0955 EXCESSIVE DAYTIME SLEEPINESS PERSISTS OVER TIME IN PEDIATRIC CRANIOPHARYNGIOMA

Abstract

Introduction: Patients with craniopharyngioma are known to have many long-term deficits secondary to tumor location and treatment, including excessive daytime sleepiness (EDS). EDS negatively impacts emotional/social functioning and daily activities. However, the trajectory of EDS and its response to typical intervention (e.g., psychostimulants) has not been widely studied. We aimed to examine change in EDS over time and whether psychostimulants reduced EDS in a sample of pediatric craniopharyngioma survivors. Methods: As part of a treatment protocol for pediatric craniopharyngioma (RT2CR), participants were evaluated with polysomnography and multiple sleep latency testing (MSLT) prior to proton therapy and 12-18 months later. Use of psychostimulants at Time2 MSLT was obtained from medical records. Results: 21 youth with craniopharyngioma (Mean age=10.8 + 3.8 at Time1 and 12.3 + 3.7 at Time2); majority male (66.7%) and white (52.4%) were studied. Most experienced EDS as defined by mean sleep onset latency (SOL) ≤ 10 minutes on MSLT at both Time1 (N=15, 71.4%; SOL mean=6.0 ± 5.4 minutes) and Time2 (N=18, 85.7%; SOL mean=4.9 ± 3.9 minutes). Only 5 (23.8%) participants were prescribed psychostimulants at Time2. Though SOL means qualitatively decreased from Time1 to Time2, a paired samples t-test did not reveal clinically significant worsening (t(20)=1.40, p=.18). Results were similar for the participants prescribed stimulants at Time2 (t(4)=.55, p=.61). An independent samples t-test was conducted to evaluate change in mean SOL across time between participants prescribed or not prescribed psychostimulants with no significant difference: t(19)=-.31, p=.31. Conclusion: The majority of pediatric patients with craniopharyngioma sampled experienced substantial EDS that worsened clinically but not statistically significantly over time. The use of psychostimulants appears to not have had an impact on EDS; however, the number of children prescribed psychostimulants in the sample is very low and unequal group numbers have likely impacted sufficient power to draw firm conclusions. Tailored interventions to improve the severe EDS in these patients are needed.