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Tourette Syndrome as an Independent Risk Factor for Subsequent Sleep Disorders in Children: A Nationwide
Wang-Tso Lee1,2, Hui-Ling Huang3,4, Lee Chin Wong1
1Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Insights
Children with Tourette syndrome (TS) have a significantly higher risk of developing sleep disorders. This increased risk is independent of other neuropsychiatric comorbidities, highlighting TS as a key factor.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Neuropsychiatry
Background:
- Tourette syndrome (TS) is frequently associated with various neuropsychiatric conditions.
- The specific relationship between TS and sleep disorders in pediatric populations remains under-investigated.
Purpose of the Study:
- To investigate the correlation between Tourette syndrome and the incidence of sleep disorders in children.
- To determine if TS is an independent risk factor for sleep disorders in this demographic.
Main Methods:
- A nationwide population-based case-control study utilizing Taiwan's National Health Insurance Research Database.
- Inclusion of 1124 children newly diagnosed with TS (2001-2007) and comparison with 3372 controls.
- Multivariate Cox proportional hazards model to calculate adjusted hazard ratios (aHR) for sleep disorder development.
Main Results:
- Children with TS exhibited a higher prevalence of sleep disorders (7.24‰) compared to controls (3.53‰).
- The TS cohort demonstrated a significantly increased crude HR of 2.05 for sleep disorders.
- Anxiety disorder, a common comorbidity, showed the highest crude HR (3.26) for sleep disorders among TS patients.
- The adjusted HR (aHR) confirmed TS as an independent risk factor, with a value of 1.72 (95% CI = 1.16-2.53, p = .007).
Conclusions:
- The elevated risk of sleep disorders in children with Tourette syndrome is not solely explained by co-occurring conditions.
- Tourette syndrome is identified as an independent risk factor for sleep disorders in pediatric populations.
Study Objectives:
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.
Methods:
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.
Results:
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).
Conclusions:
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.