Abstract
Zusammenfassung:Fragestellung: Charakterisierung des Schlafmusters einer größeren Gruppe Kinder mit Tic-Störung sowie Untersuchung ob und wie Veränderungen des Schlafs mit der Schwere der Tic-Störung assoziiert sind. Methodik: Das Schlafverhalten von 25, zum Untersuchungszeitpunkt unmedizierten Kinder mit chronischer Tic-Störung wurde polysomnographisch untersucht und mit den Befunden von 22 gesunden Kontrollen verglichen. Zwischen beiden Gruppen bestanden keine Unterschiede hinsichtlich Alter, Geschlechtsverhältnis und Intelligenz. Ergebnisse: Kinder mit einer Tic-Störung zeigten eine reduzierte Schlafqualität sowie vermehrtes, bewegungsbezogenes Arousal im Vergleich zu gesunden Kontrollen. Hinsichtlich des Schlafs ging bei Kindern mit Tic-Störung eine schwerere Ausprägung der Tics mit häufigeren bewegungsbezogenen Arousals einher. Die Anzahl der kurzen, mit motorischen Phänomenen assoziierten Arousals korrelierte mit geringerer Schlafeffizienz, verzögertem Schlafbeginn und verlängerter Tiefschlaflatenz. Des weiteren bestimmten geringere Schlafeffizienz und verlängerte Tiefschlaflatenz bei Kindern mit Tic-Störung die Schwere der Tics am Tag. Schlussfolgerungen: Bei Kindern mit Tic-Störung scheint ein Zusammenhang zwischen den bewegungsbezogenen Arousals im Schlaf und der Ausprägung der Tics am Tag zu bestehen. Beeinträchtigungen des Schlafs bei Tic-Störungen könnten die Tic-Symptomatik am Tag verschlechtern.
Summary:Objectives: Study objectives included the characterization of the sleep pattern in a large sample of children with chronic tic disorder (TD), as well if whether or not sleep changes and movement-related arousals are associated with tic severity. Methods: The sleep pattern of 25 children with a chronic tic disorder and who were unmedicated at the time of and during the study was investigated by means of polysomnography and compared to that of 22 healthy children matched for age, gender and intelligence. Results: Children with a chronic tic disorder displayed a reduced quality of sleep, as well as an increased number of movement-related arousals during sleep compared to healthy controls. Children with TD exhibited more frequent movement-related arousals the more severe the tics were during the day. The number of short arousals associated with motor phenomena correlated with lower sleep efficiency, and longer sleep onset and slow-wave sleep (SWS) latency. Moreover, lower sleep efficiency and longer SWS latency in children with TD may determine the severity of the tics during the day. Conclusions: In children with TD, motor activity during sleep seems to be related to the severity of the tics during the day. Impaired sleep in cases of TD might worsen the tic symptoms during the day.
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