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Impaired quality of sleep in Ménière's disease patients
Meiho Nakayama1, Motohiko Suzuki, Akira Inagaki
1Department of Otolaryngology, Nagoya City University, Nagoya, Japan. nakayama@med.nagoya-cu.ac.jp
Objective:
To evaluate the quality of sleep in Ménière's disease patients with the use of polysomnography.
Study Design:
Prospective study using polysomnography administered in patients diagnosed as "Definite Meniere's disease cases" according to the guidelines of the American Academy of Otolaryngology-Head and Neck Surgery.
Methods:
Thirty-five patients, 17 male and 18 female, aged 31 to 71 (58 average) years with active, unilateral, cochleovestibular Ménière's disease refractory to medical management underwent polysomnography. The results were compared with 35 healthy controls matched for age and sex. All participants underwent full-night polysomnography, and a sleep medicine physician interpreted the results.
Results:
Total sleeping time in Ménière's disease was significantly higher than in controls. Stage 2 sleep was significantly longer and stage 3+4 shorter in Ménière's disease than controls, while there was no difference of stage 1 and REM. Arousal index was significantly higher in Ménière's disease than in controls. Five cases of severe OSAS were found in Ménière's disease and 4 cases in controls; 4 cases of PLMD were found in patients and 3 in controls.
Conclusions:
Our finding of decreased deep sleep and an elevated arousal index is a striking new finding in Ménière's disease. This poor quality of sleep in Ménière's disease patients has received little attention in the past, but may cause additional stress and lead to a negative spiral of symptoms.
Insights
Ménière
Area of Science:
- Neurology
- Sleep Medicine
- Otolaryngology
Background:
- Ménière's disease is a disorder of the inner ear.
- Sleep disturbances are common in Ménière's disease patients.
- The specific impact of Ménière's disease on sleep quality requires further investigation.
Purpose of the Study:
- To evaluate the sleep quality of patients with Ménière's disease.
- To compare polysomnography findings in Ménière's disease patients versus healthy controls.
Main Methods:
- Prospective study involving 35 Ménière's disease patients and 35 matched healthy controls.
- All participants underwent full-night polysomnography.
- Sleep medicine physician interpreted polysomnography results.
Main Results:
- Ménière's disease patients had significantly longer total sleep time but reduced deep sleep (stages 3+4) and increased arousal index compared to controls.
- No significant differences were observed in stage 1 or REM sleep.
- Prevalence of severe obstructive sleep apnea (OSAS) and periodic limb movement disorder (PLMD) was similar between groups.
Conclusions:
- Ménière's disease is associated with poorer sleep quality, characterized by decreased deep sleep and elevated arousal.
- These sleep disturbances may exacerbate Ménière's disease symptoms and create a negative feedback loop.
- The impact of sleep quality on Ménière's disease warrants greater clinical attention.
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