Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

The Effect of Hypnotics on Sleep Quality and Cognitive Function in Patients with Brain Tumors

  • Chang, Min Cheol (Department of Rehabilitation Medicine, College of Medicine, Yeungnam University) ;
  • Chun, Min Ho (Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2019.02.21
  • Accepted : 2019.05.19
  • Published : 2020.03.01
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : We investigated the effect of hypnotics on sleep quality, cognitive function, and depressive mood in patients with insomnia following brain tumor resection. Methods : From patients who underwent brain tumor resection, we recruited 10 patients with insomnia who received hypnotics for more than 1 week during a 3-week follow-up period (insomnia group). We also recruited 12 control patients with brain tumors but without insomnia (control group). We evaluated sleep quality at baseline and 3 weeks later using the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Scale (SSS), and the Epworth Sleepiness Scale (ESS) and investigated cognitive function and depression using the Computerized Neuropsychological Test and the Beck Depression Inventory (BDI). Results : At baseline, SSS, ISI, PSQI, and BDI scores were significantly higher and visual continuous performance test (VCPT) and auditory continuous performance test (ACPT) scores were significantly lower in the insomnia than in the control group. Three weeks later, the patients who had received hypnotics had significantly higher ISI, PSQI, ESS, VCPT, ACPT, visual span forward and backward, and visual recognition test scores, and significantly lower BDI scores. Conclusion : Quality of sleep in patients with insomnia following brain tumor resection was initially poor but improved significantly after taking hypnotic medication. Further, the hypnotic medications appeared to contribute to the amelioration of cognitive impairments and depressive moods in patients who previously underwent brain tumor resection. We thus recommend the use of hypnotics for patients with brain tumors with insomnia.

