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

Objective: 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.

Methods: 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.

Results: 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 R²: 0.511 p < 0.001), while performance-status, fatigue and anti-seizure medication contributed to excessive daytime sleepiness (Nagelkerke's R²: 0.600, p < 0.001), and age, BMI, and tumor localization contributed to the risk of sleep apnea (Nagelkerke's R²: 0.556, p < 0.001).

Conclusions: 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.