Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, University of Copenhagen, Valdemar Hansens Vej 17, DK-2600, Glostrup, Denmark.
Department of Growth and Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark.
Sleep Med. 2021 Dec;88:13-21. doi: 10.1016/j.sleep.2021.09.016. Epub 2021 Oct 2.
Sleep disturbances are frequently reported in children with brain tumours. The objective of our cross-sectional study was to systematically examine sleep in these children. We hypothesised that children with tumours involving the sleep-wake-regulatory areas have an altered sleep-wake-regulation.
Sixty-one patients aged 0-18 years and with a diagnosis of a primary brain or cervical medullary tumour were included. They were categorised based upon tumour location into two groups - those affecting the sleep-wake regulatory regions, i.e. brain stem, basal forebrain, hypothalamus, thalamus, and posterior fossa compressing the brain stem and those that did not. Sleep history, questionnaire surveys, polysomnography, and multiple sleep latency test were used, as indicated clinically. Surveys included Pediatric Daytime Sleepiness Scale, Children's Sleep Habits Questionnaire, Strengths and Difficulties Questionnaire, and Pediatric Quality of Life Inventory, Multidimensional Fatigue Scale and Generic Core Scale.
Patients with tumours involving the sleep-wake regulatory areas were sleepier/more fatigued (p = 0.03). Sleep apnoea was observed in 86% of all the patients and comorbid narcolepsy in 8%, without group differences (p ≥ 0.12). Patients with tumours involving the sleep-wake-regulatory areas had more emotional problems (p = 0.04), were more affected by mental health problems (p < 0.001), and had poorer quality of life (p ≤ 0.03).
Many children with brain tumours suffer from disturbed sleep, poor mental health, and low quality of life. We recommend that systematic sleep evaluation is included in their routine care along with psychological and social support.
睡眠障碍在脑瘤患儿中经常被报道。本横断面研究的目的是系统地检查这些患儿的睡眠情况。我们假设肿瘤累及睡眠-觉醒调节区域的儿童存在睡眠-觉醒调节改变。
纳入了 61 名 0-18 岁的原发性脑肿瘤或颈髓肿瘤患者。他们根据肿瘤位置分为两组:累及睡眠-觉醒调节区域的肿瘤,即脑干、基底前脑、下丘脑、丘脑和后颅窝压迫脑干的肿瘤,以及不累及睡眠-觉醒调节区域的肿瘤。根据临床需要,使用睡眠史、问卷调查、多导睡眠图和多次睡眠潜伏期试验进行检查。调查包括儿童日间嗜睡量表、儿童睡眠习惯问卷、长处和困难问卷、儿科生活质量量表、多维疲劳量表和通用核心量表。
累及睡眠-觉醒调节区域的肿瘤患儿更困倦/疲劳(p=0.03)。所有患者中 86%存在睡眠呼吸暂停,8%合并发作性睡病,但两组间无差异(p≥0.12)。累及睡眠-觉醒调节区域的肿瘤患儿有更多的情绪问题(p=0.04),更受心理健康问题的影响(p<0.001),生活质量更差(p≤0.03)。
许多脑瘤患儿存在睡眠障碍、心理健康问题和生活质量下降。我们建议在常规护理中系统地进行睡眠评估,并提供心理和社会支持。