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Polysomnographic findings in craniopharyngioma patients

  • Neurology • Original Article
  • Published:
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Abstract

Purpose

The purpose of this study is to evaluate whether damage to the hypothalamus due to craniopharyngioma or consequent surgery may involve the sleep-wake regulatory system, resulting in sleep disturbances and sleepiness.

Methods

Seven craniopharyngioma patients and 10 healthy controls were evaluated with sleep questionnaires including the Epworth Sleepiness Scale, polysomnography, and a multiple sleep latency test (MSLT). Five patients and eight controls had lumbar puncture performed to determine hypocretin-1 levels.

Results

Patients tended to feel sleepier than control individuals of the same age (p = 0.09). No subjects had symptoms of hypnagogic hallucinations, sleep paralyses, or cataplexies. Four patients and one control had periodic leg movements (PLMs). One patient had fragmented sleep pattern, rapid eye movement (REM) sleep without atonia, and PLMs. One patient had short sleep periods during the daytime. Four patients had fragmented sleep pattern. With the MSLT, four patients and two controls had mean sleep latency of < 8 min. One patient and three controls had sudden onset of REM sleep in 2/5 and 3/5 sleep periods, respectively. All subjects showed normal hypocretin-1 levels. Four patients had electrophysiological findings indicative of central hypersomnia including one patient meeting the criteria of narcolepsy.

Conclusion

The sleep-wake regulatory system may be involved in craniopharyngioma patients.

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Abbreviations

MSLT:

Multiple sleep latency test

PLMs:

Periodic leg movements

REM:

Rapid eye movement

NREM:

Non-rapid eye movement

NSAID:

Non-steroidal anti-inflammatory drug

SOREM:

Sudden onset of rapid eye movement sleep

SCN:

Suprachiasmatic nucleus

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Funding

This work was supported by the Lundbeck Foundation (R83-A8175), the Augustinus Foundation (12-1119), the Arvid Nilsson Foundation (6000603), the A P Møller Foundation for the Advancement of Medical Science (Fonden til Lægevidenskabens Fremme) (1181), and the Illum Foundation (03061020). Ulla Feldt-Rasmussen’s research post is funded by an unrestricted grant from the Novo Nordisk Foundation. The sponsors had no role in the design or conduct of this research.

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Authors and Affiliations

  1. Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Rigshospitalet, Nordre Ringvej 57, DK-2600, Glostrup, Denmark

    Line Pickering & Poul Jennum

  2. Department of Medical Endocrinology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark

    Marianne Klose & Ulla Feldt-Rasmussen

Authors
  1. Line Pickering
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  2. Marianne Klose
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  3. Ulla Feldt-Rasmussen
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  4. Poul Jennum
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Corresponding author

Correspondence to Line Pickering.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the local ethical committee (J.nr. H-3-2011-057) and the Danish Data Protection Agency (J.nr. 30-0583) and is registered at ClinicalTrials.gov (NCT01881854). Informed consent was obtained from all individual participants included in the study.

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Comment

This manuscript sets out to assess the sleep-wake pattern, the tendency to fall asleep during the daytime, and the hypocretin levels in craniopharyngioma patients compared with healthy controls. Considering the fact that there were little research results, including PSG findings and the CSF hypocretin measurement, I found this study very interesting

Seung Chul Hong

Gyeonggi, Republic of Korea

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Pickering, L., Klose, M., Feldt-Rasmussen, U. et al. Polysomnographic findings in craniopharyngioma patients. Sleep Breath 21, 975–982 (2017). https://doi.org/10.1007/s11325-017-1574-6

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  • DOI: https://doi.org/10.1007/s11325-017-1574-6

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