Polysomnography analysis of sleep in a cohort of children treated for brain tumour.

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.