A longitudinal assessment of sleep architecture in children and adolescents with craniopharyngioma.
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STUDY OBJECTIVES: Craniopharyngioma is a suprasellar brain tumor often associated with hypersomnia, which may be potentially due to alterations in sleep architecture. We performed cross-sectional and longitudinal assessments of sleep architecture in pediatric patients with craniopharyngioma. METHODS: We evaluated 94 patients (median age 9) enrolled in a clinical trial that included limited surgery with proton radiotherapy or radical surgery with observation. Nocturnal polysomnography and multiple sleep latency testing were performed at baseline and at 36 months after enrollment. Sleep architecture was compared to that of healthy children reported by Zhu et al., as well as longitudinally and across hypersomnia diagnostic groups using standard median comparison tests. Chi-squared tests assessed longitudinal changes in prevalence of hypersomnia disorders. RESULTS: Pediatric patients with craniopharyngioma exhibited 1.0% and 1.5% lower N1 and 9.21% and 9.59% lower N2 sleep (p < .001) at baseline and 36 months than healthy counterparts. N3 sleep was elevated by 11.84% and 13.47% respectively (p < .001). At 36 months, 2.63% less time was spent in REM (p = .005). Analysis of the entire cohort revealed no statistically significant longitudinal changes in sleep architecture (p > .05). However, in a subset of patients with advancing Tanner stage, N1 sleep decreased and REM sleep increased over 36 months. There were no longitudinal changes in prevalence of hypersomnia disorders (p > .05), nor differences in sleep architecture between patients with and without hypersomnia. CONCLUSIONS: Children and adolescents with craniopharyngioma exhibit atypical sleep architecture following surgery, that persists with long-term follow-up. Further research is needed to determine if sleep architecture mediates hypersomnia.