Clinical characteristics of sleep disorders in patients with vestibular migraine

DOI: https://doi.org/10.1007/s11325- 019- 01994- 1

Abstract-Summary To study and analyze the sleep quality and sleep structure of patients with vestibular migraine (VM).

In this cross-sectional case-control study, the Pittsburgh Sleep Quality Index (PSQI) questionnaire and polysomnography (PSG) were used to compare the clini- cal characteristics of sleep disorders in 49 patients with VM, 52 patients with migraine, and 54 controls.

Compared with the migraine and control groups, the VM group had a higher incidence of poor sleep quality (χ2 = 36.618, p < 0.01) and greater severity of poor sleep quality (p < 0.01).

We report an effect of VM on sleep structure and an association with migraine. Similar to migraine, VM affects the sleep regulation centers and causes structural

sleep disorders.

Extended: Compared with the control group, total sleep times, sleep efficiency, and proportions of N3 and Rapid Eye Movement (REM) phases in the VM group were significantly reduced (p < 0.05).

Compared with the control group, the sleep structure of the migraine group was

similar to that of the VM group.

We aim to combine VM research with sleep research and to determine whether certain physical therapies that stimulate targeted brain nuclei, such as repetitive transcranial magnetic stimulation, can improve sleep quality in patients with VM and control the onset of VM attacks.

Objective Vestibular migraine (VM) is a vestibular paroxysmal disease that is induced by a variety of factors and characterized by paroxysmal vertigo and migraine.

In patients with migraine, sleep disorders such as insomnia can induce migraine,

and migraine can also cause insomnia and other sleep problems [651, 652].

The relationship between migraine and sleep is established, but analyses of sleep

structure in VM are lacking.

The relationship between sleep disorders and dizziness was recently reported by Kim and others, who showed a correlation between vestibular-related diseases including VM and sleep disorders in a large sample size study [653].

The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to analyze

and evaluate the subjective sleep quality of patients.

The purpose of this study was to explore the clinical characteristics of sleep dis- orders in patients with VM, and to further understand the relationship between the disease and sleep disorders.

2.4 Lifestyle

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Methods From January 2017 to December 2018, patients who presented at the outpatient department of the Neurology and Vertigo Clinic of the Second Affiliated Hospital of Zhengzhou University were included if they met the following cri- teria: (1) they met the diagnostic criteria of VM and migraine listed in the 2013 version of the ICHD- III [351]; (2) they were in the age range of 18–80 years; (3) they were willing to undergo the relevant sleep assessments and examinations; and (4) they had not taken any drugs that affect sleep within 1 week before the examination.

PSG is the gold standard method for diagnosing sleep disorders, and its compo- nents include electroencephalography (EEG), electromyography, electrocardiogra- phy, and monitoring of respiration, snoring, and oxygen saturation index values [654].

All sleep data were analyzed by the same physician trained in PSG technology, and related parameters were generated with the ProFusion PSG 4 software (Compumedics).

Results Compared with that in the migraine group (59.62%) and control group (12.96%), the incidence of poor sleep quality in the VM group (67.35%) was significantly higher (p < 0.05).

Significant differences in sleep times, sleep efficiency, sleep quality, sleep distur- bance, daytime dysfunction, and PSQI total scores were observed between the VM and migraine groups (p < 0.05).

Compared with patients in the migraine and control groups, patients with VM

had poorer sleep quality and a higher incidence of sleep disorders.

Compared with the control group, total sleep times, sleep efficiency, and propor- tions of N3 and Rapid Eye Movement (REM) phases in the VM group were signifi- cantly reduced (p < 0.05).

Waking times, sleep latencies, REM latencies, N1 phases, and N2 phases were longer, and the awakening index (AI) was significantly higher in the VM group than in the control group (p < 0.05).

Discussion The recent sleep quality of VM, migraine, and control groups was investigated using the PSQI.

We observed that the changes in the sleep structure of patients with VM were similar to those observed in the migraine group, with a significant difference between patients with VM and the control group.

Recent studies have indicated that dizziness is closely related to the severity of sleep disorders by comparing the severity of sleep disorders in patients with differ- ent types of vertigo, especially in patients with VM [653].

We found that the incidence of poor sleep quality was higher in patients with VM

than in patients with migraine and healthy controls.

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2 Mechanisms

We also found that patients with VM and patients with migraine exhibited simi- lar changes in sleep structure, including decreased sleep efficiencies, prolonged sleep latencies, and reductions in REM sleep phases.

Acknowledgement A machine generated summary based on the work of Wu, Jun; Liu, Chunling; Yu, Haitao; Li, Hui; Jia, Yanlu; Zhang, Defu; Chen, Lili; Li, Xiaonan. 2019 in Sleep and Breathing

2.5

Hormones

Machine generated keywords: hormone, estrogen, hormonal, sexual, woman migraine, hormonal contraceptive, course, contraceptive, sex hormone, withdrawal, menstrual, cluster, sex, woman, depression anxiety

Effect of exogenous estrogens and progestogens on the course of migraine during reproductive age: a consensus statement by the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESCRH)