Hostname: page-component-54dcc4c588-nx7b4 Total loading time: 0 Render date: 2025-10-10T10:28:19.881Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of sleep quality on effectiveness of repositioning therapy for patients with posterior canal benign paroxysmal positional vertigo

Published online by Cambridge University Press:  10 September 2025

Wenting Wang ,
Rui Han ,
Sai Zhang ,
Shuangmei Yan ,
Ting Zhang ,
Yongci Hao ,
Dong Li ,
Shaona Liu ,
Peifan Xie  and
Chuangwei Wang
...Show all authors
Wenting Wang
Affiliation:
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, HB, China Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, HB, China
Rui Han
Affiliation:
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, HB, China Department of Vertigo Center, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China
Sai Zhang
Affiliation:
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, HB, China Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, HB, China
Shuangmei Yan
Affiliation:
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, HB, China Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, HB, China
Ting Zhang
Affiliation:
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, HB, China Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, HB, China
Yongci Hao
Affiliation:
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, HB, China Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, HB, China
Dong Li
Affiliation:
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, HB, China Department of Vertigo Center, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China
Shaona Liu
Affiliation:
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, HB, China Department of Vertigo Center, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China
Peifan Xie
Affiliation:
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China
Chuangwei Wang
Affiliation:
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China
Xu Yang
Affiliation:
Department of Neurology, Peking University First Hospital, Beijing, China
Ping Gu*
Affiliation:
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, HB, China Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, HB, China Department of Vertigo Center, The First Hospital of Hebei Medical University, Shijiazhuang, HB, China Brain Aging and Cognitive Neuroscience Laboratory of Hebei Province, Shijiazhuang, HB, China
*
Corresponding author: Ping Gu; Email: gpwh2000@126.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

This study aimed to explore clinical characteristics and treatment efficacy in patients with posterior canal benign paroxysmal positional vertigo and different sleep qualities.

Methods

Patients with posterior canal benign paroxysmal positional vertigo were divided into high and low sleep quality groups based on Pittsburgh Sleep Quality Index scores.

Results

No significant baseline differences existed between low (n = 53) and high (n = 39) sleep quality groups. However, the proportion of cupulolithiasis was higher in the low sleep quality group (60.38 per cent vs. 35.90 per cent; p < 0.05). Additionally, the low sleep quality group had a longer median duration of upbeat nystagmus during the Dix-Hallpike test (63.50 seconds vs. 26.80 seconds; p < 0.05) and a lower cured rate in initial repositioning (9.43 per cent vs. 56.41 per cent) compared to high sleep quality group. Repositioning therapy significantly improved depressive and anxiety symptoms in all patients with posterior canal benign paroxysmal positional vertigo, with a more pronounced improvement in depressive symptoms in the low sleep quality group.

Conclusion

Poor sleep quality is associated with higher cupulolithiasis prevalence and treatment resistance, with residual symptoms mainly affecting social functioning.

Keywords

cupulolithiasisPC-BPPVresidual symptomsleep disordervertigo

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , First View , pp. 1 - 9
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Ping Gu takes responsibility for the integrity of the content of the paper

