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Sleep Disturbances in Pediatric Craniopharyngioma: A Systematic Review

Ramona Cordani1,2, Marco Veneruso1, Flavia Napoli3

  • 1Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.

Frontiers in Neurology
|June 2, 2022
PubMed

Insights

Children with craniopharyngioma (CP) frequently experience sleep disorders, including excessive daytime sleepiness and narcolepsy, due to hypothalamic involvement. Understanding these mechanisms is key to developing effective therapeutic strategies.

Area of Science:

  • Pediatric Neurology
  • Sleep Medicine
  • Endocrinology

Background:

  • Craniopharyngiomas (CP) are rare sellar region tumors, common in children, often causing severe clinical issues due to hypothalamic involvement.
  • The hypothalamus is vital for regulating bodily functions and the sleep-wake cycle, making its involvement in CP significant.
  • Sleep disorders are a critical but often under-recognized comorbidity in pediatric craniopharyngioma patients.

Approach:

  • A systematic literature review was conducted following PRISMA guidelines.
  • Searched PubMed/MEDLINE and Scopus databases for peer-reviewed articles on childhood craniopharyngioma and sleep disorders.
  • Included 32 articles focusing on sleep disturbances in pediatric CP patients.

Key Points:

  • High prevalence of excessive daytime sleepiness (25-100%) in CP patients, with objective measures showing higher rates.
  • Significant incidence of secondary narcolepsy (14-35%) and sleep-disordered breathing (4-46%) reported.
  • Sleep-wake rhythm dysregulation is noted, with potential mechanisms including hypothalamic injury, hypocretin deficiency, and obesity.

Conclusions:

  • Childhood craniopharyngioma frequently leads to diverse sleep disorders with significant impact.
  • Pathophysiology involves hypothalamic damage affecting key regulatory pathways.
  • Accurate diagnosis and management of these sleep disorders are crucial and challenging, necessitating a structured approach.

Keywords:
circadian rhythmcraniopharyngiomaexcessive daytime sleepinesshypocretinmelatoninnarcolepsysleepsleep-disordered breathing

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