Keywords

References

  1. Alhola P, Polo-Kantola P : Sleep deprivation: impact on cognitive performance. Neuropsychiatr Dis Treat 3 : 553-567, 2007
  2. Bastien CH, Vallieres A, Morin CM : Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2 : 297-307, 2001 https://doi.org/10.1016/S1389-9457(00)00065-4
  3. Bei B, Asarnow LD, Krystal A, Edinger JD, Buysse DJ, Manber R : Treating insomnia in depression: insomnia related factors predict long-term depression trajectories. J Consult Clin Psychol 86 : 282-293, 2018 https://doi.org/10.1037/ccp0000282
  4. Berch DB, Krikorian R, Huha EM : The Corsi block-tapping task: methodological and theoretical considerations. Brain Cogn 38 : 317-338, 1998 https://doi.org/10.1006/brcg.1998.1039
  5. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ : The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28 : 193-213, 1989 https://doi.org/10.1016/0165-1781(89)90047-4
  6. Callens CJ, Meltzer ML : Effect of intelligence, anxiety, and diagnosis on arithmetic and digit span performance on the WAIS. J Consult Clin Psychol 33 : 630, 1969 https://doi.org/10.1037/h0028302
  7. Campbell SS, Murphy PJ. The nature of spontaneous sleep across adulthood. J Sleep Res 16 : 24-32, 2007 https://doi.org/10.1111/j.1365-2869.2007.00567.x
  8. Chervin RD, Aldrich MS, Pickett R, Guilleminault C : Comparison of the results of the Epworth sleepiness scale and the multiple sleep latency test. J Psychosom Res 42 : 145-155, 1997 https://doi.org/10.1016/S0022-3999(96)00239-5
  9. Chua EC, Fang E, Gooley JJ : Effects of total sleep deprivation on divided attention performance. PLoS One 12 : e0187098, 2017 https://doi.org/10.1371/journal.pone.0187098
  10. Conners CK, Epstein JN, Angold A, Klaric J : Continuous performance test performance in a normative epidemiological sample. J Abnorm Child Psychol 31 : 555-562, 2003 https://doi.org/10.1023/A:1025457300409
  11. Ford DE, Kamerow DB : Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? JAMA 262 : 1479-1484, 1989 https://doi.org/10.1001/jama.1989.03430110069030
  12. Gapstur R, Gross CR, Ness K : Factors associated with sleep-wake disturbances in child and adult survivors of pediatric brain tumors: a review. Oncol Nurs Forum 36 : 723-731, 2009 https://doi.org/10.1188/09.ONF.723-731
  13. Gu SY, Chang MC : The effects of 10-Hz repetitive transcranial magnetic stimulation on depression in chronic stroke patients. Brain Stimul 10 : 270-274, 2017 https://doi.org/10.1016/j.brs.2016.10.010
  14. Ha KS, Kwon JS, Lyoo IK, Kong SW, Lee DW, Youn T : Development and standardization process, and factor analysis of the computerized cognitive function test system for Korea adults. J Korean Neuropsychiatr Assoc 41 : 551-562, 2002
  15. Hoddes E, Zarcone V, Smythe H, Phillips R, Dement WC : Quantification of sleepiness: a new approach. Psychophysiology 10 : 431-436, 1973 https://doi.org/10.1111/j.1469-8986.1973.tb00801.x
  16. Holbrook AM, Crowther R, Lotter A, Cheng C, King D : Meta-analysis of benzodiazepine use in the treatment of insomnia. CMAJ 162 : 225-233, 2000
  17. Holm KJ, Goa KL : Zolpidem: an update of its pharmacology, therapeutic efficacy and tolerability in the treatment of insomnia. Drugs 59 : 865-889, 2000 https://doi.org/10.2165/00003495-200059040-00014
  18. Husby R, Lingjaerde O : Prevalence of reported sleeplessness in northern Norway in relation to sex, age and season. Acta Psychiatr Scand 81 : 542-547, 1990 https://doi.org/10.1111/j.1600-0447.1990.tb05009.x
  19. Jang SH, Chang MC : Motor outcomes of patients with a complete middle cerebral artery territory infarct. Neural Regen Res 8 : 1892-1897, 2013
  20. Mefferd RB Jr, Wieland BA, James WE : Repetitive psychometric measures: digit span. Psychol Rep 18 : 3-10, 1966 https://doi.org/10.2466/pr0.1966.18.1.3
  21. Milner B : Interhemispheric differences in the localization of psychological processes in man. Br Med Bull 27 : 272-277, 1971 https://doi.org/10.1093/oxfordjournals.bmb.a070866
  22. Muller HL, Handwerker G, Wollny B, Faldum A, Sorensen N : Melatonin secretion and increased daytime sleepiness in childhood craniopharyngioma patients. J Clin Endocrinol Metab 87 : 3993-3996, 2002 https://doi.org/10.1210/jcem.87.8.8751
  23. Ohayon MM, Hong SC : Prevalence of insomnia and associated factors in South Korea. J Psychosom Res 53 : 593-600, 2002 https://doi.org/10.1016/S0022-3999(02)00449-X
  24. Palomaki H, Berg A, Meririnne E, Kaste M, Lonnqvist R, Lehtihalmes M, et al. : Complaints of poststroke insomnia and its treatment with mianserin. Cerebrovasc Dis 15 : 56-62, 2003 https://doi.org/10.1159/000067127
  25. Pasula EY, Brown GG, McKenna BS, Mellor A, Turner T, Anderson C, et al. : Effects of sleep deprivation on component processes of working memory in younger and older adults. Sleep 41 : zsx213, 2018
  26. Provini F, Lombardi C, Lugaresi E : Insomnia in neurological diseases. Semin Neurol 25 : 81-89, 2005 https://doi.org/10.1055/s-2005-867074
  27. Query WT, Megran J : Age-related norms for AVLT in a male patient population. J Clin Psychol 39 : 136-138, 1983 https://doi.org/10.1002/1097-4679(198301)39:1<136::AID-JCLP2270390125>3.0.CO;2-Q
  28. Roger M, Attali P, Coquelin JP : Multicenter, double-blind, controlled comparison of zolpidem and triazolam in elderly patients with insomnia. Clin Ther 15 : 127-136, 1993
  29. Rooney A, Grant R : Pharmacological treatment of depression in patients with a primary brain tumour. Cochrane Database Syst Rev 31 : CD006932, 2013
  30. Scharf MB, Mayleben DW, Kaffeman M, Krall R, Ochs R : Dose response effects of zolpidem in normal geriatric subjects. J Clin Psychiatry 52 : 77-83, 1991
  31. Schwartz MD, Kilduff TS : The neurobiology of sleep and wakefulness. Psychiatr Clin North Am 38 : 615-644, 2015 https://doi.org/10.1016/j.psc.2015.07.002
  32. Taylor DJ : Insomnia and depression. Sleep 31 : 447-448, 2008 https://doi.org/10.1093/sleep/31.4.447
  33. Zhou ES, Manley PE, Marcus KJ, Recklitis CJ : Medical and psychosocial correlates of insomnia symptoms in adult survivors of pediatric brain tumors. J Pediatr Psychol 41 : 623-630, 2016 https://doi.org/10.1093/jpepsy/jsv071

Cited by

  1. Association Between the Use of Non-benzodiazepine Hypnotics and Cognitive Outcomes: A Systematic Review vol.6, pp.1, 2020, https://doi.org/10.1007/s40675-020-00163-1
  2. Rehabilitation of Adult Patients with Primary Brain Tumors: A Narrative Review vol.10, pp.8, 2020, https://doi.org/10.3390/brainsci10080492
  3. Sleep disturbance in primary brain tumor: prevalence, risk factors, and patient preferences vol.30, pp.1, 2020, https://doi.org/10.1007/s00520-021-06476-3