Location of the brain tumor, degree of influence on sleep disorders after treatment

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Treatment for primary brain tumor (PBT) is associated with poor quality sleep in adults, with the location and grade of the tumor being important factors that can affect the severity of sleep apnea after treatment. This is based on research to be presented at the American Academy of Neurology 2021 (AAN) Annual Virtual Meeting 2021 from April 17-22, 2021.

This retrospective study included a review of adult patients with PBT who experienced insomnia from a single center. All patients were referred to a sleep center and examined polysomnographically. In addition to patients completing the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale, doctors administered the STOP-Bang questionnaire to check for obstructive sleep apnea (OSA).

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Most patients with PBT had diffuse astrocytic and oligodendroglial tumors (69%) and tumors in the cerebral cortex (71%). Approximately 18.5% had grade 1 tumors, 29.6% had grade 2 tumors, 25.9% had grade 3 tumors, and 25.9% had grade 4 tumors. Sleep disorders were prior to that in 29% of the patients Tumor diagnosis reported, while 93.5% of patients experienced sleep disorders after tumor treatment.

A higher Karnofsky performance status, which indicates the patient’s ability to perform better daily activities, was associated with a higher likelihood of normal sleep efficiency, but this was not statistically significant (P = 0.07).

Over 70% of patients referred to the facility’s sleep center had insufficient duration of non-REM and REM sleep. Patients with diffuse astrocyte tumors had a higher latency to REM sleep compared to patients with other histologies.

The primary variable associated with an apnea-hypopnea index of 15 or more was the location of the tumor in a region other than the cerebral cortex. Central apneas were 49% more common than OSAs.

Compared to patients with Grade 1 tumors, those with Grade 4 tumors were associated with higher STOP-Bang scores, suggesting that tumor grade affects the incidence of sleep apnea.

The study’s researchers noted that future prospective research should “examine clinical data and quantitative sleep parameters in larger patient cohorts to elucidate the link between sleep and tumor, measures to improve sleep and ultimately improve the quality of life in patients with PBT.


Soomro Z., Alfaro K., Balachandran D. et al. Significant sleep disorders occur in patients with primary brain cancer. an analysis of clinical features and sleep parameters. Presented at: American Academy of Neurology’s Annual Virtual Meeting 2021; 17.-22. April 2021. Abstract P20.005

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