Sleep dysfunction in long term survivors of craniopharyngioma

Peter E. Manley, Kiera McKendrick, Megan McGillicudy, Susan N. Chi, Mark W. Kieran, Laurie E. Cohen, Sanjeev Kothare, R. Michael Scott, Liliana C. Goumnerova, Pengling Sun, Wendy London, Karen J. Marcus, Scott L. Pomeroy, Nicole J. Ullrich

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations

Abstract

Craniopharyngiomas are slow growing tumors of the sellar and parasellar region and may also involve the hypothalamus. Treatment involves maximal surgical excision or subtotal resection followed by focal radiation therapy. Late effects of treatment include endocrinopathies, cognitive deficits, behavioral changes, obesity and sleep dysfunction. We conducted a retrospective review of all patients with craniopharyngioma more than 2 years off treatment and who were evaluated in the neuro-oncology survivorship clinic between 2003 and 2007. Clinical data, extent of resection, treatment modalities, endocrine status, patient symptom report and sleep study results were collected to evaluate the presence of patient reported daytime sleepiness and sleep disturbance and to determine possible risk factors. 28 patients were identified (25 %) female. 19/28 self-reported daytime fatigue or sleep disturbance; this included 4/6 patients with gross total resection and 15/22 with subtotal resection. 16/22 patients treated with cranial irradiation reported sleep-related abnormalities, compared to 3/6 patients who did not receive radiation. All but one patient had pituitary dysfunction requiring hormonal replacement. Patients with more than C2 sleep related complaints had a higher BMI (44.6 vs. 32.6, p = 0.0192). 8 patients underwent formal sleep evaluation. 3 patients had documented central or obstructive sleep apnea. The mean arousal index was 11.0/h (normal \5). Two patients were treated with melatonin for sleep disturbance and 2 were treated with stimulants for excessive daytime sleepiness. A majority of patients with craniopharyngioma have self-reported daytime fatigue and/or sleep dysfunction after treatment. Extent of resection did not increase the likelihood of patient-reported daytime sleepiness and/sleep dysfunction; however, patients who received radiation more frequently reported daytime sleepiness and/or sleep dysfunction. Patients with a higher BMI were more likely to experience sleep disturbance. Formal sleep evaluations should be considered in all patients with craniopharyngioma.

Original languageEnglish (US)
Pages (from-to)543-549
Number of pages7
JournalJournal of Neuro-Oncology
Volume108
Issue number3
DOIs
StatePublished - Jul 2012
Externally publishedYes

Keywords

  • Craniopharyngioma
  • Fatigue
  • Pediatric
  • Sleep dysfunction
  • Survivorship

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

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