title: Sleep disorders in children with Tourette syndrome.
abstract: BACKGROUND
  The objective of this study was to determine the frequency, nature, and impact of sleep disorders in children and adolescents with Tourette syndrome and to raise awareness about their possible inclusion as a Tourette syndrome comorbidity.
  
  
  METHODS
  Using a prospective questionnaire, we interviewed 123 patients of age ≤21 years with a confirmed diagnosis of Tourette syndrome. Each completed questionnaire was then reviewed in accordance with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria for categorization to a form of sleep disorder.
  
  
  RESULTS
  Of the 123 patients with Tourette syndrome, 75 (61%) had comorbid attention deficit hyperactivity disorder and 48 (39%) had Tourette without attention deficit hyperactivity disorder. The sleep problems observed included problems in the nature of sleep, abnormal behaviors during sleep, and impact of sleep disturbances on quality of life. Within these cohorts, 31 (65%) of the 48 Tourette-only patients and 48 (64%) of the 75 Tourette + attention deficit hyperactivity disorder patients could fit into some form of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, coded sleep disorders. Of the 48 Tourette + attention deficit hyperactivity disorder patients with sleep disorders, 36 (75%) had insomnia signs, which could be explained by the co-occurrence of attention deficit hyperactivity disorder and high stimulant use. However, 10 (32%) of the 31 Tourette-only patients with sleep disorders had insomnia irrespective of attention deficit hyperactivity disorder or medication use.
  
  
  CONCLUSIONS
  Sleep problems are common in children with Tourette syndrome irrespective of comorbid attention deficit hyperactivity disorder, justifying their inclusion as a comorbidity of Tourette syndrome.
authors.affiliation: Division of Pediatric Neurology, Nationwide Children's Hospital, Columbus, Ohio. Electronic address: Debabrata.ghosh@nationwidechildrens.org.
authors.forename: Debabrata
authors.initials: D
authors.lastname: Ghosh
authors.affiliation: Harvard Medical School, Boston, Massachusetts.
authors.forename: Prashant V
authors.initials: PV
authors.lastname: Rajan
authors.affiliation: Pediatric Neurology Center, Children's Hospital, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Deepanjana
authors.initials: D
authors.lastname: Das
authors.affiliation: Pediatric Neurology Center, Children's Hospital, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Priya
authors.initials: P
authors.lastname: Datta
authors.affiliation: Pediatric Neurology Center, Children's Hospital, Cleveland Clinic, Cleveland, Ohio.
authors.forename: A David
authors.initials: AD
authors.lastname: Rothner
authors.affiliation: Pediatric Neurology Center, Children's Hospital, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Gerald
authors.initials: G
authors.lastname: Erenberg
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D005879:Tourette Syndrome / Q000453:epidemiology*
keywords: Tourette; comorbidity; sleep; tics