Objective: Our aim was to identify and treat sleep disorders in asymptomatic patients with craniopharyngioma and to identify co-existing respiratory disease.
Methods: 5 patients (1 male) with a diagnosis of craniopharyngioma, were identified from the local pituitary database and admitted for polysomnography (Alice 4, Respironics), as part of a study of hypothalamic disease in craniopharyngioma. Sleep disturbance was defined as an apnoea index (AHI) of >5 events/hour. Daytime somnolence was assessed using the Epworth Sleepiness Score. Height and weight were measured for calculation of Body Mass Index (BMI, kg/m2). Arterial oxygen and carbon dioxide were measured using arterial blood gas samples taken in the morning. All patients underwent measurement of lung volumes, pulmonary function and DLCO for assessment of underlying respiratory disease. Local ethics committee approval was obtained, and patients gave written informed consent.
Results: All 5 patients were obese (BMI range 3061). All patients had normal morning arterial gases. 1 patient with a known diagnosis of asthma had evidence of mild obstructive lung disease. Mean Epworth score was 7.6 (range 411). 2 patients had AHI in the normal range (4.0 and 4.2/hour). 2 patients had evidence of mild apnoea (AHI 6.7 and 6.9/hour). 1 patient with an AHI of 10.5/hour failed to tolerate continuous positive airway pressure (CPAP) therapy and reported improvement in somnolence after a trial of modafenil.
Conclusions: Sleep apnoea occurred in 3 patients with craniopharyngioma who had not previously presented to a respiratory service. We plan to compare the incidence of apnoea in craniopharyngioma to that in a BMI-matched cohort in a future study, in order to control for the effect of hypothalamic obesity.