Tourette’s and sleep: why the night never rests
Tourette’s and sleep are closely linked: when you sleep poorly, the tics get worse.
The link between Tourette’s syndrome and sleep is one of the most underestimated yet crucial aspects of day-to-day management. Sleep is not just a time for rest, but a veritable biochemical workshop where the brain attempts to rebalance dopamine and serotonin levels. For those with Tourette’s, however, this process is often hindered by a nervous system that struggles to find the ‘brake’ switch.
Poor-quality sleep acts as an amplifier: the less you sleep, the more frequent and difficult to manage your tics become the following day. This creates a vicious circle in which tiredness fuels the syndrome and the syndrome prevents rest. Understanding how the Tourette’s brain behaves at night is the first step towards building a recovery strategy that really works.
Why sleep is often disrupted
People with Tourette’s often have a different sleep architecture. The REM phase and deep sleep phases can be interrupted by micro-awakenings or residual motor activity. Although tics tend to decrease dramatically or disappear during deep sleep, the nervous system remains in a state of ‘light alertness’. This prevents the brain from properly completing its toxin-clearing and memory-consolidation cycles, leaving a feeling of chronic fatigue upon waking.
The link between fatigue and tics
Fatigue is the number one enemy of the inhibitory circuits in the prefrontal cortex. When you are tired, your brain loses the ability to filter motor impulses coming from the basal ganglia. It is scientifically proven that sleep deprivation increases neuronal excitability, making tics more explosive and frequent. In practice, a tired brain is a brain without brakes, where every premonitory stimulus immediately becomes a movement or a sound.
Difficulty falling asleep
The phase of falling asleep is often the most challenging. Whilst the body tries to relax, the premonitory urge of the tic can be felt more strongly precisely because the distractions of the day are absent. Many people describe a sort of ‘motor restlessness’ that prevents them from finding a comfortable position. Furthermore, the anxiety linked to the thought of not being able to sleep raises adrenaline levels, further delaying the onset of sleep and keeping the brain in a state of hyper-arousal.
Waking episodes and night-time tension
It is not uncommon for people with Tourette’s to suffer from parasomnias, such as sleepwalking or night terrors, or from periodic limb movements. Although these are not tics in the strict sense, they are signs of a motor system that never switches off completely. These episodes of waking fragment rest and increase night-time muscle tension. In the morning, the body may feel sore or stiff, as if it had exerted itself physically during the night instead of resting.
The importance of routine
The Tourette’s brain thrives on predictability. A strict evening routine helps signal to the nervous system that the day is over and that it is safe to lower its defences. Regular bedtimes help stabilise the circadian rhythm and melatonin production. Avoiding overstimulating activities (such as video games or bright screens) in the hour before sleep is crucial to avoid overstimulating the dopaminergic circuits just when they should be calming down.
Strategies for better sleep
Improving sleep requires a multi-pronged approach. Sleep hygiene is the foundation: a dark, quiet and cool bedroom. Progressive relaxation techniques can help release muscle tension built up during the day. Some people find weighted blankets beneficial, as they provide deep pressure that can calm the sensory nervous system. Finally, reducing daily stress through afternoon physical activity allows you to reach the evening with significantly lower adrenaline levels, making it easier to drift off to sleep.
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The information contained in this article is for informational purposes only. For medical advice or a diagnosis, always consult a professional.
