Longitudinal and cross-sectional predictors of sleep disturbance in a treatment follow-up sample with Tourette’s disorder

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Background Sleep disturbance is common in individuals with Tourette’s disorder (TD). Tic symptoms, medication, functional impairment, and psychiatric comorbidity frequently contribute to sleep disturbance in children and adults with TD. However, long-term predictors of sleep disturbance in TD are not known. This study examined longitudinal and cross-sectional predictors of sleep disturbance in a treatment follow-up sample with TD. Methods Eighty subjects who completed a 10-week randomized controlled trial of behavior therapy for tics in childhood ( M age = 11.47, SD = 2.42 years) participate in follow-up evaluation on average, 11.17 ( SD = 1.25) years after post-treatment assessment ( M age = 22.87, SD = 2.70 years). At post-treatment (10-week) and long-term follow-up, an independent evaluator assessed tic severity and tic-related impairment using the Yale Global Tic Severity Scale. Parents provided demographic and medical history (e.g., tic medication and stimulant medication status) and rated ADHD severity. Children rated anxiety and depression. At follow-up, participants rated anxiety, depression, and ADHD severity, and reported tic and stimulant medication status. Multiple linear regression was performed to examine longitudinal and cross-sectional predictors of sleep disturbance (Pittsburgh Sleep Quality Index) at long-term follow-up. Results tic-related impairment ( β = .34, p = .014) at post-treatment positively predicted sleep disturbance at follow-up. Chronological age ( β = .21, p = .041), anxiety severity ( β = .40, p = .001), and ADHD severity ( β = .31, p = .010) were positive cross-sectional predictors of sleep disturbance at follow-up. Conclusion Results highlight the role of residual tic-related impairment following behavior therapy for tics delivered in childhood in addition to older age, anxiety severity, and ADHD severity in early adulthood in sleep disturbance in a treatment follow-up sample of adults with TD.

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