Sleep–wake and melatonin pattern in craniopharyngioma patients

Abstract

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.

Reduced sleep quality and depression associate with decreased quality of life in patients with pituitary adenomas

“…These findings are in accordance with previous results about QoL in patients with pituitary adenomas (1) as well as with results about the subjective sleep quality of individual patient groups, e.g. of acromegaly (10), NFPAs (14), or craniopharyngeomas (44). .746, P!0.001).…”

A review of sleep disorders and melatonin

“…Craniopharyngioma patients who present with altered circadian pattern have been shown to benefit from exogenous melatonin [38]. A high prevalence of sleep-wake disturbances and daytime sleepiness occurs in Parkinson's disease (PD) patients.…”

Postoperative outcome of body core temperature rhythm and sleep-wake cycle in third ventricle craniopharyngiomas

“…This can explain the paucity of attention paid to these alterations in the current literature on craniopharyngiomas affecting the third ventricle. 1,5,6,9,14,16,22,28 In our series, postoperative outcome after the EEA is encouraging, with complete recovery of sleep efficiency in 50% of cases and normalization or improvement of BCT rhythm in 5 of 6 cases with preoperative disturbances. Furthermore, only 1 patient presented with a de novo onset of temperature rhythm alteration at follow-up.…”

“…[2][3][4]8,21 However, few data about the outcome of the functions involving the hypothalamus after surgery are available, and in particular data regarding the body core temperature (BCT) rhythm and sleep-wake cycle. 1,5,6,9,11,15,22,28 The aim of this study was to investigate the outcome of the BCT rhythm and sleep-wake cycle dysfunctions in patients with craniopharyngiomas involving the third ventricle undergoing operation via an EEA.…”