Romano A, Cundari G, Bruni O, Cardona F
Dipartimento di Scienze Neurologiche e Psichiatriche dell'Età Evolutiva, Università degli Studi di Roma La Sapienza, Roma, Italy.
Minerva Pediatr. 2004 Jun;56(3):327-34.
Tourette Syndrome (TS) shows a significant comorbidity with obsessive-compulsive disorders, behavioral problems (i.e. attention-deficit/hyperactivity disorders) and sleep disturbances. Several studies showed that sleep problems are common in TS patients affecting 12% to 62% of patients. Aim of this study was to evaluate the relationships between tics, sleep disorders and behavioral disturbances.
Fourty-nine consecutive children and adolescents with tics have been studied by the following procedure: a) the Yale Global Tic Severity Scale (YGTSS) was administered in order to establish the severity of tics; b) the Child Behavior Checklist (CBCL) was used to evaluate behavioural disturbances; c) the Sleep Disturbance Scale for Children (SDSC) was filled out in order to assess the presence of sleep disorders. An age-matched control group was used for comparison.
All patients (either TS or non-TS) showed a higher prevalence of sleep disturbances versus the control group. Sleep-wake transition disorders (SWTD) were the most frequent sleep disturbances found in our sample, followed by disorders of initiating and maintaining sleep (DIMS). These latter sleep disturbances were highly correlated with the severity of tics. Internalization problems, anxiety/depression and attention and thinking problems were very frequent in our sample. Correlation analysis showed a positive relationship between internalization problems and DIMS and also between aggressive behaviour and respiratory disturbances during sleep (RDS).
The results obtained seem to confirm the literature reports on the strict relationship between tics and sleep disturbances, mainly SWTD, and further support the hypothesis of a dysfunction of arousal mechanism in TS.
抽动秽语综合征(TS)与强迫症、行为问题(如注意力缺陷多动障碍)和睡眠障碍有显著的共病关系。多项研究表明,睡眠问题在TS患者中很常见,影响12%至62%的患者。本研究的目的是评估抽动、睡眠障碍和行为障碍之间的关系。
对49名连续的抽动儿童和青少年进行了以下研究:a)采用耶鲁全球抽动严重程度量表(YGTSS)确定抽动的严重程度;b)使用儿童行为检查表(CBCL)评估行为障碍;c)填写儿童睡眠障碍量表(SDSC)以评估睡眠障碍的存在。使用年龄匹配的对照组进行比较。
所有患者(TS患者和非TS患者)的睡眠障碍患病率均高于对照组。睡眠-觉醒转换障碍(SWTD)是我们样本中最常见的睡眠障碍,其次是入睡和维持睡眠障碍(DIMS)。后一种睡眠障碍与抽动的严重程度高度相关。内化问题、焦虑/抑郁以及注意力和思维问题在我们的样本中非常常见。相关分析表明,内化问题与DIMS之间以及攻击行为与睡眠期间的呼吸障碍(RDS)之间存在正相关关系。
获得的结果似乎证实了文献中关于抽动与睡眠障碍(主要是SWTD)之间密切关系的报道,并进一步支持了TS患者觉醒机制功能障碍的假说。