Risk factors for hypersomnia/narcolepsy and response to therapy in survivors of childhood brain tumors (P3.148)

Objective: Describe the risk factors for hypersomnia/narcolepsy and response to stimulant therapy in childhood brain tumor survivors. Background: Idiopathic hypersomnia and narcolepsy are diagnosed by mean sleep onset latency and numbers of sleep onset REM sleep episodes during multiple sleep latency testing (MSLT). Daytime sleepiness is recognized in brain tumor survivors but few studies have reported risk factors or response to therapy. Design/Methods: Institutional medical records were reviewed for all brain tumor survivors coded as having sleep disorder, hypersomnia or narcolepsy. Hypersomnia/narcolepsy were diagnosed according to International Headache Society classification based on overnight polysomnogram/MSLT. Each affected survivor was matched by gender, and age and time from tumor diagnosis to 2–3 survivors without daytime sleepiness. Study variables included tumor location, radiation dose, number of surgeries, ventricular shunt, and BMI. Treatment response was obtained by parent report. Results: The 39 survivors with hypersomnia (n=13) and narcolepsy (n=26) were matched with 110 controls. A total of 2336 brain tumor patients were treated during the study period, translating to an estimated hypersomnia/narcolepsy prevalence of 1670/100,000. Median time from tumor diagnosis to hypersomnia/narcolepsy was 6.1 years (range 0.4 – 13.2), and 4.7 years (range −1.5 – 10.4) from radiation. Only midline tumor location (OR 5.3, CI 2.2 – 12.7, p = 30 Gray (p = Conclusions: Hypersomnia/narcolepsy prevalence of 1670/100,000 among childhood brain tumor survivors is much higher than 20–50/100,000 reported in general population. Midline tumor location and >30 gray radiation to the brain strongly correlated with hypersomnia/narcolepsy. Stimulant therapy is beneficial in this population. Disclosure: Dr. Khan has nothing to disclose. Dr. Merchant has nothing to disclose. Dr. Sadighi has nothing to disclose. Dr. Crabtree has nothing to disclose. Dr. Bello has nothing to disclose. Dr. Sykes has nothing to disclose. Dr. Lu has nothing to disclose. Dr. Zabrowski has nothing to disclose. Dr. Simmons has nothing to disclose. Dr. mandrell has nothing to disclose.