title: Comprehensive assessment of Somnolence Syndrome in patients undergoing radiation to the brain.
abstract: OBJECTIVE
  The aim of this prospective study was to assess Somnolence Syndrome (SS) in patients undergoing radiation to the brain.
  
  
  BACKGROUND
  SS is one of the sequelae of radiation to the brain, which is observed within three months of radiation. This is a self-limiting condition and a failure to diagnose leads to unnecessary investigations. This study was undertaken to objectively and subjectively analyze the occurrence, clinical presentation and severity of SS.
  
  
  METHODS
  Thirty-three patients receiving radiation to the brain were included in the study. Visual Analog Scale (VAS) was used for subjective assessment and the Littman Somnolence Syndrome (LSS) scale was used for objective assessment of SS. Sleep Latency Test (SLT) was used to quantify SS.
  
  
  RESULTS
  VAS scores showed an initial fall until week 3, followed by a plateau and a sudden increase after week 10. LSS scale at week 11 and 12 showed that 13 patients (43.3%) had grade 2, 5 (16.7%) had grade 3; and 2 (6.7%) had grade 4 SS. SLT revealed a shift of predominant sleep pattern from NREM 1 to NREM 2 at 6 weeks after radiation with apvalue of 0.0412.
  
  
  CONCLUSIONS
  An insight into SS, its features, frequency of occurrence and self limiting nature can prevent anxiety and unwarranted investigations in the immediate post radiation period.
authors.affiliation: Department of Radiation Oncology, Gujarat Cancer & Research Institute, Ahmedabad, India.
authors.forename: Ritika R
authors.initials: RR
authors.lastname: Harjani
authors.affiliation: Department of Radiation Oncology, M.S. Ramaiah Medical College, Bangalore, India.
authors.forename: Janaki Manur
authors.initials: JM
authors.lastname: Gururajachar
authors.affiliation: Department of Pulmonary Medicine, St. John's National Academy of Health Sciences, Bangalore, India.
authors.forename: Umamaheswari
authors.initials: U
authors.lastname: Krishnaswamy
keywords: Brain irradiation; Littman score; Sleep Latency Test; Somnolence Syndrome; VAS