Sensory stimulation in the treatment of children with sleep-related rhythmic movement disorder: a feasibility and acceptability study

• Main Authors: Rachel M. van Sluijs, Elisabeth Wilhelm, Quincy J. Rondei, Lukas Jäger, Markus Gall, Heinrich Garn, Peter Achermann, Oskar G. Jenni, Robert Riener, Catherine M. Hill
• Format: Article
• Language: English
• Published: BMC 2020-07-01
• Series: Sleep Science and Practice
• Subjects: Pediatrics; Jactatio capitis nocturna; Rythmie du sommeil; Head banging; Sensory substitution; Vestibular stimulation
• Online Access: http://link.springer.com/article/10.1186/s41606-020-00049-9

Abstract Background 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. 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. Methods Children 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. Results The 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. Conclusions Providing 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 registration The trial was retrospectively registered at clinicaltrials.gov ( NCT03528096 ) on May 17th 2018.