Kostanecka-Endress Tatiana, Banaschewski Tobias, Kinkelbur Jörg, Wüllner Ina, Lichtblau Sigrid, Cohrs Stefan, Rüther Eckart, Woerner Wolfgang, Hajak Göran, Rothenberger Aribert
Child and Adolescent Psychiatry, University of Göttingen, von-Siebold-Str 5, D-37075 Göttingen, Germany.
J Psychosom Res. 2003 Jul;55(1):23-9. doi: 10.1016/s0022-3999(02)00602-5.
To evaluate objective data on sleep quantity/quality and motor activity during night sleep in children with Tourette syndrome (TS).
Polysomnography of 17 unmedicated TS children (ages: 7;11-15;5, mean: 11;10 years) without comorbid attention-deficit hyperactivity disorder (ADHD) was compared with 16 age-, sex- and IQ-matched healthy controls. Sleep analyses according to the procedure of Rechtschaffen and Kales were supplemented by counting epochs with short arousal-related movements (<or=15 s), thus allowing to calculate correlations between motor activity and sleep parameters.
Children with TS demonstrated changes in sleep parameters, including longer sleep period time, longer sleep latency, reduced sleep efficiency, and prolonged wakefulness after sleep onset. Their sleep profiles showed significantly more time awake and less sleep stage II. However, REM sleep variables, slow-wave sleep, and number of sleep stage changes were unaffected. Movement time was similar in both groups, but epochs with short arousal-related movements were increased in TS. Further analyses showed no significant correlations between sleep parameters and nighttime nontic movements, level of psychopathology or tic severity during daytime. Periodic limb movements during sleep (PLMS) were only seen in one TS patient (low PLMS index of 7.8/h).
Children with TS have disturbed sleep quality with increased arousal phenomena, which both may be intrinsic to the disorder and might trigger tics and other behavioral problems during daytime. This indicates the need for sleep evaluation in patients with TS.
评估抽动秽语综合征（TS）患儿夜间睡眠的睡眠量/质及运动活动的客观数据。
将17例未用药且无共病注意缺陷多动障碍（ADHD）的TS患儿（年龄：7岁11个月至15岁5个月，平均11岁10个月）的多导睡眠图与16例年龄、性别和智商匹配的健康对照者进行比较。根据 Rechtschaffen 和 Kales 的程序进行睡眠分析，并补充计算与觉醒相关的短运动（≤15秒）的时段数，从而能够计算运动活动与睡眠参数之间的相关性。
TS患儿表现出睡眠参数的变化，包括睡眠时间延长、睡眠潜伏期延长、睡眠效率降低以及睡眠开始后觉醒时间延长。他们的睡眠特征显示清醒时间显著增加，睡眠Ⅱ期减少。然而，快速眼动睡眠变量、慢波睡眠和睡眠阶段变化次数未受影响。两组的运动时间相似，但TS组与觉醒相关的短运动时段增加。进一步分析显示，睡眠参数与夜间非抽动性运动、精神病理学水平或白天抽动严重程度之间无显著相关性。仅在1例TS患者中观察到睡眠期周期性肢体运动（PLMS）（PLMS指数低，为7.8次/小时）。
TS患儿睡眠质量受到干扰，觉醒现象增加，这两者可能是该疾病固有的，并且可能在白天引发抽动和其他行为问题。这表明TS患者需要进行睡眠评估。
