Non-24-hour sleep-wake rhythm disorder and melatonin secretion impairment in a patient with pineal cyst

Lorenzo Ferri, Marco Filardi, Monica Moresco, Fabio Pizza, Stefano Vandi, Elena Antelmi, Francesco Toni, Mino Zucchelli, Giulia Pierangeli, Giuseppe Plazzi

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)1355-1357
Number of pages3
JournalJournal of Clinical Sleep Medicine
Volume13
Issue number11
DOIs
Publication statusPublished - Jan 1 2017

Keywords

  • Actigraphy
  • Body-core temperature
  • Free-running disorder
  • Melatonin
  • Pineal cyst

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

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