title: Sleep-wake and melatonin pattern in craniopharyngioma patients.
abstract: OBJECTIVE
  To assess the influence of craniopharyngioma or consequent surgery on melatonin secretion, and the association with fatigue, sleepiness, sleep pattern and sleep quality.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A total of 15 craniopharyngioma patients were individually matched to healthy controls. In this study, 24-h salivary melatonin and cortisol were measured. Sleep-wake patterns were characterised by actigraphy and sleep diaries recorded for 2 weeks. Sleepiness, fatigue, sleep quality and general health were assessed by Multidimensional Fatigue Inventory, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Short-Form 36.
  
  
  RESULTS
  Patients had increased mental fatigue, daytime dysfunction, sleep latency and lower general health (all, P≤0.05), and they tended to have increased daytime sleepiness, general fatigue and impaired sleep quality compared with controls. The degree of hypothalamic injury was associated with an increased BMI and lower mental health (P=0.01). High BMI was associated with increased daytime sleepiness, daytime dysfunction, mental fatigue and lower mental health (all, P≤0.01). Low midnight melatonin was associated with reduced sleep time and efficiency (P≤0.03) and a tendency for increased sleepiness, impaired sleep quality and physical health. Midnight melatonin remained independently related to sleep time after adjustment for cortisol. Three different patterns of melatonin profiles were observed; normal (n=6), absent midnight peak (n=6) and phase-shifted peak (n=2). Only patients with absent midnight peak had impaired sleep quality, increased daytime sleepiness and general and mental fatigue.
  
  
  CONCLUSIONS
  Craniopharyngioma patients present with changes in circadian pattern and daytime symptoms, which may be due to the influence of the craniopharyngioma or its treatment on the hypothalamic circadian and sleep regulatory nuclei.
authors.affiliation: Department of EndocrinologyCopenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen East, DenmarkDanish Center for Sleep MedicineDepartment of Clinical BiochemistryCopenhagen University Hospital, Glostrup Hospital, Ndr. Ringvej 57, DK-2600 Glostrup, DenmarkDepartment of NeurosurgeryCopenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen East, Denmark.
authors.forename: Line
authors.initials: L
authors.lastname: Pickering
authors.affiliation: Department of EndocrinologyCopenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen East, DenmarkDanish Center for Sleep MedicineDepartment of Clinical BiochemistryCopenhagen University Hospital, Glostrup Hospital, Ndr. Ringvej 57, DK-2600 Glostrup, DenmarkDepartment of NeurosurgeryCopenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen East, Denmark.
authors.forename: Poul
authors.initials: P
authors.lastname: Jennum
authors.affiliation: Department of EndocrinologyCopenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen East, DenmarkDanish Center for Sleep MedicineDepartment of Clinical BiochemistryCopenhagen University Hospital, Glostrup Hospital, Ndr. Ringvej 57, DK-2600 Glostrup, DenmarkDepartment of NeurosurgeryCopenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen East, Denmark.
authors.forename: Steen
authors.initials: S
authors.lastname: Gammeltoft
authors.affiliation: Department of EndocrinologyCopenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen East, DenmarkDanish Center for Sleep MedicineDepartment of Clinical BiochemistryCopenhagen University Hospital, Glostrup Hospital, Ndr. Ringvej 57, DK-2600 Glostrup, DenmarkDepartment of NeurosurgeryCopenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen East, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Poulsgaard
authors.affiliation: Department of EndocrinologyCopenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen East, DenmarkDanish Center for Sleep MedicineDepartment of Clinical BiochemistryCopenhagen University Hospital, Glostrup Hospital, Ndr. Ringvej 57, DK-2600 Glostrup, DenmarkDepartment of NeurosurgeryCopenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen East, Denmark ufeldt@rh.dk.
authors.forename: Ulla
authors.initials: U
authors.lastname: Feldt-Rasmussen
authors.affiliation: Department of EndocrinologyCopenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen East, DenmarkDanish Center for Sleep MedicineDepartment of Clinical BiochemistryCopenhagen University Hospital, Glostrup Hospital, Ndr. Ringvej 57, DK-2600 Glostrup, DenmarkDepartment of NeurosurgeryCopenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen East, Denmark.
authors.forename: Marianne
authors.initials: M
authors.lastname: Klose
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002940:Circadian Rhythm / Q000502:physiology*; D003397:Craniopharyngioma / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D005221:Fatigue / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008550:Melatonin / Q000097:blood*; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology; D012890:Sleep / Q000502:physiology*; D055815:Young Adult
chemical_list: D008550:Melatonin