Getting to bed and falling asleep can be difficult for a child with Tourette Syndrome (TS). It has been estimated that as many as 80% of patients with TS have sleeping difficulties. This can be for a variety of reasons including:
- Increased time it takes to fall asleep secondary to tics
- Some studies even showed increased in arousal levels during sleep (2)
- Sleep more disturbed with percentage of awake, increased movements and decreased sleep efficiency. It was even noted that increased correlation of sleep difficulties related to the severity of the tics (3)
- ADHD has more difficulty with falling asleep and staying asleep (1)
- Even some medications utilized to treat TS and/or comorbid conditions can have side effects of sleep difficulties
It has also been noted that there are many sleep disturbances with the comorbid conditions that are noted with TS (ADHD and OCD). (1)
In order to most effectively manage sleep difficulties at home, the following are recommended strategies to explore:
- Explore sleep diary to keep an appropriate log of pre and post sleep activities to hopefully locate a common link or factor impacting sleep
- Create a nighttime ritual or schedule that stays consistent
- Avoid electronics for at least 1 hour prior to bedtime
- Explore calming strategies prior to bedtime and ensure your bedroom is as calm as possible, such as:
- Listening to soft, slow music
- Explore use of calming scents
- Taking a warm bath or shower
- Snuggle up in blankets, etc
- Avoid food known to trigger increased sleep difficulties such as chocolate and caffiene
- Make sure you set your sleep schedule to allow for at least 8.5 hours of sleep a night (dependent on age)
- Only use bedroom for sleep. Avoid spending time in your bedroom throughout the day or a place to relax.
- Get on a regular exercise or physical activity routine, but being mindful to avoid at least a couple of hours before sleep.
Follow up with your physician or Occupational Therapist for further sleep treatment strategies.
1) Packer, L. (2/2009). Sleep Disorders. Retrieved from: http://www.tourettesyndrome.net/disorders/sleep-disorders/sleep-disorders/
2) Kirov R, Kinkelbur J, Banaschewski T & Rothenberger A. (2007). Sleep patterns in children with attention deficit/hyperactivity disorder, tic disorder and comorbidity. Journal of Child Psychology and Psychiatry, 48:6 (2007), pages 561-570. http://onlinelibrary.wiley.com/doi/10.1111/j.1469-7610.2007.01729.x/pdf
3) Cohrs S, Rasch T, Altmeyer S, et al (2001). Decreased sleep quality and increased sleep related movements in patients with Tourette’s Syndrome. Journal of Neurology and Neurosurgery Psychiatry; volume 70, pages 192-197. http://jnnp.bmj.com/content/70/2/192.full.pdf+html