Melatonin Secretion and Increased Daytime Sleepiness in Childhood Craniopharyngioma Patients

Müller, Hermann L.; Handwerker, G.; Wollny, Brigitte; Faldum, Andreas; Sörensen, N.

doi:10.1210/jcem.87.8.8751

Cited by 123 publications

(68 citation statements)

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“…In healthy controls, similar associations were only observed for time of night sleep. In keeping with our findings, Muller et al (4) reported in their study of craniopharyngioma patients that decreased night-time melatonin concentration was significantly correlated with increased daytime sleepiness (ESS). In addition, low midnight melatonin was associated with a reduced physical activity assessed by activity counts.…”

Section: European Journal Of Endocrinologysupporting

confidence: 93%

“…the hypothalamus, the pituitary, the third ventricle and the optic nerve (3). Tumour growth or its treatment often leads to hypopituitarism, visual field defects, obesity and increased daytime sleepiness (4). As compared with healthy controls, patients successfully treated for craniopharyngiomas had previously been reported with both normal (5) and impaired quality of life (6), increased self-reported general and physical fatigue (7), increased daytime sleepiness and sleep disturbances (8,9,10,11,12,13) and increased prevalence of severe sleepiness despite normal sleep pattern (14,15).…”

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confidence: 99%

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Sleep–wake and melatonin pattern in craniopharyngioma patients

Pickering

Jennum

Gammeltoft

et al. 2014

European Journal of Endocrinology

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Objective: To assess the influence of craniopharyngioma or consequent surgery on melatonin secretion, and the association with fatigue, sleepiness, sleep pattern and sleep quality. Design: Cross-sectional study. Methods: A total of 15 craniopharyngioma patients were individually matched to healthy controls. In this study, 24-h salivary melatonin and cortisol were measured. Sleep-wake patterns were characterised by actigraphy and sleep diaries recorded for 2 weeks. Sleepiness, fatigue, sleep quality and general health were assessed by Multidimensional Fatigue Inventory, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Short-Form 36. Results: Patients had increased mental fatigue, daytime dysfunction, sleep latency and lower general health (all, P%0.05), and they tended to have increased daytime sleepiness, general fatigue and impaired sleep quality compared with controls. The degree of hypothalamic injury was associated with an increased BMI and lower mental health (PZ0.01). High BMI was associated with increased daytime sleepiness, daytime dysfunction, mental fatigue and lower mental health (all, P%0.01). Low midnight melatonin was associated with reduced sleep time and efficiency (P%0.03) and a tendency for increased sleepiness, impaired sleep quality and physical health. Midnight melatonin remained independently related to sleep time after adjustment for cortisol. Three different patterns of melatonin profiles were observed; normal (nZ6), absent midnight peak (nZ6) and phase-shifted peak (nZ2). Only patients with absent midnight peak had impaired sleep quality, increased daytime sleepiness and general and mental fatigue. Conclusion: Craniopharyngioma patients present with changes in circadian pattern and daytime symptoms, which may be due to the influence of the craniopharyngioma or its treatment on the hypothalamic circadian and sleep regulatory nuclei.

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Section: European Journal Of Endocrinologysupporting

confidence: 93%

mentioning

confidence: 99%

Sleep–wake and melatonin pattern in craniopharyngioma patients

Pickering

Jennum

Gammeltoft

et al. 2014

European Journal of Endocrinology

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“…ciation has been demonstrated across a wide range of brain injuries caused by trauma, 1,2 tumors, [3][4][5][6][7][8][9][10][11] stroke, 12,13 ionizing radiation, 14 -16 and infection. 17,18 The sleep diagnoses that have been associated with brain injury include sleepiness, [2][3][4][5][6][7]10,11,15,17,18 sleep apnea, 8 respiratory insufficiency, 19 insomnia, 9 and loss of circadian rhythmicity.…”

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confidence: 99%

Sleep in Children With Neoplasms of the Central Nervous System: Case Review of 14 Children

Rosen

Bendel²,

Neglia³

et al. 2003

Pediatrics

101

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ABSTRACT.Objective. Sleep is a complex neurologic process that is generated by and primarily benefits the brain. Sleep can be disrupted by a wide range of brain injuries, many of which may occur in children with neoplasms of the central nervous system (CNS). The specific sleep problems that have been associated with brain injuries include sleepiness, apnea, insomnia, and loss of circadian rhythmicity. The objective of this study was to characterize the sleep problems seen in children with neoplasms of the CNS through a comprehensive clinical and objective sleep evaluation.Methods. A retrospective case series review was conducted of all children with neoplasms of the CNS referred to the sleep clinic for a clinical evaluation between 1994 and 2002. The sleep evaluation of the 14 children in this report included a sleep history, a sleep log, and a polysomnogram. In the 12 children with complaints of daytime sleepiness and/or fatigue, a multiple sleep latency test was performed the day after the polysomnogram. Three children also had a 2-week actigraphic study.Results. The most common sleep complaint in this group of children was excessive daytime sleepiness (EDS), present in 9 of the 14 children. In these children, the sleepiness was manifest by 1 or more of the following symptoms: 1) an increase in total sleep time per 24 hours; 2) the resumption of daytime naps that had been previously discontinued at a younger age; 3) an inability to awaken in the morning to begin the days activities; or 4) the inability to remain awake during activities of daily living, such as school. Of the 9 children with daytime sleepiness, Conclusions. Brain injuries, which invariably are present in children with neoplasms of the CNS, may result in a variety of diagnosable and treatable sleep disorders. The sleep symptoms did not appear to be directly related to the specific therapy the child received, nor the presence of residual tumor. Rather, the primary determinant of the sleep symptoms was the area of the brain that was damaged, regardless of how the damage occurred. Children who sustained damage to the hypothalamic/pituitary region developed EDS regardless of whether the damage was the result of the tumor, surgery, hydrocephalus, or radiation to the whole brain or localized to the suprasellar area. The only children who developed respiratory insufficiency had an injury to the medulla. This observation is consistent with the view that sleep is a specific, albeit complex, neurologic process that is controlled by specific brain regions. EDS and respiratory insufficiency were the most commonly diagnosed severe sleep disorders in these children. The sleep problems of children with brain tumors may develop before, but more often soon after, their tumor diagnosis and treatment. However, the sleep symptoms may not be appreciated by medical providers until years after their onset, which may delay the beginning of effective interventions. Pediatrics 2003;112:e46 -e54. URL: http: //www.pediatrics.org/cgi/content/full/112/1/e46; excessive daytim...

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“…11 This coupled with disruptions in melatonin secretion via the pituitary have been implicated in the pathogenesis of secondary narcolepsy in these patients. 12 Craniopharyngiomas are commonly seen in childhood and neurosurgeons involved in removal of these tumors must be aware of the complications of resection so that parents are forewarned in the beginning and so that these symptoms are examined on follow up. …”

Section: Discussionmentioning

confidence: 99%