title: Compression of the optic chiasm is associated with permanent shorter sleep duration in patients with pituitary insufficiency.
abstract: OBJECTIVE
  Patients with pituitary insufficiency often experience some degree of impaired sleep. Sleep-wake rhythm is regulated to a large extent by the suprachiasmatic nucleus (SCN). Because the SCN is located just superior to the optic chiasm, we hypothesized that a history of compression of the optic chiasm (CC) due to a tumour with suprasellar extension is associated with altered sleep patterns in patients with pituitary insufficiency.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  We studied 38 patients (mean age 55·7 ± 13·1 years; 71·1% men) with CC and 18 patients (mean age 53·3 ± 16·6 years, 38·9% men) without CC.
  
  
  METHODS
  Objective measures of sleep patterns were assessed by wrist actigraphy. Validated sleep questionnaires were used to evaluate subjective sleep parameters.
  
  
  RESULTS
  Objective total sleep duration was 36 min shorter in patients with CC than in patients without CC [454 (295-553) vs 490 (432-740) min, P = 0·034]. Moreover, patients with CC had a later habitual bedtime [23:15 (22:30-03:00) vs 22:55 (20:00-02:00) h, P = 0·044] and a later actigraphic sleep onset [23:57 (22:31-01:33) vs 23·16 (19:47-03:04) h, P = 0·020]. Linear regression analysis confirmed the difference in total sleep duration after adjustment for age, sex, body mass index, cranial radiotherapy and pituitary/hypothalamic surgery. Subjective sleep parameters were similar in both groups.
  
  
  CONCLUSIONS
  Compression of the optic chiasm due to a tumour with suprasellar extension is associated with permanent changes in total sleep duration in patients with pituitary insufficiency.
authors.affiliation: Department of Endocrinology and Metabolism, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. a.j.f.borgers@amc.uva.nl
authors.forename: Anke J
authors.initials: AJ
authors.lastname: Borgers
authors.forename: Nico
authors.initials: N
authors.lastname: Romeijn
authors.forename: Eus
authors.initials: E
authors.lastname: van Someren
authors.forename: Eric
authors.initials: E
authors.lastname: Fliers
authors.forename: Anneke
authors.initials: A
authors.lastname: Alkemade
authors.forename: Peter H
authors.initials: PH
authors.lastname: Bisschop
mesh_terms: D056044:Actigraphy; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000473:pathology / Q000503:physiopathology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000503:physiopathology*; D009897:Optic Chiasm / Q000473:pathology / Q000503:physiopathology*; D010911:Pituitary Neoplasms / Q000150:complications; D012658:Sella Turcica / Q000473:pathology; D012890:Sleep / Q000502:physiology*; D013493:Suprachiasmatic Nucleus / Q000503:physiopathology; D013997:Time Factors