Sleep disturbances in adult survivors of childhood brain tumors

Abstract

Purpose The aims of this study are to compare self-reported sleep quality in adult survivors of childhood brain tumors and a population-based comparison group, to identify treatment-related factors associated with sleep disturbances, and to identify the impact of post-treatment obesity and depression on sleep scores in adult survivors of childhood brain tumors. Methods Randomly selected adult survivors of childhood brain tumors (n = 78) and age, sex and zip code matched population-group members (n = 78) completed the Pittsburgh Sleep Quality Index and the Brief Symptom Inventory. Sleep quality and the effect of demographic, treatment, and post-treatment characteristics were evaluated with linear and logistic regression analyses. Results Brain tumor survivors were 2.7 (95% CI: 1.1, 6.0) times more likely than the comparison group to take greater than 30 minutes to fall asleep. Females in both groups reported worse sleep quality and impaired daytime functioning. Among survivors, post-treatment obesity was associated with daytime dysfunction. Conclusions These results agree with previous studies associating sleep, sex and obesity and identified longer sleep latency as being a problem among childhood brain tumor survivors. Further study identifying factors contributing to sleep latency, and its impact on quality of life among adult survivors of childhood brain tumors is needed.

Melatonin secretion following brain midline irradiation is diminished, but not correlated with subjective sleep disturbances

“…One possible explanation for this gender difference may be depression as prevalence of depressive symptoms was higher in females with more than half of the females in our cohort reporting mild‐to‐severe depressive symptoms. These findings are in accordance with some but not all controlled studies using as well ESS and PSQI . According to our study, ESS scores improved with time since radiotherapy, potentially due to a gradual recovery from the severe illness or due to a decreasing anxiety towards the underlying cancer diagnosis over time.…”

“…We found a highly significant correlation between depression and ESS/PSQI scores, suggesting that depression might additionally contribute to the reported sleeping difficulties. The increased daytime sleepiness reported by overweight subjects can be explained by their easier fatigability and is in accordance with previous works that also used the ESS . Overweight patients might also be more prone to OSA which often leads to increased daytime sleepiness and elevated scores on the ESS .…”

“…This is in accordance with epidemiological data from the general population which show that women have a higher prevalence of sleep disturbances and score higher on the PSQI . Nolan et al also identified female sex as a risk factor for impaired sleep quality and daytime sleepiness in a cohort of brain tumour survivors as well as in their control group. Our female participants also had a significantly higher burden of depressive symptoms than their male counterparts.…”

Sleep Disturbances in Childhood Cancer Survivors

“…Medical and psychosocial correlates of SDis in CCS are receiving increasing attention particularly in survivors of pediatric brain tumors and lymphoblastic leukemia . Our findings and those of Ruble et al.…”

Life Satisfaction in Adult Survivors of Childhood Brain Tumors

“…Endocrine late effects include growth hormone deficiency, diabetes insipidus, abnormal thyroid function, obesity, and adrenocorticotropic hormone deficiency (Crom et al, 2010; Shaw, 2009) . Brain tumor survivors also struggle with a spectrum of neurologic sequelae such as sensory impairment, seizures, sleep dysregulation, cognitive deficits, apathy, executive dysfunction, inattention or processing speed impairment, and emotional deficits (Armstrong et al, 2011; Conklin et al, 2012; Di Pinto, Conklin, Li, & Merchant, 2012; Nolan et al, 2013). These substantial adverse consequences lead to disabilities that affect the daily lives of survivors who grapple with poor educational attainment, unemployment/underemployment (Kirchhoff et al, 2011), lower rates of marriage (Kirchhoff, Yi, Wright, Warner, & Smith, 2012), depression or anxiety (Gurney et al, 2009), and physical performance limitations resulting in restricted access to the environment (Brinkman, Li, et al, 2013; Ness et al, 2010).…”