Sleep disturbance

Sleep problems and night awakening are common in RTT. Management must include evaluation of the circadian rhythm or identification of problems in the initiation of sleep. Arousals due to breathing dysrhythmia should also be considered. Drug treatments recommended are Melatonin and or Pipamperon/Risperidon to restore the circadian rhythm, pipamperon if agitation is a major factor in the sleep disturbance, L-tryptophan if there is difficulty in the initiation of sleep. The CPAP (Continuous Positive Airway Pressure) system should be considered in cases where defence arousals are the major cause of the sleep disturbance.