A Naturalistic Study Investigating Sleep and Cognitive Learning in Children With and Without Tic Disorders

This study will explore the relationship between sleep, learning, cognition, mood and behaviour in children with Tic Disorders (Tourette Syndrome and Chronic Tic Disorder) compared to typically developing peers.

Study Overview

• Status: Completed
• Conditions: Tic Disorders
• Intervention / Treatment: Other: Actigraphy to measure sleep duration and efficiency; Other: 'Sleepsuite' novel cognitive learning tasks

Detailed Description

This project explores the relationship between sleep and learning in childhood with tic disorders, such as Tourette syndrome (TS) and chronic tic disorders (CTD).

TS/CTD are movement disorders characterized by repetitive involuntary movements and/or vocalizations called tics. Sleep related problems are commonly reported for children with TS/CTD and may include problems getting to sleep, waking up frequently during the night, early wakening and tic-related movements in sleep. For typically developing children, sleep disturbances have been linked to problems with mood, behaviour and learning. To date, the relationship between sleep and learning has not been explored for children with TS/CTD.

The aim of this project is to investigate whether there is a relationship between sleep efficiency and learning in boys with and without TS/CTD aged 11-14 years.

Sleep efficiency will be measured using a small actigraphy watch, which will collect information about movements during sleep, night time waking and light exposure. Children will be required to wear the watch for 14 days and nights. Before one night of sleep and again the next morning, children will be asked to complete some tasks on an iPad Air to assess learning. These include 1) 'popping' balloons with faces on them according to specific rules (e.g. boys faces, happy faces), 2) learning novel animal names, 3) navigating a 3D maze. Children will also be administered some standard tests to look at level of intellectual functioning, memory and other thinking skills that may contribute to performance on the computerized tasks. Additionally, children and their parents will be asked to complete questionnaires to assess tics, quality of life, mood and behaviour. The findings of this study will help improve understanding of sleep problems for children with tic disorders to aid the development of specific interventions for this group.

• Study Type: Observational
• Enrollment (Actual): 32

Contacts and Locations

Study Locations

• United Kingdom
  • London, United Kingdom
    • Evelina Children's Hospital, St Thomas' Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 11 years to 14 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

• Sampling Method: Non-Probability Sample

Study Population

Students at mainsteam secondary schools, patients of the Tic and Neurodevelopmental (TANDeM) service at the Evelina Children's Hospital.

Description

Inclusion Criteria:

• Diagnosis of Tourette Syndrome or Chronic Tic Disorder (for clinical group)

Exclusion Criteria:

• Diagnosis of Intellectual Disability (i.e. Full Scale IQ (IntellIigence Quotient) below 70), Autism Spectrum Disorder or Depression
• Currently taking medications to support tic, mood and/or behaviour management

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Cross-Sectional

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Tic Disorder; Boys with a diagnosis of Tourette Syndrome (TS) or chronic tic disorder (CTD) aged 11-14 years	Other: Actigraphy to measure sleep duration and efficiency; Actigraphy watch to be worn on participants' wrist for 14 days and nights; Other: 'Sleepsuite' novel cognitive learning tasks; Novel iPad-administered learning tasks, to be completed one evening and the next morning during actigraphy monitoring period.
Control; Boys aged 11-14 years without a diagnosis of TS/CTD (i.e. typically developing)	Other: Actigraphy to measure sleep duration and efficiency; Actigraphy watch to be worn on participants' wrist for 14 days and nights; Other: 'Sleepsuite' novel cognitive learning tasks; Novel iPad-administered learning tasks, to be completed one evening and the next morning during actigraphy monitoring period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Relationship between sleep efficiency/duration and cognitive learning	14 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cognitive functioning	A range of cognitive measures will be used to assess general level of intellectual functioning and cognitive skills that are hypothesised to contribute to performance on the SleepSuite learning tasks (including memory, attention, visuo-motor co-ordination and phonological awareness).	Within the 14 days of the study
Mood and behavioural functioning	A range of self- and parent-report questionnaires will be used to measure participants' mood and behaviour and to see whether these relate to the primary outcome measures of sleep and cognitive learning.	Within the 14 days of the study

Collaborators and Investigators

• Sponsor: King's College London
• Collaborators: Guy's and St Thomas' NHS Foundation Trust
• Investigators: Principal Investigator: Sally Robinson, Guy's and St Thomas' NHS Foundation Trust

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2016
• Primary Completion (Actual): March 1, 2017
• Study Completion (Actual): March 1, 2017

Study Registration Dates

• First Submitted: February 3, 2016
• First Submitted That Met QC Criteria: February 3, 2016
• First Posted (Estimate): February 8, 2016

Study Record Updates

• Last Update Posted (Actual): August 22, 2017
• Last Update Submitted That Met QC Criteria: August 17, 2017
• Last Verified: August 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Central Nervous System Diseases; Nervous System Diseases; Neurologic Manifestations; Movement Disorders; Dyskinesias; Neurodevelopmental Disorders; Tic Disorders; Tics
• Other Study ID Numbers: HR-15/16-2278