title: Tourette Syndrome as an Independent Risk Factor for Subsequent Sleep Disorders in Children: A Nationwide Population-Based Case-Control Study.
abstract: Tourette syndrome (TS) is associated with a variety of neuropsychiatric comorbidities. However, the relationship between TS and sleep disorders in children is less investigated. This nationwide population-based case-control study aimed to determine the correlation of TS and sleep disorders in children.
  
  
  
  Patients aged less than 18 years with newly diagnosed TS from 2001 to 2007 were collected (n = 1124) using data from Taiwan's National Health Insurance Research Database and were compared with a comparison cohort (n = 3372). The adjusted hazard ratio (aHR) for developing sleep disorders was calculated by multivariate Cox proportional hazards model.
  
  
  
  TS was more prevalent in boys, with a male to female ratio of 3.16:1. TS group also had significantly higher urbanization level of residence than controls (p < .001). The overall incidence rate of sleep disorders was 7.24‰ in children with TS, compared to 3.53‰ in controls. The TS group was associated with a significantly higher rate of sleep disorders, with a crude HR of 2.05 (95% confidence inerval [CI] = 1.43-2.95, p < .001). Among the comorbidities of TS, anxiety disorder was associated with the highest risk for sleep disorders (crude HR = 3.26, 95% CI = 1.52-7.00, p < .001). The aHR for TS cohort to develop sleep disorders was 1.72 (95% CI = 1.16-2.53, p = .007).
  
  
  
  The increased risk of sleep disorders in children with TS cannot be fully attributed to its comorbidities, and TS is an independent risk factor for sleep disorders in children.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.|Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan.
authors.forename: Wang-Tso
authors.initials: WT
authors.lastname: Lee
authors.affiliation: Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan.|Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Huang
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Lee Chin
authors.initials: LC
authors.lastname: Wong
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Wen-Chin
authors.initials: WC
authors.lastname: Weng
authors.affiliation: Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Tamara
authors.initials: T
authors.lastname: Vasylenko
authors.affiliation: Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Yuh-Jyh
authors.initials: YJ
authors.lastname: Jong
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital Yun-Lin branch, Yun-Lin, Taiwan.
authors.forename: Wei-Sheng
authors.initials: WS
authors.lastname: Lin
authors.affiliation: Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan.|Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Shinn-Ying
authors.initials: SY
authors.lastname: Ho
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D005879:Tourette Syndrome / Q000175:diagnosis* / Q000453:epidemiology*
keywords: Tourette syndrome; children.; sleep disorders