Isomura Kayoko, Sidorchuk Anna, Sevilla-Cermeño Laura, Åkerstedt Torbjörn, Silverberg-Morse Maria, Larsson Henrik, Mataix-Cols David, Fernández de la Cruz Lorena
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Mov Disord. 2022 Feb;37(2):392-400. doi: 10.1002/mds.28842. Epub 2021 Oct 24.
Insomnia is common in Tourette syndrome (TS) and chronic tic disorder (CTD), but precise prevalence estimates are lacking.
In this Swedish register-based cohort study, we estimated the prevalence of insomnia in TS/CTD and quantified the magnitude of this association, accounting for familial confounders and relevant somatic and psychiatric comorbidities.
Of 10,444,702 individuals living in Sweden during the period from 1997 to 2013, 5877 had a diagnosis of TS/CTD and were compared to unexposed individuals from the general population on the presence of insomnia using logistic regression models.
Individuals with TS/CTD had a period prevalence of insomnia of 32.16%, compared to 13.70% of the unexposed population. This translated into a 6.7-fold increased likelihood of insomnia in TS/CTD (odds ratio adjusted [aOR] for sex, birth year, birth country, and somatic disorders = 6.74; 95% confidence interval [CI], 6.37-7.15). A full sibling comparison, designed to adjust for shared familial factors, attenuated the estimates (aOR = 5.41; 95% CI, 4.65-6.30). When individuals with attention-deficit/hyperactivity disorder (ADHD) and pervasive developmental disorders were excluded, the association was also attenuated, whereas exclusion of other psychiatric comorbidities had minimal impact. Having persistent TS/CTD, comorbid ADHD, and taking ADHD medication greatly increased the likelihood of insomnia.
Insomnia is significantly associated with TS/CTD, independently from somatic disorders, familial factors or psychiatric comorbidities, although familial factors, neurodevelopmental comorbidities, and ADHD/ADHD medication may explain part of the association. Insomnia should be routinely assessed and managed in TS/CTD, particularly in chronic patients and in those with comorbid ADHD. Other sleep disorders require further study. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
失眠在抽动秽语综合征（TS）和慢性抽动障碍（CTD）中很常见，但缺乏精确的患病率估计。
在这项基于瑞典登记册的队列研究中，我们估计了TS/CTD中失眠的患病率，并量化了这种关联的程度，同时考虑了家族混杂因素以及相关的躯体和精神共病。
在1997年至2013年期间居住在瑞典的10444702人中，5877人被诊断为TS/CTD，并使用逻辑回归模型将其与来自普通人群的未暴露个体在失眠情况方面进行比较。
TS/CTD个体的失眠期间患病率为32.16%，而未暴露人群为13.70%。这意味着TS/CTD个体患失眠的可能性增加了6.7倍（根据性别、出生年份、出生国家和躯体疾病调整后的优势比[aOR]=6.74；95%置信区间[CI]，6.37 - 7.15）。旨在调整共享家族因素的全同胞比较使估计值减弱（aOR = 5.41；95% CI，4.65 - 6.30）。当排除注意力缺陷多动障碍（ADHD）和广泛性发育障碍个体时，这种关联也减弱了，而排除其他精神共病的影响最小。患有持续性TS/CTD、共病ADHD以及服用ADHD药物会大大增加失眠的可能性。
失眠与TS/CTD显著相关，独立于躯体疾病、家族因素或精神共病，尽管家族因素、神经发育共病以及ADHD/ADHD药物可能解释部分关联。在TS/CTD中应常规评估和管理失眠，特别是在慢性病患者以及共病ADHD的患者中。其他睡眠障碍需要进一步研究。© 2021作者。《运动障碍》由Wiley Periodicals LLC代表国际帕金森和运动障碍协会出版。
