Craniopharyngiomas are rare solid or mixed solid and cystic tumors that arise from Rathke’s pouch remnants along the pituitary-hypothalamic axis, from the sella turcica to the brain third ventricle. Both the tumor and its treatment can lead to significant neurological and endocrinological complications. Due to the essential role of the hypothalamus in the complex neurophysiologic process of sleep, tumors involving the hypothalamic area may be responsible for disturbances in sleep–wake regulation with alterations in the circadian rhythm, sleep fragmentation, and increased daytime sleepiness. We report two cases of patients with craniopharyngioma, who came to our attention due to the occurrence of episodes characterized by psychomotor slowing and afinalistic limb movements, temporal and spatial disorientation, psychomotor agitation, and oneiric stupor like episodes. A comprehensive clinical data collection and a targeted diagnostic work-up led to a diagnosis of severe sleep disorder characterized by hypersomnia, altered sleep–wake rhythm, and sleep-related breathing disorder. In addition, the polysomnography revealed peculiar alterations in the sleep structure. The diagnostic work-up lead to an accurate differential diagnosis between epileptic seizures and episodes expressions of sleep disturbances. These clinical features can be challenging to diagnose and can lead to misdiagnosis and inappropriate treatment. Diagnosis of sleep disorders is crucial, considering the impact of sleep on general health, cognition, and neuropsychological functioning. These findings support the need to incorporate a comprehensive sleep evaluation in childhood brain tumor involving the suprasellar/hypothalamic region.

颅咽管瘤是罕见的实性或混合实性和囊性肿瘤，起源于沿垂体-下丘脑轴的 Rathke 囊残余物，从蝶鞍到大脑第三脑室。肿瘤及其治疗都可能导致严重的神经和内分泌并发症。由于下丘脑在复杂的睡眠神经生理过程中的重要作用，累及下丘脑区域的肿瘤可能是导致睡眠-觉醒调节紊乱、昼夜节律改变、睡眠碎片化和白天嗜睡增加的原因。我们报告了两例颅咽管瘤患者，他们因出现以精神运动减慢和肢体运动迟钝、时间和空间定向障碍、精神运动性激越为特征的发作而引起我们的注意。和梦幻般的昏迷，如剧集。全面的临床数据收集和有针对性的诊断检查导致诊断为严重睡眠障碍，其特征是嗜睡、睡眠-觉醒节律改变和睡眠相关呼吸障碍。此外，多导睡眠图显示睡眠结构的特殊变化。诊断检查导致癫痫发作和睡眠障碍的发作表现之间的准确鉴别诊断。这些临床特征可能难以诊断，并可能导致误诊和不适当的治疗。考虑到睡眠对整体健康、认知和神经心理功能的影响，诊断睡眠障碍至关重要。