Sleep Disorder in Children Treated for Brain tumor. A Polysomnography Study

Background/Objectives: Few studies evaluated sleep disor- der in children with brain tumours. We aim to characterize the sleep disorders in this population. Design/Methods: Polysomnography study (PSG) was per- formed in our paediatric oncology centre from October 2017 to March 2019. Inclusion criteria: patients between 2-16 years old, affected by brain tumour, at least 6 months after the end of treatment. Children with seizure, taking sleep-interfering therapies and with adenotonsillar hypertrophy were excluded. We performed PSG following American Academy of Sleep Medicine (AASM) guidelines. Results: We enrolled 16 patients (5 female, 11 male). Median age at the diagnosis was 9.3 years (IQR 25◦-75◦ 3.5-11.5), and median age at PSG exam was 12.5 years (IQR 25◦- 75◦ 6.9-15.3). 8/16 patients had subtentorial tumour. The histologic distribution was: 31% pilocytic astrocitoma, 19% glioneuronal tumour, 12% choroid plexus papilloma, 38% other. Mean sleep record was 514 min (SD +/- 86 min). The mean oxygen saturation was 97% and mean FC was 71 bpm (SD +/-14). The respiratory record showed a CAI (central apnoea index) increased in subtentorial group with a median value 1.2 (IQR 25◦-75◦ 0.85-1.45) compared with sovraten- torial group with a median value 0.3 (IQR 25◦-75◦ 0.2-0.5), p 0.0156. We did not find any alteration related with radiother- apy treatment. The electroencephalogram record showed an alteration of night sleep organization: an increased N1 period, a shorter N2 period, and higher delta-sleep activity N3 period, compared with healthy populations. Conclusions: We found an increased central apnoea index related with cerebellum localization, showing an impact of posterior fossa tumour on sleep and ventilatory control. More- over, we described a sleep structure alteration. These modi- fications could determine consequences for the neurocogni- tive performance. We aim to highlight the role of sleep follow up in patients treated for brain tumour, to potentially set up a behavioural or pharmacological therapy to improve children’s quality of life.