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Open Access 01-12-2020 | Sleep Apnea

The importance of specialized sleep investigations in children with a suprasellar tumor

Authors: J. van Schaik, S. Pillen, R. R. L. van Litsenburg, N. L. E. Vandenbussche, J. M. de Bont, A. Y. N. Schouten-van Meeteren, H. M. van Santen

Published in: Pituitary | Issue 6/2020

Abstract

Purpose

Disruption of sleep has great impact on quality of life. In children with a suprasellar tumor and hypothalamic-pituitary dysfunction, the circadian rhythm may be disturbed causing sleep problems. However, also other factors may influence sleep. Awareness of these different etiologies and careful history taking with appropriate additional diagnostics will aid in restoring sleep quality.

Methods

We present the workup of 4 cases with a suprasellar tumor and disturbances of sleep initiation, sleep maintenance, and daytime sleepiness. In parallel, we developed a flowchart, to aid clinicians in the diagnostics of sleep problems in children after treatment for a (supra) sellar brain tumor.

Results

All four patients, known with hypopituitarism, presented with sleep complaints and increased daytime sleepiness. In all four, the cause of sleep problems showed to be different. In the first case, sleep evaluation revealed a severe obstructive sleep apnea, whereupon nocturnal ventilation was started. The second case revealed poor sleep hygiene in combination with an obsessive compulsive disorder. Sleep hygiene was addressed and psychiatric consultation was offered. Dexamphetamine treatment was started to reduce her obsessive compulsive complaints. The third case showed a delayed sleep phase syndrome, which improved by educational support. The fourth case revealed a secondary organic hypersomnia for which modafinil treatment was started.

Conclusion

Sleep disturbances in children with hypopituitarism due to a (supra) sellar tumor can have different entities which require specific therapy. Awareness of these different entities is important to enable appropriate counseling. Referral to an expertise sleep center may be advised, if standard educational support is insufficient.

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Title: The importance of specialized sleep investigations in children with a suprasellar tumor
Authors: J. van Schaik
S. Pillen
R. R. L. van Litsenburg
N. L. E. Vandenbussche
J. M. de Bont
A. Y. N. Schouten-van Meeteren
H. M. van Santen
Publication date: 01-12-2020
Publisher: Springer US
Keywords: Sleep Apnea
Multiple Sleep Latency Test
Brain Tumor
Polysomnography
Published in: Pituitary / Issue 6/2020
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI: https://doi.org/10.1007/s11102-020-01065-9

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