持续性姿势-知觉性头晕患者睡眠障碍与认知功能障碍

Sleep disturbance and cognitive dysfunction in patients with persistent postural and perceptual dizziness

目的研究持续性姿势-知觉性头晕(PPPD)患者的睡眠与认知状况,以期通过改善患者睡眠质量,来改善其认知功能。方法采用简易智力状态检查量表(MMSE)、蒙特利尔量表(MoCA)、匹兹堡睡眠质量指数量表(PSQI)和多导睡眠监测(PSG)对70例PPPD患者进行睡眠质量和认知功能状况的调查,分析其相关性。结果(1)MMSE总分为25.10±3.87,在轻度认知障碍的范围内;MoCA总分为23.10±6.11,在轻度认知障碍的范围内;PSQI总分为14.60±2.06,在中度失眠患者的范围内;(2)PPPD患者在MMSE上的注意力、记忆力、回忆能力3个维度、MoCA上的视空间与执行能力、注意力、延迟回忆3个维度与PSQI上睡眠质量、睡眠潜伏期、睡眠时间、睡眠效率、睡眠紊乱、日间功能障碍等维度均呈显著正相关。结论PPPD患者普遍存在着中度睡眠障碍和轻度认知功能障碍,其睡眠质量与认知功能水平存在相关性,提示改善PPPD患者的睡眠质量有助于改善其认知功能。

Objective To study sleep quality and cognitive status and their correlation in patients with persistent postural and perceptual dizziness(PPPD).Methods We assessed sleep quality and cognitive function among 70 patients with PPPD and 70 age-matched heathy volunteers using Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),Pittsburgh Sleep Quality Index and polysomnography(PSG).Results The patients had a mean MMSE score of 25.10±3.87 and a mean MoCA score of 23.10±6.11,both suggesting mild cognitive impairment of the patients.The mean PSQI score of the patients was 14.60±2.06,suggesting moderate insomnia among the patients.The MMSE scores in 3 dimensions(attention,memory and recall ability)and the dimension scores of MoCA for visual space and executive ability,attention and delayed recall all showed significant positive correlations with PSQI scores for sleep quality,sleep latency,sleep duration,sleep efficiency,sleep disorders and daytime dysfunction.Conclusion Moderate sleep disorder and mild cognitive dysfunction are common in PPPD patients.Sleep quality is correlated with cognitive function among these patients,suggesting that improving sleep quality of the patients helps to improve their cognitive function.