Article2013

Relationship Between Polysomnographic Sleep Architecture and Behavior in Medication-free Children with TS, ADHD, TS and ADHD, and Controls

Robyn J. Stephens · Sharon A. Chung · Paul Sandor · Colin Michael Shapiro

47 citations0/0 files storedJournal of Developmental & Behavioral Pediatrics

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Abstract

OBJECTIVE: To describe the relationship between sleep architecture and behavioral measures in unmedicated children and adolescents with Tourette syndrome (TS), attention-deficit hyperactivity disorder (ADHD), TS and comorbid ADHD (TS + ADHD), and healthy controls. The study also set out to examine differences in sleep architecture with each diagnosis. METHOD: A cross-sectional, 2-night consecutive polysomnographic sleep study was conducted in 90 children. All participants were matched for age, gender, and level of intelligence. RESULTS: Scores on the Child Behavior Checklist delinquency measure were modestly but significantly correlated with the number of movements during REM sleep (r = .36, p = .003). Significant correlations were also noted among the number of total arousals and arousals from slow wave sleep (SWS), and scores on the measures of conduct disorder, hyperactivity/immaturity, and restless/disorganized behaviors. There were a few significant differences in sleep architecture among the diagnostic groups. The ADHD-only group exhibited a significantly higher number of total arousals (p < .01) and arousals from SWS (p < .01) compared with the other three study groups. DISCUSSION: Our findings indicate that children with TS and/or ADHD and who have more arousals from sleep are significantly more likely to have issues with conduct disorder, hyperactivity/immaturity, and restless/disorganized behavior. It was also noted that having ADHD, alone or comorbid with TS, is associated with a significantly greater number of movements during both non-REM and REM sleep. This study underscores the compelling need for the diagnosis and treatment of any sleep disorders in children with TS and/or ADHD so as to facilitate better management of problem behaviors.

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References

1989The Yale Global Tic Severity Scale: Initial Testing of a Clinician-Rated Scale of Tic Severity 2000An international perspective on Tourette syndrome: selected findings from 3500 individuals in 22 countries 2005The ADHD and Sleep Conundrum 2007Tic disorders and ADHD: answers from a world-wide clinical dataset on Tourette syndrome 2012Impact of Sleep Extension and Restriction on Children’s Emotional Lability and Impulsivity 2006Sleep in children with attention-deficit hyperactivity disorder: A meta-analysis of polysomnographic studies 2007Sleep patterns in children with attention‐deficit/hyperactivity disorder, tic disorder, and comorbidity 2001Decreased sleep quality and increased sleep related movements in patients with Tourette's syndrome

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