572A number of studies have documented a variety of sleep disorders associated with To u r e t t e 's syndrome, 1 -6 i n c l u d i n g higher incidence of parasomnias, and periodic limb movement disorder 7,8 persisting both in rapid eye movement (REM) and non-REM sleep. [8][9][10][11] Some researchers also reported increased general movements in REM sleep. 12 Previously, there was no report of REM sleep behaviour disorder (RBD) in this population, and only two single case history reports existed 13,14 describing RBD in children, until our initial description of a series of pre-pubescent patients with Tourette's syndrome 15 and a report of RBD in otherwise asymptomatic children. 16 In our previous work 15 we presented a series of 16 patients with To u r e t t e 's syndrome, age 6-65 (14 males) who were referred to our clinic for a variety of sleep-related complaints, but predominantly for suspected nocturnal movement disorder (periodic leg movements in sleep (PLMS), restless legs syndrome (RLS), nocturnal tics) and parasomnic behaviour. In 12 patients we observed raised muscle activity in REM sleep, either in the form of (periodic) leg movements or attenuated tics, or (majority) as augmented phasic electromyograph (EMG) without associated movements. Three of these patients had confirmed, and two strongly possible RBD. Following the initial series of patients, further patients with the various sleep pathology were seen, including the case presented in this article.
CASE HISTORYWe present a case of a seven-year-old boy with Tourette's syndrome and RBD. The patient was seen over the four-year period starting in 1998 when he was three years old. Polysomnographic (PSG) sleep assessments were done in late 1999 and mid-2002.
ABSTRACT: Purpose:To describe an association of Tourette's syndrome with rapid eye movement sleep behaviour disorder (RBD) in a prepubescent boy. Methods: A four year longitudinal single-case s t u d y. R e s u l t s : The co-existence of To u r e t t e 's syndrome and RBD was confirmed after polysomnographic studies using the standard criteria. The authors propose possible overlap in the pathophysiological mechanisms underlying the two disorders. Can.
Introduction:Major Depressive Disorder (MDD) is a common health problem characterized by low mood, sadness and irritability. Sleep disturbances are a central feature of depression and adolescence is a period of rapid change in sleep physiology.Aim:To evaluate the categorization of sleep change in three of sleep elements : REM changes; Slow weave sleep changes and fragmentation of sleep. We evaluated this as a tool to detect depressionObjective:To assess features of sleep macro architecture as markers for evaluating and detecting adolescent depressionMethods:Adolescents completed a two-week protocol that included a formal psychiatric interview, standardized scales, polysomnographic (PSG) assessment, actigraphy, salivary melatonin sampling, and holter monitoring.Results:Depressed adolescents (n = 22) differed from controls (n = 20) on features of sleep macroarchitecture measured by PSG. 59% of the depressed subjects had more than one PSG marker from each category as compared to control (N = 20). This indicates that subjects who were depressed on clinical assessments using the standardized scales and evaluations had changes in sleep suggestive of depressionConclusion:The categorization of sleep change in three categories of sleep components (see above) can be a useful tool to detect depression. The results suggests that the individual markers of depression in children and adolescents may not be as effective as the categorization of sleep changes into three categories and using this general approach
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