睡眠对后半规管良性阵发性位置性眩晕的影响

The Impact of Sleep on the Treatment Efficacy of Posterior Benign Paroxysmal Positional Vertigo

目的探讨睡眠对原发性后半规管良性阵发性位置性眩晕(PC-BPPV)的影响。方法选取2019年9月~2020年6月经SRM-Ⅳ型BPPV诊疗系统明确诊断为PC-BPPV的患者83例(单侧67例,双侧16例),根据匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)评分,分为睡眠障碍组(56例)及对照组(27例),比较两组复位后1周及1个月的疗效,并分析单侧PC-BPPV患耳的侧别与睡眠姿势侧别的相关性。结果①治疗后1周,睡眠障碍组和对照组的治愈率和总有效率分别为46.43%和76.79%以及74.07%和92.59%,差异无统计学意义(P=0.127,P>0.05)。治疗后1个月,两组治愈率和总有效率分别为50.00%和83.93%以及85.19%和92.59%,差异无统计学意义(P=0.490,P>0.05)。②单侧PC-BPPV患者67例中,40例患耳与睡姿同侧,占59.7%(40/67),两者的相关性有统计学意义(χ^(2)=8.908,P<0.01),Pearson列联系数为0.340,低度相关。结论睡眠对原发性PC-BPPV有一定影响,本组伴睡眠障碍的BPPV患者复位的短期疗效较差;单侧PC-BPPV患耳的侧别与睡眠姿势侧别存在相关性,适当改变睡姿对预防单侧BPPV可能有一定价值。

Objective To investigate the impact of sleep on the treatment efficacy of primary posterior benign paroxysmal positional vertigo(PC-BPPV).Methods The participants of this study were 83 patients who were diagnosed with primary PC-BPPV at the clinic from Sep 2019 to June 2020.All the patients were treated with the automatic vestibular function diagnosis and therapy system(SRM-IV).Participants completed the Pittsburgh sleep quality index(PSQI),and the comorbid sleep disorders group(n=56)and control group(n=27)were respectively defined.We compared the effect of the 7th day and 1 month between the 2 groups and analyzed the association between the ear affected by BPPV and the preferred head-lying side during sleep onset.Results All the patients completed the treatment successfully.①In the comorbid sleep disorders group the cure rate was 46.43%and total effective rate was 76.79%at 7 days follow-up,and 50.00%and 83.93%at 1 month follow-up respectivery.In the control group,the cure rate was 74.07%and the total effective rate was 92.59%at 7 days follow-up,and 85.19%and 92.59%at 1 month follow-up respectivery.There were no significant differences in the short-term outcome between the 2 groups(P>0.05).②During sleep onset,there were 40 patients who suffered the same affected side ear and head-lying side during sleep onset among the 67 patients with unilateral PC-BPPV,and the percentage was 59.7%(40/67).The association between the affected ear and the head-lying side during sleep onset was statistically significant(χ^(2)=8.908,P<0.01)and Pearson coefficient of conlinency was 0.340.Conclusion The short-term effect in primary PC-BPPV patients with comorbid sleep disorders is poorer compared to control group,but there were no significant differences.However,there was association between the ear affected by BPPV and the preferred head-lying side during sleep onset,appropriate change of sleeping posture may play a role in preverting unilateled BPPV.