持续性姿势–知觉性头晕患者多导睡眠监测特征分析

Analysis of Polysomnographic Characteristics in Patients with Persistent Postural-Perceptual Dizziness

摘要: 目的：探讨持续性姿势–知觉性头晕(Persistent Postural-Perceptual Dizziness, PPPD)患者的多导睡眠监测(Polysomnography, PSG)特征，分析其潜在睡眠障碍模式，为临床管理提供依据。方法：本研究采用病例–对照设计，纳入102例符合巴拉尼协会2017年诊断标准的PPPD患者及80例性别、年龄匹配的健康对照者。收集人口学信息、匹兹堡睡眠质量指数、阿森斯失眠量表、过度嗜睡量表，以及汉密尔顿抑郁量表及焦虑量表。所有受试者完成整夜PSG监测，比较两组睡眠结构、睡眠效率及呼吸事件差异，并进行相关性分析。结果：PPPD患者主观睡眠质量显著下降(匹兹堡睡眠质量指数评分显著增高，P = 0.001)。PSG显示其总睡眠时间显著缩短(P < 0.001)、睡眠效率降低(P < 0.001)、入睡后觉醒时间延长(P < 0.001)。睡眠结构方面，浅睡眠比例增加，而深睡眠(N3)及REM睡眠减少(均P < 0.05)。此外，PPPD组阻塞性睡眠呼吸暂停(Obstructive Sleep Apnea, OSA)患病率显著升高，呼吸暂停低通气指数显著高于对照组(P < 0.001)。结论：PPPD患者呈现特征性睡眠障碍模式，包括睡眠维持困难、睡眠结构浅化及OSA高共病率。建议在PPPD的临床管理中常规纳入睡眠评估，尤其是OSA筛查。

Abstract: Objective: To investigate the polysomnographic (PSG) characteristics of patients with Persistent Postural-Perceptual Dizziness (PPPD) and analyze potential sleep disturbance patterns, providing evidence for clinical management. Methods: This case-control study included 102 PPPD patients diagnosed according to the 2017 Barany Society criteria and 80 age- and sex-matched healthy controls. Demographic information, Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), Epworth Sleepiness Scale (ESS), and Hamilton Depression and Anxiety Scales were collected. All participants underwent full-night PSG monitoring. Differences in sleep structure, sleep efficiency, and respiratory events were compared between the two groups, and correlation analyses were performed. Results: PPPD patients showed significantly impaired subjective sleep quality (higher PSQI scores, P = 0.001). PSG results revealed significantly reduced total sleep time (P < 0.001), lower sleep efficiency (P < 0.001), and prolonged wakefulness after sleep onset (P < 0.001). In terms of sleep structure, there was an increase in light sleep, while deep sleep (N3) and REM sleep were reduced (both P < 0.05). Additionally, the PPPD group had a significantly higher prevalence of obstructive sleep apnea (OSA), with a higher apnea-hypopnea index compared to the control group (P < 0.001). Conclusion: PPPD patients exhibit a characteristic sleep disturbance pattern, including difficulties in sleep maintenance, shallower sleep structure, and high comorbidity with OSA. Routine sleep assessment, especially OSA screening, should be incorporated into the clinical management of PPPD.