Compression of the optic chiasm is associated with permanent shorter sleep duration in patients with pituitary insufficiency

• Published in: Clinical endocrinology (Oxford) 2011-09, Vol.75 (3), p.347-353
• Main Authors: Borgers, Anke J., Romeijn, Nico, van Someren, Eus, Fliers, Eric, Alkemade, Anneke, Bisschop, Peter H.
• Format: Article
• Language: English
• Subjects: Actigraphy; Adult; Age; Aged; Biological and medical sciences; Body mass index; Case-Control Studies; Compression; Endocrinopathies; Female; Fundamental and applied biological sciences. Psychology; Humans; Hypopituitarism - pathology; Hypopituitarism - physiopathology; Hypothalamus; Hypothalamus. Hypophysis. Epiphysis (diseases); Inventories; Linear Models; Male; Medical sciences; Middle Aged; Multivariate Analysis; Nerve Compression Syndromes - etiology; Nerve Compression Syndromes - physiopathology; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Optic chiasm; Optic Chiasm - pathology; Optic Chiasm - physiopathology; Pituitary; Pituitary Neoplasms - complications; Radiotherapy; Regression analysis; Rhythms; Sella Turcica - pathology; Sex; Skull; Sleep; Sleep - physiology; Sleep and wakefulness; Suprachiasmatic nucleus; Suprachiasmatic Nucleus - physiopathology; Surgery; Time Factors; Vertebrates: endocrinology; Wrist
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1111/j.1365-2265.2011.04053.x

Summary 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. Design  Case–control study. Patients  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. Measurements  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.