Clinical features and influencing factors of sleep disturbance in vestibular migraine patients: A multi-center cross-sectional study

Abstract

Background

Vestibular migraine (VM) is frequently complicated by sleep disorders, potentially involving abnormalities in vestibular-brainstem neural pathways. This study aimed to analyze sleep characteristics and influencing factors in VM patients through a multicenter cross-sectional survey, explore associations with symptoms like vertigo and headache, and provide a basis for precise interventions.

Objective

To profile the sleep characteristics and clinical features of patients with vestibular migraine (VM), and to explore the influencing factors of sleep disturbance in VM patients.

Methods

In this multi-center cross-sectional study, we recruited VM patients who were treated in otolaryngology department and neurology department of 5 hospitals in Sichuan Province from June 2022 to June 2024 as experimental group (including two subgroups divided based on PSQI score: poor sleep quality (PSQI > 5) and good sleep quality (PSQI ≤ 5)), Meanwhile, the control group was composed of non-VM volunteers matching clinical characteristics of experimental group. After clinical data organization, participants were subjected to sleep quality assessment using the Pittsburgh Sleep Quality Index (PSQI). A multivariate Logistic regression was employed to outline factors influencing sleep disturbance in VM patients. In addition, Spearman correlation coefficient was used as a criterion to identify the correlation of sleep disturbance with headache, vertigo and hearing and other clinical features in VM patients.

Results

With 530 VM patients included, 332 patients had poor sleep quality (PSQI > 5) (62.64%), 198 patients had good sleep quality (PSQI ≤ 5) (37.36%), and 50 patients were selected as the control. VM group had higher total and individual scores of PSQI (p < 0.05). PSQI in VM patients was correlated with VAS and DHI positively (r = 0.797, p < 0.05; r = 0.834, p < 0.05), but PSQI had no correlation with pure tone hearing (r = 0.324, p = 0.167). Moreover, female, age ≥60 years, living alone, duration of disease ≥3 months, motion sickness history, and HADS-A were independent influencing factors for VM patients with poor sleep quality (p < 0.05).

Conclusion

Sleep disturbance is a major interfering factor in VM patients, and patients may experience more severe headache and vertigo when sleep disorder aggravates. VM patients who are female, ≥60 years old, live alone, have a disease course ≥3 months, have a history of motion sickness, and have anxiety should undergo sleep assessment to determine whether there is poor sleep quality, so as to provide a theoretical basis for VM intervention precisely.