School of Psychology, University College Dublin, Ireland.
Department of Psychology, Maynooth University, Ireland.
Sleep Med. 2024 Jan;113:313-327. doi: 10.1016/j.sleep.2023.11.1137. Epub 2023 Dec 9.
There is increasing recognition of the high prevalence of sleep issues in children with Tourette syndrome (TS), a condition characterised by motor and vocal tics. Overnight polysomnography (PSG) has been the primary mode of sleep assessment in the TS literature, despite the extensive use of actigraphy in other neurodevelopmental populations. As a result, there are existing research gaps surrounding day-to-day variability of sleep in TS and links to daytime functioning. This study adopts a naturalistic, intensive longitudinal design to examine sleep in children with TS while considering potential links to tic severity and daytime functioning. Participants were 34 children aged between 8 and 12 years (12 with TS, 22 neurotypical controls). Wrist actigraphs tracked sleep-wake cycles across two weeks and a battery of scales and cognitive assessments measured sleep disturbances and daytime functioning. Mixed models using N = 476 nights of actigraphy data found that relative to controls, children with TS had significantly increased time in bed, increased sleep onset latency, reduced sleep efficiency, lower subjective sleep quality, but comparable actual sleep time. Higher self-report tic severity at bedtime did not predict increased sleep onset latency. In the sleep disturbance scale, 83.33 % of children with TS met the clinical cut-off for a sleep disorder. Parent-report emotional, behavioural, and executive difficulties were greater in the TS group relative to controls, but performance on cognitive tasks was comparable between groups. Together, findings highlight sleep disturbances as an important clinical factor to consider in the management of TS, though further research is required to substantiate findings in larger-scale studies. This study demonstrates the feasibility of assessing sleep via actigraphy in children with TS, supporting more widespread use in the future.
越来越多的人认识到抽动秽语综合征（TS）儿童中睡眠问题的高发率，这种疾病的特征是运动和发声抽搐。尽管在其他神经发育人群中广泛使用活动记录仪，但 overnight polysomnography（PSG）一直是 TS 文献中睡眠评估的主要模式。因此，围绕 TS 中睡眠的日常可变性以及与白天功能的联系，存在现有的研究空白。本研究采用自然主义、密集纵向设计来检查 TS 儿童的睡眠情况，同时考虑到 tic 严重程度和白天功能的潜在联系。参与者为 34 名 8 至 12 岁的儿童（12 名患有 TS，22 名神经典型对照）。腕部活动记录仪在两周内跟踪睡眠-觉醒周期，一系列量表和认知评估测量睡眠障碍和白天功能。使用 N=476 晚活动记录仪数据的混合模型发现，与对照组相比，患有 TS 的儿童在床上的时间明显增加，入睡潜伏期延长，睡眠效率降低，主观睡眠质量下降，但实际睡眠时间相当。睡前自我报告的 tic 严重程度越高，入睡潜伏期越长。在睡眠障碍量表中，83.33%的 TS 儿童达到了睡眠障碍的临床临界值。与对照组相比，TS 组的父母报告情绪、行为和执行困难更大，但两组在认知任务上的表现相当。总之，研究结果强调了睡眠障碍是 TS 管理中一个重要的临床因素，尽管需要进一步的大规模研究来证实这些发现。本研究证明了在 TS 儿童中通过活动记录仪评估睡眠的可行性，支持未来更广泛的应用。
