Chiara Pilotto, Michael Vidoni, Francesco Tuniz, Maristella Toniutti, Vincenzo Patruno, Paola Cogo, Ilaria Liguoro
Pediatric Clinic, ASUFC S. Maria della Misericordia, University Hospital, Udine, Italy.
Department of Neurosurgery, ASUFC S. Maria della Misericordia, University Hospital, Udine, Italy.
Childs Nerv Syst. 2025 Apr 30;41(1):174. doi: 10.1007/s00381-025-06828-y.
The knowledge of sleep disorders in children with brain tumours is limited. We aim to investigate the presence of possible sleep disturbances in this population.
Polysomnography (PSG) analysis was performed in our Paediatric Clinic from October 2017 to March 2019. Patients between 2 and 16 years old, treated for brain tumours at least 6 months after the end of treatments, were included. The exclusion criteria were children with seizures, taking sleep-interfering therapies, and adenotonsillar hypertrophy. We performed overnight PSG according to the American Academy of Sleep Medicine guidelines.
We enrolled 16 patients (11 male). The median age at the diagnosis was 9.3 years (IQR 25-75°, 3.5-11.5), and the median age at PSG exam was 12.5 years (IQR 25-75°, 6.9-15.3). Eight out of sixteen patients had infratentorial tumours. The mean sleep record duration was 514 min (SD ± 86 min). The mean oxygen saturation was 97%, and the mean heart rate was 71 bpm (SD ± 14). Respiratory records showed a significantly increased median central apnoea index (CAI) in the infratentorial group (median value 1.2, IQR 25-75°, 0.85-1.45) compared with the supratentorial group (median value 0.3; IQR 25-75°, 0.2-0.5; p 0.0156). Electroencephalogram records showed alterations of night sleep organization: in particular, an increased N1 period, a shorter N2 period, and higher delta-sleep activity N3 period, compared with healthy populations.
Our results highlighted a higher prevalence of central apnoea in children with infratentorial tumours, showing a possible impact of posterior fossa localization on sleep and ventilatory control. Moreover, we described several sleep structure alterations, identifying an important issue to be taken into account in the follow-up of patients with brain tumours.
关于脑肿瘤患儿睡眠障碍的了解有限。我们旨在调查这一人群中可能存在的睡眠障碍情况。
2017年10月至2019年3月在我们的儿科诊所进行了多导睡眠图（PSG）分析。纳入了年龄在2至16岁之间、治疗结束后至少6个月接受脑肿瘤治疗的患者。排除标准为患有癫痫、接受干扰睡眠治疗以及腺样体扁桃体肥大的儿童。我们根据美国睡眠医学学会的指南进行了整夜PSG检查。
我们纳入了16例患者（11例男性）。诊断时的中位年龄为9.3岁（四分位间距25 - 75°，3.5 - 11.5），PSG检查时的中位年龄为12.5岁（四分位间距25 - 75°，6.9 - 15.3）。16例患者中有8例患有幕下肿瘤。平均睡眠记录时长为514分钟（标准差±86分钟）。平均血氧饱和度为97%，平均心率为71次/分钟（标准差±14）。呼吸记录显示，与幕上肿瘤组相比，幕下肿瘤组的中枢性呼吸暂停指数（CAI）中位数显著升高（中位数为1.2，四分位间距25 - 75°，0.85 - 1.45），幕上肿瘤组中位数为0.3；四分位间距25 - 75°，0.2 - 0.5；p = 0.0156）。脑电图记录显示夜间睡眠结构改变：特别是与健康人群相比，N1期增加，N2期缩短，慢波睡眠活动的N3期增加。
我们的结果突出了幕下肿瘤患儿中枢性呼吸暂停的患病率较高，表明后颅窝定位可能对睡眠和通气控制有影响。此外，我们描述了几种睡眠结构改变，确定了脑肿瘤患者随访中需要考虑的一个重要问题。
