Sleep Disorders in Children with Central Nervous System Tumors

Sleep complaints are common in pediatric patients with central nervous system (CNS) tumors. These problems may result from disruption of normal homeostatic, circadian, neuroendocrine, and cardiorespiratory pathways and vary by tumor location and treatment received. Children with tumors within the hypothalamus and surrounding regions are prone to excessive daytime sleepiness. Sleep-related breathing disorders, especially those involving abnormal control of breathing, may occur in patients with tumors of the brainstem and posterior fossa. Maintaining a high index of suspicion for sleep disorders in children with CNS tumors is essential for early recognition and treatment. In this article, we will review the various sleep problems reported in pediatric brain tumor survivors, explore underlying neurobiological mechanisms, and discuss approaches to screening and diagnosis.