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J Dev Behav Pediatr. 2013 Nov-Dec;34(9):688-96. doi: 10.1097/DBP.0000000000000012.

Relationship between polysomnographic sleep architecture and behavior in medication-free children with TS, ADHD, TS and ADHD, and controls.

Author information

  • 1*Youthdale Treatment Centres, Toronto, ON, Canada; †Department of Psychiatry, University of Toronto, Toronto, ON, Canada; ‡Youthdale Child and Adolescent Sleep Centre, Toronto, ON, Canada; §Tourette's Syndrome Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada; ‖Department of Psychiatry, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.

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.

PMID:
24247912
[PubMed - in process]
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