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Sleep disturbance after pinealectomy in patients with pineocytoma WHO°I
Sandro M Krieg1, Helen Slawik, Bernhard Meyer
1Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. sandro.krieg@lrz.tum.de
Background:
Because the pineal gland produces melatonin, it is suggested to be involved in the regulation of sleep and circadian rhythm, though there is scant proof of this. Tumors of the pineal gland are rare and various in terms of histological and biological malignancy. We evaluated the occurrence of subjective sleep disturbances in nine patients who underwent a pinealectomy due to pineocytoma WHO°I without additional therapy.
Methods:
Patients with intracranial low-grade lesions and patients without a craniotomy who underwent a microscopic lumbar discectomy were matched to our study group by gender, age, and date of surgery. We used standardized sleep questionnaires on sleepiness during the daytime, sleep disturbances, and general pathologic sleep patterns.
Results:
Patients who underwent a craniotomy either without a pinealectomy (7.2 ± 2.0 points) or with a pinealectomy experienced increased sleep disturbances (6.6 ± 1.3 points) compared to patients who had a lumbar discectomy (2.8 ± 0.4 points), according to the Pittsburgh Sleep Quality Index (PSQI) (p < 0.05). Moreover, sleep disturbances as measured by the insomnia severity index (ISI) were most pronounced in patients who underwent a craniotomy without a pinealectomy (10.4 ± 3.1 points) compared to patients who underwent a pinealectomy or discectomy (5.9 ± 1.9 and 3.3 ± 1.3 points).
Conclusions:
Pinealectomy itself did not cause specific sleep impairment, but craniotomy in general did. This interesting and clinically relevant finding needs further investigation.
Insights
Craniotomy, not pinealectomy, is linked to sleep disturbances. This study suggests that the surgical approach, rather than pineal gland removal, impacts sleep quality in patients.
Area of Science:
- Neurosurgery
- Sleep Medicine
- Endocrinology
Background:
- The pineal gland's role in melatonin production suggests involvement in sleep and circadian rhythm regulation, though evidence is limited.
- Pineal gland tumors are rare and vary in malignancy; this study focuses on pineocytoma WHO I.
- Subjective sleep disturbances were evaluated in patients who underwent pinealectomy.
Purpose of the Study:
- To investigate the occurrence of subjective sleep disturbances after pinealectomy.
- To determine if pinealectomy or the craniotomy procedure itself contributes to sleep impairment.
- To compare sleep quality in patients who underwent pinealectomy with control groups.
Main Methods:
- A case series of nine patients undergoing pinealectomy for pineocytoma WHO I.
- Matched control groups: patients with intracranial low-grade lesions and patients without craniotomy (lumbar discectomy).
- Standardized sleep questionnaires assessed daytime sleepiness, sleep disturbances, and general sleep patterns.
Main Results:
- Patients undergoing craniotomy (with or without pinealectomy) reported significantly higher sleep disturbances (PSQI scores) compared to lumbar discectomy controls (p < 0.05).
- Insomnia Severity Index (ISI) scores were highest in patients who had craniotomy without pinealectomy, followed by those with pinealectomy, and lowest in lumbar discectomy controls.
- Pinealectomy patients showed elevated sleep disturbances, but less pronounced than those undergoing craniotomy without pinealectomy.
Conclusions:
- Pinealectomy itself does not appear to cause specific sleep impairment.
- Craniotomy, as a surgical procedure, is associated with increased subjective sleep disturbances.
- Further research is warranted to explore the clinical implications of craniotomy on sleep patterns.
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