Impaired Quality of Sleep in Ménière's Disease Patients

Nakayama, Meiho; Suzuki, Motohiko; Inagaki, Atsushi; Takemura, Keiji; Watanabe, Nobuhiro; Tanigawa, Tohru; Okamoto, Kazushi; Hattori, Hidekazu; Brodie, Hilary A.; Murakami, Shingo

doi:10.5664/jcsm.27933

Cited by 34 publications

(21 citation statements)

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“…In addition, the rate of sleep disturbance in dizzy patients is higher in women, and it is also associated with emotional stress and anxiety [ 10 ]. However, these studies discussed relationships between sleep disturbance and dizziness symptoms, or only one disease entity, rather than various disease categories [ 11 ]. A study of the relationship between sleep quality and vestibular function in patients with OSAS indicated that vestibular function was decreased in those with moderate to severe OSAS [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

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Relationship between sleep quality and dizziness

Kim

Jeon

et al. 2018

PLoS ONE

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ObjectivePoor sleep quality has a number of significant negative effects on daytime function. However, few studies have examined sleep quality in patients with dizziness. Here, we investigated the potential association between sleep quality and various types of dizziness.Subjects and methodsWe examined dizziness and sleep disturbance in 237 patients experiencing dizziness using Korean versions of the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and Dizziness Handicap Inventory (DHI). All participants were classified as having benign paroxysmal positional vertigo (BPPV), Ménière’s disease (MD), vestibular neuritis (VN), vestibular migraine (VM), psychogenic dizziness (PD), or Other.ResultsThe mean PSQI and ISI scores were highest in the PD group. The rate of sleep disturbance was highest in the Other group when the cut-off score for each questionnaire was set differently, except ISI ≥ 15. The correlation between DHI and sleep disturbance indices was highest in the VM group. Multivariate regression showed that PSQI score and DHI-E score were significantly related to the PD and Other groups, while the Other group was significantly related to the ISI score.ConclusionThe findings of this study strongly suggest that there are associations between sleep quality and some disease subtypes associated with dizziness. Therefore, it is important to consider sleep disturbance in patients with psychogenic dizziness, such as phobic postural vertigo and chronic subjective dizziness, or nonspecific dizziness.

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Section: Discussionmentioning

confidence: 99%

“…[ 10 ] and Nakayama et al . [ 11 ] also investigated the relationship between dizziness and sleep disturbance, but these studies focused only on the comorbidity between sleep disturbance and chronic dizziness or one type of disease.…”

Section: Introductionmentioning

confidence: 99%

Relationship between sleep quality and dizziness

Kim

Jeon

et al. 2018

PLoS ONE

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“…Tympanic ventilation tubes might correct middle-inner ear pressure, resulting in modification of AVP secretion from the hypothalamic–pituitary system mediated by vestibulo-hypothalamic neural interactions [ 29 ]. In G-IV: Generally, patients with Meniere’s disease have some degree of sleep disorder [ 30 ]. Therefore, supporting the circadian rhythm of these patients by treating any sleep disorder is an important therapeutic approach.…”

Section: Discussionmentioning

confidence: 99%

A Two-Year Randomized Trial of Interventions to Decrease Stress Hormone Vasopressin Production in Patients with Meniere’s Disease—A Pilot Study

et al. 2016

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Meniere's disease, a common inner ear condition, has an incidence of 15–50 per 100,000. Because mental/physical stress and subsequent increase in the stress hormone vasopressin supposedly trigger Meniere's disease, we set a pilot study to seek new therapeutic interventions, namely management of vasopressin secretion, to treat this disease. We enrolled 297 definite Meniere's patients from 2010 to 2012 in a randomized-controlled and open-label trial, assigning Group-I (control) traditional oral medication, Group-II abundant water intake, Group-III tympanic ventilation tubes and Group-IV sleeping in darkness. Two hundred sixty-three patients completed the planned 2-year-follow-up, which included assessment of vertigo, hearing, plasma vasopressin concentrations and changes in stress/psychological factors. At 2 years, vertigo was completely controlled in 54.3% of patients in Group-I, 81.4% in Group-II, 84.1% in Group-III, and 80.0% in Group-IV (statistically I < II = III = IV). Hearing was improved in 7.1% of patients in Group-I, 35.7% in Group-II, 34.9% in Group-III, and 31.7% in Group-IV (statistically I < II = III = IV). Plasma vasopressin concentrations decreased more in Groups-II, -III, and -IV than in Groups-I (statistically I < II = III = IV), although patients’ stress/psychological factors had not changed. Physicians have focused on stress management for Meniere’s disease. However, avoidance of stress is unrealistic for patients who live in demanding social environments. Our findings in this pilot study suggest that interventions to decrease vasopressin secretion by abundant water intake, tympanic ventilation tubes and sleeping in darkness is feasible in treating Meniere’s disease, even though these therapies did not alter reported mental/physical stress levels.Trial Registration: ClinicalTrials.gov NCT01099046

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“…GS works mainly during sleep and it is largely disengaged during wakefulness. 27 Nakayama et al 28 found in 35 patients that total sleeping time was significantly higher than in controls. Nevertheless, they also showed in these patients, for the first time, a poor quality of sleep with decreased deep sleep and an elevated arousal index allowing speculating an impairment of GS at least in some patients affected with MD.…”

Section: The Putative Role Of Brain Lymphatic System Brain Tissues Armentioning

confidence: 96%

“…Similarly Lei Y et al 23 emphasized the potential role of ISF to better deliver specific drugs to brain cells taking in account that neural cells occupy only 70-80% of the total brain volume, the vascular system and ISS together form the brain microenvironment and ISF alone occupies 15-20% of the total brain volume. Both Authors [23][24][25][26][27][28][29][30][31][32][33][34][35][36] suggested that neurological afflictions can be viewed as diseases with a neuro-lympho-vascular component and should be therapeutically targeted as such. This kind of approach may be extended to MD treatment, too.…”

Section: The Putative Role Of Brain Lymphatic System Brain Tissues Armentioning

confidence: 99%

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2018

MOJI

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Ménière's disease (MD) is a chronic illness of the inner ear. It is characterised by intermittent episodes of vertigo lasting from minutes to hours, with sensor neural, usually fluctuating, hearing loss, tinnitus, and aural pressure. Diagnosis is mainly based on clinical course and MD is usually considered as a multifactorial disease. Thus there are not yet evidences of a specific treatment. Authors start from a particular case of MD patient that was completely healed after tonsillectomy, an absolute unusual treatment for this kind of disease. On the basis of Literature and their studies about the role of vascular, viral, allergologic and immunologic disorders in MD patients, Authors speculates about the Brain Lymphatic System as an unitary explanation of the effects of infective foci, like chronic palatine tonsils, viral infections, inner ear epitopes activation and allegro-immunologic disturbances in MD pathogenesis. This kind of approach, in the aim of the Authors, may help to better planning a tailored treatment for the patient.

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Impaired Quality of Sleep in Ménière's Disease Patients

Cited by 34 publications

References 21 publications

Relationship between sleep quality and dizziness

Relationship between sleep quality and dizziness

A Two-Year Randomized Trial of Interventions to Decrease Stress Hormone Vasopressin Production in Patients with Meniere’s Disease—A Pilot Study

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