Polysomnography analysis of sleep in a cohort of children treated for brain tumour.

Purpose: The knowledge of sleep disorders in children with brain tumours is limited. We aim to investigate the presence of possible sleep disturbances in this population.

Methods: Polysomnography (PSG) analysis was performed in our Paediatric Clinic from October 2017 to March 2019. Patients between 2 and 16 years old, treated for brain tumours at least 6 months after the end of treatments, were included. The exclusion criteria were children with seizures, taking sleep-interfering therapies, and adenotonsillar hypertrophy. We performed overnight PSG according to the American Academy of Sleep Medicine guidelines.

Results: We enrolled 16 patients (11 male). The median age at the diagnosis was 9.3 years (IQR 25-75°, 3.5-11.5), and the median age at PSG exam was 12.5 years (IQR 25-75°, 6.9-15.3). Eight out of sixteen patients had infratentorial tumours. The mean sleep record duration was 514 min (SD ± 86 min). The mean oxygen saturation was 97%, and the mean heart rate was 71 bpm (SD ± 14). Respiratory records showed a significantly increased median central apnoea index (CAI) in the infratentorial group (median value 1.2, IQR 25-75°, 0.85-1.45) compared with the supratentorial group (median value 0.3; IQR 25-75°, 0.2-0.5; p 0.0156). Electroencephalogram records showed alterations of night sleep organization: in particular, an increased N1 period, a shorter N2 period, and higher delta-sleep activity N3 period, compared with healthy populations.

Conclusion: Our results highlighted a higher prevalence of central apnoea in children with infratentorial tumours, showing a possible impact of posterior fossa localization on sleep and ventilatory control. Moreover, we described several sleep structure alterations, identifying an important issue to be taken into account in the follow-up of patients with brain tumours.