Beyond sleep disturbance: Structured analysis of sleep habits, chronotype and sleep disorders in adults with glioma. A cross-sectional exploratory study.

in Sleep medicine by Thomas Mitterling, Vivien Riffert, Sophie Heimel, Annette Leibetseder, Andreas Kaindlstorfer, Anna Heidbreder, Josef Pichler, Tim J von Oertzen

TLDR

  • The study examined the prevalence and associations of sleep disorders, sleep-related motor phenomena, and chronotype in 79 adults with glioma, finding that sleep disorders were common and linked to various tumor-related factors.
  • Key findings include increased prevalence of insomnia, excessive daytime sleepiness, and sleep apnea, as well as associations with tumor localization, grade, and patient symptomatology.

Abstract

To evaluate the prevalence of the whole spectrum of sleep disorders as well as sleep related motor phenomena and chronotype in adults with glioma and to analyze their link with tumor localization and grade. This prospective cross-sectional exploratory study included 79 patients with glioma irrespective of localization and type. Sleep habits, sleep disorders of any kind and chronotype were evaluated in structured interviews using validated disease specific scales. For the whole sample the PSQI score was not increased, and specific insomnia severity was low. Patients with frontal tumors had worse sleep quality according to the PSQI and were more often allocated to worse ISI categories. The prevalence of EDS was markedly increased (ESS >10 in 17.7 % of patients), and 43 % scored ≥3 on STOPBANG. The predominant chronotype was a moderate morning type (54.4 %). Seven patients fulfilled RLS criteria and 9 fulfilled criteria for probable RBD, a self-report of hypnic jerks and nightmares were most common (45.6 % and 31.6 % respectively). According to regression analyses tumor relapse, depressive symptoms and fatigue determined poor sleep quality (Nagelkerke's R: 0.511 p < 0.001), while performance-status, fatigue and anti-seizure medication contributed to excessive daytime sleepiness (Nagelkerke's R: 0.600, p < 0.001), and age, BMI, and tumor localization contributed to the risk of sleep apnea (Nagelkerke's R: 0.556, p < 0.001). This study shows the broad range of sleep symptoms in glioma patients, and a complex association with tumor grade and localization. This underlines the need for a comprehensive evaluation of sleep related symptoms in glioma patients.

Overview

  • The study aimed to evaluate the prevalence of sleep disorders, sleep-related motor phenomena, and chronotype in adults with glioma, and analyze their link with tumor localization and grade.
  • The study used a prospective cross-sectional exploratory design, enrolling 79 patients with glioma regardless of localization and type.
  • The study aimed to identify factors contributing to poor sleep quality, excessive daytime sleepiness, and sleep apnea in glioma patients.

Comparative Analysis & Findings

  • The study found that patients with frontal tumors had worse sleep quality and were more likely to have insomnia compared to patients with tumors in other locations.
  • The prevalence of excessive daytime sleepiness (EDS) was increased in glioma patients, with 17.7% scoring above 10 on the Epworth Sleepiness Scale (ESS) and 43% scoring ≥3 on the STOPBANG scale.
  • The study found that tumor relapse, depressive symptoms, and fatigue were the strongest predictors of poor sleep quality, while performance status, fatigue, and anti-seizure medication were associated with excessive daytime sleepiness, and age, BMI, and tumor localization were associated with sleep apnea.

Implications and Future Directions

  • The study highlights the need for comprehensive evaluation of sleep-related symptoms in glioma patients, as sleep disorders are common and associated with various tumor-related factors.
  • The study's findings suggest that individualized approaches to managing sleep disorders may be necessary, depending on the patient's tumor location and grade.
  • Future studies should investigate the impact of sleep disorders on glioma patient outcomes and explore the potential benefits of insomnia and EDS treatments in reducing sleep-related symptoms and improving quality of life in glioma patients.
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