I Can’t Get No Sleep… (Serbian)

In this talk, Karen Spruyt presents a summary of sleep findings in individuals with Rett syndrome. Sleep is essential for maintaining optimal health. In children with neurodevelopmental disorders, problematic sleep is found with greater frequency and severity. 

Sleeping involves a cyclic, physiological pattern of shifts between the different sleep stages, including non-rapid eye movement (NREM, stages 1 to 3) and rapid eye movement (REM) sleep. Several studies suggest that the neurobiology of sleep benefits molecular, cellular, and network mechanisms of brain plasticity, which govern both learning and subsequent long-term adaptive behavior.  

Till 2022, only 13 studies reported on clinically collected sleep data (i.e., clinical referral samples) and 19 survey studies. Individuals with Rett syndrome exhibit problematic sleeping, in particular, excessive somnolence (67.5%; 95%CI: 47.5% to 82.7%) and difficulties initiating and maintaining sleep (61%; 95%CI: 49.6% to 71.4%). Disturbed sleep not otherwise specified was reported in 57.1% (95%CI: 34.5% to 81.3%). Sleep-disordered breathing occurs in a large proportion of individuals with Rett syndrome. Regarding sleep structure, shortened sleep duration and aberrant sleep staging may vary with age or the presence of epilepsy. More studies are needed to explore and elucidate the pathophysiological mechanisms of these sleep findings in the future. 

The implementation of behavioral strategies and sleep hygiene is the first-line management of problematic sleeping. At a sleep clinic, sleep disorders such as sleep-disordered breathing can be diagnosed and treated. For pharmacological management please consult your primary care physician or the multidisciplinary team involved. 

• Spruyt K. 2022 Sleep problems in individuals with Rett syndrome: a systematic review and meta-analysis. Sleep Epidemiology, 100027 
• Zhang XY, Spruyt K. A meta-review of standard polysomnography parameters in Rett Syndrome. Front Neurol. 2022. 20;13:963626. doi: 10.3389/fneur.2022.963626. PMID: 36203990; PMCID: PMC9530595. 
• Zhang X, Smits M, Curfs L, Spruyt K. Sleep Respiratory Disturbances in Girls with Rett Syndrome. Int J Environ Res Public Health. 2022;19(20):13082. 
• Zhang XY, Smits M, Curfs L, Spruyt K. An investigation of the sleep macrostructure of girls with Rett syndrome. Sleep Med. 2023;101:77-86.