Sci 2004; 31(4): 572-5.
[http://dx.doi.org/10.1017/S031716710000384X ] [PMID: 15595270]
[32]
Picchietti DL, Bruni O, de Weerd A, et al. International Restless Legs Syndrome Study Group (IRLSSG). Pediatric restless legs syndrome diagnostic criteria: An update by the international restless legs syndrome study group. Sleep Med 2013; 14(12): 1253-9.
[http://dx.doi.org/10.1016/j.sleep.2013.08.778 ] [PMID: 24184054]
[33]
Voderholzer U, Müller N, Haag C, Riemann D, Straube A. Periodic limb movements during sleep are a frequent finding in patients with Gilles de la Tourette’s syndrome. J Neurol 1997; 244(8): 521-6.
[http://dx.doi.org/10.1007/s004150050136] [PMID: 9309560]
[34]
Lipinski JF, Sallee FR, Jackson C, Sethuraman G. Dopamine agonist treatment of Tourette disorder in children: results of an open-label trial of pergolide. Mov Disord 1997; 12(3): 402-7.
[http://dx.doi.org/10.1002/mds.870120320] [PMID: 9159736]
[35]
Peterson BS, Gore JC, Riddle MA, Cohen DJ, Leckman JF. Abnormal magnetic resonance imaging T2 relaxation time asymmetries in Tourette’s syndrome. Psychiatry Res 1994; 55(4): 205-21.
[http://dx.doi.org/10.1016/0925-4927(94)90015-9] [PMID: 7701035]
[36]
Cortese S, Lecendreux M, Bernardina BD, Mouren MC, Sbarbati A, Konofal E. Attention-deficit/hyperactivity disorder, Tourette’s syndrome, and restless legs syndrome: the iron hypothesis. Med Hypotheses 2008; 70(6): 1128-32.
[http://dx.doi.org/10.1016/j.mehy.2007.10.013] [PMID: 18164140]
[37]
Allen RP, Barker PB, Wehrl FW, Song HK, Earley CJ. MRI measurement of brain iron in patients with restless legs syndrome. Neurology 2001; 56(2): 263-5.
[http://dx.doi.org/10.1212/WNL.56.2.263] [PMID: 91116096]
[38]
Ghosh D, Burkman E. Relationship of serum ferritin level and tic severity in children with Tourette syndrome. Childs Nerv Syst 2017; 33(8): 1373-8.
[http://dx.doi.org/10.1007/s00381-017-3424-z] [PMID: 28470381]
[39]
Murphy TK, Lewin AB, Storch EA, Stock S. American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI). Practice parameter for the assessment and treatment of children and adolescents with tic disorders. J Am Acad Child Adolesc Psychiatry 2013; 52(12): 1341-59.
[http://dx.doi.org/10.1016/j.jaac.2013.09.015 ] [PMID: 24290467]
[40]
McGuire JF, Piacentini J, Brennan EA, et al. A meta-analysis of behavior therapy for Tourette Syndrome. J Psychiatr Res 2014; 50: 106-12.
[http://dx.doi.org/10.1016/j.jpsychires.2013.12.009] [PMID: 24398255]

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