Division of Nursing Research, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA.
Pediatr Blood Cancer. 2012 May;58(5):746-51. doi: 10.1002/pbc.23311. Epub 2011 Oct 18.
Improvements in treatment and management for pediatric central nervous system (CNS) tumors have increased survival rates, allowing clinicians to focus on long-term sequelae, including sleep disorders. The objective of this study was to describe a series of CNS tumor survivors who had sleep evaluations that included polysomnography (PSG) with attention to sleep disorder in relation to the tumor site.
We report on 31 patients who had retrievable reports including an overnight PSG; 17 also underwent multiple sleep latency tests (MSLT) to characterize their sleepiness.
Mean age at tumor diagnosis was 7.4 years, mean age at sleep referral 14.3 years, and a mean time between tumor diagnosis and sleep referral of 6.9 years. The most common tumor location was the suprasellar region, the most common reason for sleep referral was excessive daytime sleepiness (EDS), and the most common sleep diagnosis was obstructive sleep apnea (n = 14) followed by central sleep apnea (n = 4), hypersomnia due to medical condition (n = 4), and narcolepsy (n = 3). Twenty-six of the 31 subjects were obese/overweight, and among those with the concurrent complaint of EDS, the mean sleep latency on MSLT was 3.16 minutes, consistent with excessive sleepiness.
Suprasellar region tumor survivors who are obese or overweight are more likely to have complaints of EDS and are at greater risk of sleep-disordered breathing. Sleep-related symptoms may not be recognized and referral initiated until years after CNS diagnosis. A periodic and thorough sleep history should be taken when caring for CNS tumor survivors.
儿科中枢神经系统 (CNS) 肿瘤的治疗和管理得到改善，提高了生存率，使临床医生能够专注于长期后遗症，包括睡眠障碍。本研究的目的是描述一系列接受过睡眠评估的 CNS 肿瘤幸存者，这些评估包括多导睡眠图 (PSG)，并关注与肿瘤部位相关的睡眠障碍。
我们报告了 31 名患者的可检索报告，其中包括一次夜间 PSG；其中 17 名还进行了多次睡眠潜伏期测试 (MSLT)，以描述他们的嗜睡情况。
肿瘤诊断时的平均年龄为 7.4 岁，睡眠转诊时的平均年龄为 14.3 岁，肿瘤诊断和睡眠转诊之间的平均时间为 6.9 年。最常见的肿瘤部位是鞍上区，最常见的睡眠转诊原因是日间嗜睡过多 (EDS)，最常见的睡眠诊断是阻塞性睡眠呼吸暂停 (n = 14)，其次是中枢性睡眠呼吸暂停 (n = 4)、因医疗状况引起的嗜睡 (n = 4)和发作性睡病 (n = 3)。31 名患者中有 26 名肥胖/超重，在那些同时有 EDS 抱怨的患者中，MSLT 的平均睡眠潜伏期为 3.16 分钟，表明存在过度嗜睡。
肥胖或超重的鞍上区肿瘤幸存者更容易出现 EDS 抱怨，并且更有可能患有睡眠呼吸障碍。当照顾 CNS 肿瘤幸存者时，可能不会识别和启动睡眠相关症状的转诊，直到 CNS 诊断多年后。应定期全面地进行睡眠史评估。
