1011 Childhood Predictors and Adult Factors Associated with Long-Term Sleep Disturbance in Tourette’s Disorder

Abstract Introduction Tourette’s Disorder (TD) is a childhood-onset neurological disorder characterized by motor and vocal tics present beyond one year. Sleep disturbance presents in 80% of individuals with TD and rises with advancing age. Common clinical correlates are tic severity, functional impairment, female sex, and co-occurring psychiatric symptoms, including attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety and depression. However, we lack understanding of long-term predictors of sleep disturbance in TD. Therefore, this investigation examined childhood predictors and adolescent/adult factors associated with sleep disturbance in a treatment follow-up sample of adolescents/adults with TD. Methods Eighty participants of a randomized-placebo controlled trial of behavior therapy for tics in childhood (M = 11.47, SD = 2.42 years) received follow-up evaluation 11.7 (SD = 1.25) years later in adolescence/adulthood (M = 22.87, SD = 2.70 years). At baseline and long-term follow-up, an independent evaluator assessed tic severity tic-related impairment and psychiatric diagnosis via interviews. At baseline, children rated anxiety and depression, and parents rated ADHD, and provided demographic and psychiatric history (e.g., tic and stimulant medication status). At follow-up, adolescents/adults rated anxiety, depression, and ADHD severity, and reported tic medication and stimulant medication status since trial termination. Multiple linear regression analysis was performed without and with backward elimination to examine childhood predictors and adult factors (sex, tic and stimulant medication status, tic severity and impairment, anxiety, depression, and ADHD severity, OCD diagnosis) sleep disturbance (Pittsburgh Sleep Quality Index) at long-term follow-up. Results Childhood tic-related impairment significantly predicted sleep disturbance (β = 0.35, t = 2.66, p = .010). However, with backward elimination both childhood tic-related impairment (β = 0.32, t = 2.81, p = .007) and depression (β = 0.33, t = 2.92, p = .005) significantly predicted sleep disturbance. There were no significant adolescent/adult factors associated with sleep disturbance. However, backward elimination showed depression was associated with sleep disturbance (β = 0.46, t = 3.95, p < .001). Conclusion Findings highlight the role of tic-related impairment in childhood and depression in childhood and adulthood in sleep disturbance in adolescents/adults with TD. Findings suggest the utility of targeted intervention for tic-related impairment and depression to minimize their long-term influence on sleep in TD. Support (if any)