Brain tumours result in sleep disorders in children and adolescents
Line Pickering1, Katharina M Main2, Astrid Sehested3
1Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, University of Copenhagen, Valdemar Hansens Vej 17, DK-2600, Glostrup, Denmark.
Insights
Children with brain tumors often have sleep disturbances. Tumors affecting sleep-wake regulation correlate with increased sleepiness, fatigue, and poorer quality of life.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Neuro-oncology
Background:
- Sleep disturbances are common in children diagnosed with brain tumors.
- Understanding the impact of tumor location on sleep is crucial for patient care.
Purpose of the Study:
- To systematically examine sleep patterns in children with brain tumors.
- To investigate the hypothesis that tumors affecting sleep-wake regulatory areas alter sleep-wake regulation.
Main Methods:
- Cross-sectional study of 61 children (0-18 years) with primary brain or cervical medullary tumors.
- Tumor categorization based on involvement of sleep-wake regulatory regions (brain stem, basal forebrain, hypothalamus, thalamus, posterior fossa).
- Utilized sleep history, questionnaires (e.g., Pediatric Daytime Sleepiness Scale), polysomnography, and multiple sleep latency test.
Main Results:
- Patients with tumors in sleep-wake regulatory areas reported increased sleepiness and fatigue (p=0.03).
- High prevalence of sleep apnea (86%) and narcolepsy (8%) observed, without significant group differences.
- Tumor involvement in regulatory areas was linked to more emotional problems (p=0.04), mental health issues (p<0.001), and reduced quality of life (p≤0.03).
Conclusions:
- Children with brain tumors frequently experience disturbed sleep, poor mental health, and diminished quality of life.
- Systematic sleep evaluation should be integrated into routine care for these patients.
- Psychological and social support are recommended alongside medical management.
Background And Objectives:
Sleep disturbances are frequently reported in children with brain tumours. The objective of our cross-sectional study was to systematically examine sleep in these children. We hypothesised that children with tumours involving the sleep-wake-regulatory areas have an altered sleep-wake-regulation.
Methods:
Sixty-one patients aged 0-18 years and with a diagnosis of a primary brain or cervical medullary tumour were included. They were categorised based upon tumour location into two groups - those affecting the sleep-wake regulatory regions, i.e. brain stem, basal forebrain, hypothalamus, thalamus, and posterior fossa compressing the brain stem and those that did not. Sleep history, questionnaire surveys, polysomnography, and multiple sleep latency test were used, as indicated clinically. Surveys included Pediatric Daytime Sleepiness Scale, Children's Sleep Habits Questionnaire, Strengths and Difficulties Questionnaire, and Pediatric Quality of Life Inventory, Multidimensional Fatigue Scale and Generic Core Scale.
Results:
Patients with tumours involving the sleep-wake regulatory areas were sleepier/more fatigued (p = 0.03). Sleep apnoea was observed in 86% of all the patients and comorbid narcolepsy in 8%, without group differences (p ≥ 0.12). Patients with tumours involving the sleep-wake-regulatory areas had more emotional problems (p = 0.04), were more affected by mental health problems (p < 0.001), and had poorer quality of life (p ≤ 0.03).
Conclusions:
Many children with brain tumours suffer from disturbed sleep, poor mental health, and low quality of life. We recommend that systematic sleep evaluation is included in their routine care along with psychological and social support.
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