Abstract
BackgroundSleep-related rhythmic movement disorder is characterized by repetitive gross-motor movements at sleep onset or during sleep, which result in clinical consequences such as impact on daytime functioning and injury. No well-established therapies exist today. Substituting the patient’s movements with external sensory stimulation may offer a treatment modality. The aim of the current study was to test the feasibility and acceptability of vestibular stimulation using a rocking bed (Somnomat) in children with rhythmic movement disorder and to assess children’s movement preference.MethodsChildren with rhythmic movement disorder (n = 6, Age: 5–14 years) were studied over three nights in a sleep laboratory: adaptation night (normal bed) and randomised-order baseline (Somnomat) and intervention nights (Somnomat). Child’s preferred movement direction (head-to-toe or side-to-side) and frequency (between 0.25 and 2 Hz), determined during an afternoon protocol, were applied using the Somnomat for 1 h after lights out, and in response to subsequent episodes of rhythmic movement during intervention nights. Comfort assessed using a questionnaire, and objective sleep parameters assessed using videosomnography, were compared.ResultsThe participants’ sometimes violent rhythmic movements did not disturb device performance. All children rated intervention nights equally or more comfortable than baseline nights. Self-reported sleep quality, as well as the number and duration of movement episodes did not significantly differ between baseline and intervention nights.ConclusionsProviding rocking movements using the Somnomat is both technically feasible and acceptable to the target population. The therapeutic value of this novel stimulus substitution for rhythmic movement disorder should now be evaluated in a larger sample over a longer period in the home setting.Trial registrationThe trial was retrospectively registered at clinicaltrials.gov (NCT03528096) on May 17th 2018.
Highlights
Sleep-related rhythmic movement disorder is characterized by repetitive gross-motor movements at sleep onset or during sleep, which result in clinical consequences such as impact on daytime functioning and injury
Sleep-related rhythmic movement disorder (RMD) is a childhood-onset sleep disorder characterized by gross motor movements occurring at sleep onset and during sleep (Manni and Terzaghi 2005) (Supplemental Information Documents 1 and 2)
We previously reported the benefits of vestibular stimulation, in the form of a swinging motion passively generated when sleeping in a hammock, in five children with RMD treated in the Southampton Children’s Hospital sleep clinic (Hewertson and Hill 2018)
Summary
Sleep-related rhythmic movement disorder is characterized by repetitive gross-motor movements at sleep onset or during sleep, which result in clinical consequences such as impact on daytime functioning and injury. Sleep-related rhythmic movement disorder (RMD) is a childhood-onset sleep disorder characterized by gross motor movements occurring at sleep onset and during sleep (Manni and Terzaghi 2005) (Supplemental Information Documents 1 and 2). These nocturnal episodes of rhythmic movement may disrupt the sleep of both the sufferer and other household members with impact on daytime functioning, and can result in injury (Sateia 2014). Evaluation of therapeutic interventions for this poorly researched sleep disorder are overdue
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