0817 Predictors of Hypersomnia and Narcolepsy in Pediatric Craniopharyngioma. (12th April 2019)

• Record Type: Journal Article
• Authors: LaRosa, Kayla N; Crabtree, Valerie; Sykes, April; Lu, Zhaohua; Merchant, Thomas E; Wise, Merrill S; Hancock, Donna; Caples, Mary; Mandrell, Belinda
• Is Part Of: Sleep. Volume 42(2019)Supplement 1
• Page Start: A327
• Page End: A328
• Publication Date: 2019-04-12
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsz067.815
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Craniopharyngioma is a low-grade embryogenic malformation in the suprasellar region that often extends to involve the hypothalamus. Structural abnormalities associated with the tumor may induce hypersomnolence, including both narcolepsy and hypersomnia due to a medical condition. This study is the first to describe the sleep disturbances among children with newly diagnosed craniopharyngioma and the associated patient, disease, and treatment variables. Methods: 110 children diagnosed with craniopharyngioma were enrolled in an institutional phase II trial of either limited surgical resection followed by proton therapy (PT) or observation after total resection. Prior to PT, patients ≥4 years completed a baseline polysomnography (PSG) and those ≥6 years completed a multiple sleep latency test (MSLT). Logistic regression models were conducted to explore the relationship between patient characteristics and a diagnosis of hypersomnia due to medical condition or narcolepsy. Results: Of the 98 patients who completed a baseline PSG, none met criteria for obstructive sleep apnea (OSA). Of those who completed the PSG and MSLT, 45% were diagnosed with hypersomnia due to medical condition, and 35% with narcolepsy, indicating 80% of the sample experienced pathological sleepiness. Overweight/obesity predicted the presence of hypersomnia due to medical condition ( p =.012) and narcolepsy ( p =.009) compared to patients who were not overweight/obese. Lastly, compared to patients with grade 1 preoperative hypothalamic involvement (HI), grade 2 HI indicated higher odds of narcolepsy diagnosis (odds ratio = 6.3, p =.008). Conclusion: This study is the first to describe the prevalence and associated predictors of sleep disturbance after surgical resection and prior to PT in pediatric patients with newly diagnosed craniopharyngioma. Findings indicated a high prevalence of central disorders of hypersomnolence in pediatric craniopharyngioma. Greater HI was predictive of narcolepsy diagnosis, and higher BMI z-score was predictive of both hypersomnia due to medical condition and narcolepsy. This study highlights the importance of assessing sleep/wake disturbance prior to the initiation of PT, as well as the promotion of wakefulness interventions with repeated sleep assessment. Support (If Any): This study was supported by ALSAC.