Surgical Outcomes and Long-Term Postoperative Sleep Quality in Patients with Craniopharyngioma: A Prospective Cohort Study of Hypothalamic-Sparing Techniques
Abstract
Abstract Background Craniopharyngiomas (CPs) are benign parasellar tumors with significant morbidity related to hypothalamic syndrome, including sleep disorders. The relationship between surgical techniques and postoperative sleep outcomes remains incompletely characterized. Objective This article evaluates sleep quality and circadian rhythm dysfunction in CP patients treated with hypothalamic-sparing endoscopic endonasal approaches (EEAs) versus transcranial microsurgical approaches (TCs) and identifies the risk factors for postoperative sleep disturbances. Methods This prospective cohort study enrolled 118 adult patients with suprasellar/intrasellar CPs treated between January 2020 and December 2023. Patients underwent preoperative and postoperative evaluation (3 months, 12 months, and extended follow-up at 24–36 months) using standardized sleep assessment tools including the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Multiple Sleep Latency Test (MSLT), and polysomnography. Circadian rhythm assessment included salivary melatonin concentrations and dim light melatonin onset (DLMO) measurements were measured at baseline and 12-month follow-up. Results EEA resulted in significantly lower rates of postoperative excessive daytime somnolence (EDS) compared with TC (18.6% vs. 41.2%, p = 0.008). Mean MSLT sleep latency improved in the EEA group (11.4 ± 3.2 minutes at baseline to 15.8 ± 4.1 minutes at 12 months) versus the TC group (10.2 ± 2.8 to 11.9 ± 3.5 minutes,…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 118 participants or records.
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