Head-and-neck paragangliomas are associated with sleep-related complaints, especially in the presence of carotid body tumors

Abstract

Objectives: The carotid body functions as a chemoreceptor. We hypothesized that head-and-neck paragangliomas (HNP) may disturb the function of these peripheral chemoreceptors and play a role in sleep-disordered breathing. Design: This is a case-control study. Setting: This study was conducted in a tertiary referral center. Participants and main outcome measures: We assessed fatigue, sleep, and exercise capacity in 74 HNP patients using three questionnaires (Epworth Sleepiness Scale, St. George Respiratory Questionnaire, and a standard clinical sleep assessment questionnaire). Outcomes were compared to those of age- and sex-matched controls. Results and conclusions: Activity, disturbance of psychosocial function, and total score were worse compared to controls (15.4±18.5 vs. 7.2±9.9, P=0.007; 5.3±10.5 vs. 1.2±2.6, P=0.008; and 10.4±12.9 vs. 5.0±4.8, P=0.006, respectively). Patients reported more daytime fatigue, concentration difficulties, and depression (51% vs. 24%, P= 0.006; 31% vs. 10%, P=0.010; and 19% vs. 2%, P=0.012). Waking up was reported to be less refreshing in HNP patients (53% vs. 73%, P=0.038). Dysphonia was a predictor of symptoms, activity, disturbance of psychosocial function, and total scores. Remarkably, the presence of a carotid body tumor was an independent predictor of increased daytime sleepiness (β=0.287, P=0.029). In conclusion, patients with HNP have remarkable sleep-related complaints. Especially the presence of carotid body tumors appears to be associated with increased daytime somnolence. © The Author(s) 2011.