Non-24-Hour Sleep-Wake Rhythm Disorder and Melatonin Secretion Impairment in a Patient With Pineal Cyst.

Abstract

ABSTRACT:

We report the case of a 14-year-old girl with a wide non-compressive pineal cyst, associated with the inability to control her sleep-wake schedule. Actigraphic monitoring showed a 24-hour free-running disorder (tau 26.96 hours). A 24-hour serum melatonin curve assay, with concomitant video-polysomnographic and body-core temperature monitoring, was performed. Melatonin curve showed a blunted nocturnal peak, lower total quantity of melatonin, and prolonged melatonin secretion in the morning, with normal temperature profile and sleep parameters. Treatment with melatonin up to 14 mg at bedtime was initiated with complete realignment of the sleep-wake rhythm (tau 23.93 hours). The role of the pineal cyst in the aforementioned alteration of melatonin secretion and free-running disorder remains controversial, but our case supports the utility of monitoring sleep/wake, temperature, and melatonin rhythms in the diagnostic work-up of pineal cysts associated with free-running disorder.

• Authors: Lorenzo Ferri, Marco Filardi, Monica Moresco, Fabio Pizza, Stefano Vandi, Elena Antelmi, Francesco Toni, Mino Zucchelli, Giulia Pierangeli, Giuseppe Plazzi
• Journal: Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine (J Clin Sleep Med) Vol. 13 Issue 11 Pg. 1355-1357 (Nov 15 2017) ISSN: 1550-9397 [Electronic] United States
• PMID: 28992833 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2017 American Academy of Sleep Medicine

Chemical References

• Central Nervous System Depressants
• Melatonin

Topics

• Adolescent
• Central Nervous System Depressants (therapeutic use)
• Cysts (complications, physiopathology)
• Female
• Humans
• Melatonin (therapeutic use)
• Pineal Gland (physiopathology)
• Sleep Disorders, Circadian Rhythm (complications, drug therapy)
• Treatment Outcome