ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Adolescent and Young Adult Psychiatry
This article is part of the Research TopicLife with Tic Disorders: From Childhood to AdulthoodView all 15 articles
Longitudinal and Cross-sectional Predictors of Sleep Disturbance in a Treatment Follow-up Sample with Tourette's Disorder
Provisionally accepted
Maya S Tooker1
Kathryn E Barber2
Joseph F McGuire3
Flint M Espil4Jordan T Stiede2Jennifer S Schild5Shannon M Bennett6
Matthew Specht6
Walkup T John7Douglas W Woods2
John Piacentini1
Emily J Ricketts1*- 1Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, United States
- 2Department of Psychology, Klingler College of Arts and Sciences, Marquette University, Milwaukee, Wisconsin, United States
- 3Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins Medicine, Baltimore, Maryland, United States
- 4Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, United States
- 5Department of Psychology, College of Arts & Sciences, Suffolk University, Boston, United States
- 6Department of Psychiatry, Weill Cornell Medicine, Cornell University, New York, New York, United States
- 7Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
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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 (Mage=11.47, SD=2.42 years) participate in follow-up evaluation on average, 11.17 (SD=1.25) years after post-treatment assessment (Mage=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.
Keywords: tics and tourette syndrome, Psychiatric comorbidity, impairment, Sleep, medication
Received: 15 Mar 2025; Accepted: 28 Oct 2025.
Copyright: © 2025 Tooker, Barber, McGuire, Espil, Stiede, Schild, Bennett, Specht, John, Woods, Piacentini and Ricketts. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Emily J Ricketts, ericketts@mednet.ucla.edu
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