THE QUALITY OF SLEEP IN PATIENTS WITH VERTEBRAL ARTERY SYNDROME
Kharkiv Medical Academy of Postgraduate Education, Ukraine
Sleep disorder is one of the most common complaints in patients with myofascial pain syndrome and vertebral artery syndrome. In myofascial pain syndrome, sleep disorders are most commonly caused by the reflected pain resulting from compression of trigger points during sleep or shortening of the affected muscles. According to many authors, the leading role in development of sleep disorders accompanying vertebral artery syndrome, is played by dyshemic disorders in the brain stem, and located in it ascending activating reticular structures, regulating sleep and wakefulness. The quality of sleep and features of its disorders were investigated in 75 patients with myofascial pain syndrome of neck and shoulder location and vertebral artery syndrome resulting from it. Insomnia Severity Index, Epworth Sleepiness Scale were used. Severity of pain was assessed using visual analog scale. The musculotonic disorders were assessed on the basis of calculation of muscle syndrome index. To assess vertebral−basilar insufficiency Hoffenberth scale was used. In patients with myofascial pain syndrome of cervicobrachial location and vertebral artery syndrome accompanying it, sleep disorders consisting in difficulties in falling asleep, interrupted sleep, early final awakening, as well as daytime sleepiness were identified. A positive correlation between the severity of the musculotonic disorders, the pain severity and insomnia severity was found. Sleep disorders in the patients with comorbidity were characterized by more severe form of falling asleep at night, frequent waking up at night, early final awakening, and more pronounced daytime sleepiness. Severity of insomnia directly correlated with the score by B. Hoffenberth et al. scale. Combination of myofascial pain syndrome located in the neck and shoulders and vertebral artery syndrome significantly increases severity of dyssomniac disorders and daytime sleepiness, which should be considered when dealing with this category of patients. The problem of sleep disorders in vertebral artery syndrome requires further investigation in order to develop optimal treatment strategies.
Key words: insomnia, myofascial pain syndrome, vertebral artery syndrome.