ID #957 Sleep disturbances in childhood craniopharyngioma
Marta Molteni, Antonella Barbieri, Sara De Giuseppe, Sonia Di Profio, Valentina Marazzotta, Gianluca Piatelli, Diego Criminelli, Flavio Giannelli, Salvina Barra, Natascia Di Iorgi, Flavia Napoli, Massimiliano Serafino, Antonia Ramaglia, Gabriele Gaggero, Marta Scalas, Claudia Mercuri, Gianluca Piccolo, Claudia Milanaccio, Lorenzo Chiarella, Lino Nobili, Antonella Iadarola, Ramona Cordani, Antonio VerricoAbstract
Background
Survival exceeds 90% in childhood craniopharyngioma (cCP); however, cCP survivors’ quality of life is affected by long-term outcomes related to tumor site and treatments. Sleep disturbances represent a disabling late effect, mainly assessed with subjective methods such as questionnaires.
Aim
To assess sleep disturbances in a cohort of cCP survivors using both objective and subjective assessment methods.
Materials and Methods
Prospective observational study assessing sleep disturbances in cCP survivors by objective (actigraphy, polysomnography and Multiple Sleep Latency Test-MSLT) and subjective methods (questionnaires: daytime sleepiness Epworth’s scale-ESS, Pittsburgh Sleep Quality Index-PSQI).
Results
Twenty patients were analysed (10 males; median age at tumour diagnosis: 9 years; IQR: 7.3–13.3). All patients underwent neurosurgery (median number of procedures: 1; range: 1–8) and 14 (70%) received radiotherapy. The median age at sleep disturbance assessment was 19 years (IQR 13.5–23.5) with a median interval of 6.2 years (IQR 3.9–11.6) since the end of treatment. Subjective evaluation (PSQI, ESS) revealed sleep disturbances or excessive daytime sleepiness (EDS) in 30% of patients, whereas objective assessment identified sleep disorders in 70%. Specifically, 40% were diagnosed with central disorder of hypersomnolence (20% secondary narcolepsy and 20% with hypersomnia), and 35% with obstructive sleep-disordered breathing with night-time or daytime symptoms of obstructive sleep apnea. In 10% of patients, the apnea–hypopnea index exceeded the mild pathological threshold in the absence of clinical impairment. Overall, nocturnal sleep duration was shorter than age-recommended values (median total sleep time: 455 minutes) with increased Wake After Sleep Onset (median: 48.15 minutes); reduced sleep efficiency was observed in 25% of subjects (median: 89.2%; range: 65.5-98%).
Conclusions
cCP survivors subjectively tend to underestimate the prevalence of sleep disturbances. An objective sleep evaluation is required to accurately determine the prevalence of sleep disturbances and guide targeted interventions aimed at improving long-term quality of life in this population.