Endocrine Abstracts

Patients with craniopharyngioma have increased mortality attributed to cardiorespiratory disease, when compared to other hypopituitary populations. There is little data on the cause for excess of fatal respiratory disease in this condition. Clinical observation had identified sleep apnoea in some craniopharyngioma patients in our cohort. Sleep apnoea increases cerebrovascular and cardiovascular morbidity and mortality. Our hypothesis was that sleep apnoea could be a contributor to cardiorespiratory disease in craniopharyngioma patients.

All 51 surviving patients in our craniopharyngioma cohort were invited to participate in the study of the prevalence of sleep apnoea, with local Ethics Committee approval. 21 patients (12 male) agreed to the full protocol. Median body mass index (BMI) was 33 kg/m² (range 26–61.1), with 17/21 obese (BMI >30 kg/m²). Out-patient somnolence was assessed with the Epworth Sleepiness Score (ESS); 7/21 had an abnormal ESS (>10/24). Patients were admitted for polysomnography with morning arterial blood sampling. Apnoea was defined as an apnoea hypopnoea index (AHI)>5 events/hour. AHI range was 2.1–46.4 events/hour, and 9 patients had sleep apnoea (6 male). AHI did not correlate with BMI (Spearman’s Rho, r=0.197) or with ESS (r=−0.05). No respiratory pathology was identified on formal pulmonary function tests.

In the largest series of craniopharyngioma patients studied with polysomnography, we have demonstrated that sleep apnoea is common. Outpatient assessment of somnolence and obesity did not predict sleep apnoea. Sleep apnoea is potentially a treatable cause of the excess cardiovascular morbidity associated with craniopharyngioma and we recommend sleep studies for all craniopharyngioma patients.