Chapter 10 - Sleep in tic disorders and Tourette syndrome

Sleep disturbances are highly prevalent in patients with tic disorders and Tourette syndrome, with up to 80% of patients experiencing sleep difficulties. Insomnia is notably present, and pediatric patients often experience parasomnias, including sleepwalking and night terrors. Disruptions in circadian rhythms are also reported, with a pronounced evening chronotype. Concurrently, patients may also suffer from sleep-related movement disorders, and tics are reported to often persist during sleep, further contributing to significant sleep fragmentation. The presence of comorbid attention-deficit hyperactivity disorder may further exacerbate sleep disturbances. Current genetic and neurobiologic evidence suggests shared pathophysiologic mechanisms, particularly involving the dopaminergic system, that underlie both tic manifestations and sleep disruptions. While pharmacologic and nonpharmacologic interventions offer potential therapeutic avenues, their efficacy in a combined tic-sleep disorder context requires further investigation.