Effects of sleep disturbance on neuropsychological functioning in patients with pediatric brain tumor

Purpose While the effects of sleep on cognition in typically developing children are well established, there is a paucity of research in patients with pediatric brain tumor (PBT), despite their increased risk for sleep-related disturbances. The aim of this retrospective study was to examine the impact of sleep factors on patient-reported outcome (PRO) measures, including adaptive and executive functioning within this population. Methods 133 patients with PBT (52% male) ages 5-23 (x = 12.8 years; SD = 4.5 years) underwent neuropsychological evaluation, including assessment of adaptive and executive functioning. Subjective sleep concerns, nocturnal sleep duration, and daytime sleep behavior were also collected and compared to age-based guidelines. Results Nearly 30% of patients endorsed subjective sleep concerns, while the sample as a whole reported reduced nocturnal sleep duration (approximately one hour below age-based recommendations). Despite the expectation for monophasic sleep by age five, nearly half of the sample reported consistent daytime napping. Inadequate sleep predicted decreased adaptive functioning, F(1, 56) = 4.23, p = .022 (R-2 = .07), as well as increased symptoms of executive dysfunction, F(1, 108) = 3.51, p = .003 (R-2 = .03). Conclusion Patients with PBT demonstrate several aspects of abnormal sleep, which are associated with poorer long-term PROs. Further exploration of diagnostic, treatment-related, and demographic variables will be needed to better understand these relationships among patients with PBT in order to inform appropriate interventions.