Resources
Authors & Affiliations
Lucija Grbić, Darko Orešković, Tonko Marinović, Darko Chudy, Pia Barač, Tin Luka Petanjek, Andrea Blažević
Abstract
Glioblastoma, highly aggressive neoplasms, deliver a devastating diagnosis and induce severe symptoms, notably sleep disturbances. Disrupted sleep triggers systemic pro-tumor effects in various cancers. Our research explores the pro-tumor impact of disturbed sleep and potential pathophysiological effects of the brain lesion on sleep ability in our patients, and as indicated by the available literature. To assess sleep quality of patients with neuroradiologically proven brain tumors, participants completed The Pittsburgh Sleep Quality Index questionnaire. After obtaining the pathological diagnosis, we categorized patients into groups based on tumor type, focusing this summary on those with a confirmed glioblastoma diagnosis. Our results in addition to a comprehensive literature search reveals a direct link between neoplasms and sleep disruption. Patients with disrupted sleep exhibit a higher prevalence of diseases, and those with CNS pathology show susceptibility to sleep disruption. Precise reasons for brain tumors affecting sleep remain unknown. Various articles mention potential explanations, including comorbidities, medications, and neuropsychiatric effects. A malignant lesion disrupting neural projections or structures in sleep-wake circuitry can impair sleep due to complex changes involving the entire brain. The literature proposes mechanisms linking disrupted sleep to malignancy's pro-tumor effects: phase shifts, reduced antioxidants, immunosuppression, metabolic changes, melatonin depletion, cognitive impairment, and epigenetic changes. Given all these, disrupted sleep might not only be a symptom but also a potential factor in disease progression. Addressing this in glioblastoma patients could extend beyond palliative measures, offering a therapeutic approach to enhance quality of life and limit disease progression, particularly when other treatments are exhausted.