0864 Evolution of Sleep Symptoms over Time Among Youth with Craniopharyngioma
Bibliographic record
Abstract
Abstract Introduction Craniopharyngioma is a non-malignant tumor that arises in the suprasellar region of the intracranial compartment. Hypothalamic dysfunction is common and associated with diabetes insipidus, hormone deficiencies, neurocognitive impairment, sleep disturbance, obesity, and decreased health-related quality of life. Patients with craniopharyngioma commonly have excessive daytime sleepiness, and are often diagnosed with narcolepsy without cataplexy and even obstructive sleep apnea (OSA). This study examined the change in apnea/hypopnea index (AHI) and prevalence of disorders of hypersomnia among pediatric patients with craniopharyngioma, from the time of diagnosis to 3 years after the completion of proton therapy. Methods A total of 110 pediatric patients diagnosed with craniopharyngioma were prospectively evaluated on a protocol of limited surgery and proton therapy or observation. Prior to proton therapy , patients age ≥4 years completed a baseline overnight polysomnography (PSG) and the next day multiple sleep latency test (MSLT) when age ≥7 years. Follow-up PSG and MSLT were repeated 3 years later. Patients were excluded from the analysis if they did not complete the sleep study at either time points. Results 71 completed the baseline and 3-year PSG/MSLT. A paired samples t-test determined the change between time points. When compared to baseline (M=1.30, SE=.22) the AHI significantly increased at the 3-year evaluation (M=3.00, SE=.60), with a difference of t=-1.69, (p=.002). Fifty-one patients completed the baseline and 3-year MSLT. At baseline, 8 patients did not exhibit a hypersomnolence disorder, 30 were diagnosed with hypersomnia due to medical disorder and 13 were diagnosed with narcolepsy due to medical disorder. At the 3-year MSLT, 2 of the 51 did not exhibit a hypersomnolence disorder, 30 were diagnosed with hypersomnia due to medical condition and 19 were diagnosed with narcolepsy due to medical condition. Conclusion Pediatric patients with craniopharyngioma have disorders of hyposomnolence at diagnosis. The number impacted by hypersomnia increase with time, with the added burden of hypothalamic obesity and OSA. Interventions should be initiated early after diagnosis for promotion of wakefulness and prevention of obesity to deter the onset of OSA. Support (if any) This work was supported by the Cancer Center Support Grant (CA21765) from the National Cancer Institute and ALSAC.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".