References

Bhattacharyya, N, Gubbels, SP, Schwartz, SR, Edlow, JA, El-Kashlan, H, Fife, T, et al. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg 2017;156:S1–47Google Scholar
Power, L, Murray, K, Szmulewicz, DJ. Characteristics of assessment and treatment in Benign Paroxysmal Positional Vertigo (BPPV). J Vestib Res 2020;30:55–62Google Scholar
Li, K, Li, K, Zhang, X, Yang, J, Tan, H. Study on the correlation of residual symptoms after different repositioning methods for posterior semicircular canal benign paroxysmal positional vertigo. Chin J Otorhinolaryngol Integ Med 2023;31:214–17Google Scholar
Seok, JI, Lee, HM, Yoo, JH, Lee, DK. Residual dizziness after successful repositioning treatment in patients with benign paroxysmal positional vertigo. J Clin Neurol 2008;4:107–10Google Scholar
Hu, Y, Lu, Y, Wang, S, Quan, X, Ren, Y, Rong, K, et al. Global research trends in benign paroxysmal positional vertigo: a bibliometric analysis. Front Neurol 2023;14:1204038Google Scholar
Ke, Y, Ma, X, Jing, Y, Diao, T, Yu, L. Risk factors for residual dizziness in patients with benign paroxysmal positional vertigo after successful repositioning: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2022;279:3237–56Google Scholar
Zhu, S, Peng, B. The impact of sleep disorders on the treatment effectiveness of benign paroxysmal positional vertigo. Chin J Otol 2016;14:549–50Google Scholar
Shu, Y, Liao, N, Fang, F, Shi, Q, Yan, N, Hu, Y. The relationship between psychological conditions and recurrence of benign paroxysmal positional vertigo: a retrospective cohort study. BMC Neurol 2023;23:137Google Scholar
Yuanyuan, C, Jing, Z, Yan, X, Huifang, Z. The impact of sleep on the treatment efficacy of posterior benign paroxysmal positional vertigo. J Audiol Speech Pathol 2022;30:235–8Google Scholar
von Brevern, M, Bertholon, P, Brandt, T, Fife, T, Imai, T, Nuti, D, et al. Benign paroxysmal positional vertigo: diagnostic criteria. J Vestib Res 2015;25:105–17Google Scholar
Wang, W, Yan, S, Zhang, S, Han, R, Li, D, Liu, Y, et al. Clinical application of different vertical position tests for posterior canal-benign paroxysmal positional vertigo-cupulolithiasis. Front Neurol 2022;13:930542Google Scholar
Shuai, Y, Fu, S, Lei, S, Hui, L. Relationship between video head impulse test and duration of residual dizziness after repositioning in benign paroxysmal positional vertigo. Chin J Otol 2023;21:476–480Google Scholar
Giommetti, G, Lapenna, R, Panichi, R, Mobaraki, PD, Longari, F, Ricci, G, et al. Residual dizziness after successful repositioning maneuver for idiopathic benign paroxysmal positional vertigo: a review. Audiol Res 2017;7:178Google Scholar
Martellucci, S, Pagliuca, G, de Vincentiis, M, Greco, A, De, Virgilio A, Nobili Benedetti, FM, et al. Features of residual dizziness after canalith repositioning procedures for benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2016;154:693–701Google Scholar
Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery; Society of Otorhinolaryngology Head and Neck Surgery Chinese Medical Association. Guideline of diagnosis and treatment of benign paroxysmal positional vertigo (2017). Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017;52:173–7Google Scholar
Liu, R, Zheng, J, Dong, H, Xiang, D, He, G, Wen, Y, et al. Analysis of reduction effect of the evoked nystagmus in the non-affect side during Dix-Hallpike or Roll-test in unilateral posterior semicircular canal benign paroxysmal positional vertigo. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020;34:1027–9Google Scholar
Xue, H, Wang, B, Meng, T, Zhao, S, Wang, Q, Zhang, X, et al. Differences of sleep disorders between vestibular migraine and benign paroxysmal positional vertigo. Front Psychiatry 2021;12:726038Google Scholar
Shih, C-P, Wang, C-H, Chung, C-H, Lin, HC, Chen, H-C, Lee, J-C, et al. Increased risk of benign paroxysmal positional vertigo in patients with non-apnea sleep disorders: a nationwide, population-based cohort study. J Clin Sleep Med 2018;14:2021–9Google Scholar
Tsai, MS, Lee, LA, Tsai, YT, Yang, YH, Liu, CY, Lin, MH, et al. Sleep apnea and risk of vertigo: a nationwide population-based cohort study. Laryngoscope 2018;128:763–8Google Scholar
Ichijo, H. Analysis of 30 patients with cupulolithiasis of the posterior semicircular canal. Eur Arch Otorhinolaryngol 2023;280:599–603Google Scholar
Han, D-G, Kim, D-J. The evolutionary hypothesis of benign paroxysmal positional vertigo. Med Hypotheses 2020;134:109445Google Scholar
Valli, P, Botta, L, Zucca, G, Valli, S, Buizza, A. Simulation of cupulolithiasis and canalolithiasis by an animal model. J Vestib Res 2008;18:89–96Google Scholar
Li, KL, Li, JR. The effect of OSAHS on middle ear and inner ear vestibule function advances. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016;30:841–4Google Scholar
Deveze, A, Bernard-Demanze, L, Xavier, F, Lavieille, J-P, Elziere, M. Vestibular compensation and vestibular rehabilitation. Current concepts and new trends. Neurophysiol Clin 2014;44:49–57Google Scholar
Vats, AK, Kothari, S, Biswas, A. Vestibular rehabilitation of the persons affected by Benign Paroxysmal Positional Vertigo (BPPV) by physical therapy and repositioning maneuvers. Ann Indian Acad Neurol 2023;26:S1–9Google Scholar
Wang, Y, Zhang, D, Lei, M, Zeng, P, Cai, C. Study on the relationship between benign paroxysmal positional vertigo and sleep disturbance. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021;35:62–5Google Scholar
Qian, S, Wang, Y, Zhang, X. Inhibiting histamine signaling ameliorates vertigo induced by sleep deprivation. J Mol Neurosci 2019;67:411–17Google Scholar
Wang, CX, Wang, JM. Risk factors for recurrence of benign paroxysmal positional vertigo: a meta analysis. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018;32:1298–303Google Scholar
Sfakianaki, I, Binos, P, Karkos, P, Dimas, GG, Psillas, G. Risk factors for recurrence of benign paroxysmal positional vertigo. A clinical review. J Clin Med 2021;10:4372Google Scholar
Li, S, Wang, Z, Liu, Y, Cao, J, Zheng, H, Jing, Y, et al. Risk factors for the recurrence of benign paroxysmal positional vertigo: a systematic review and meta-analysis. Ear Nose Throat J 2022;101:NP112–34Google Scholar
Gu, L, Chen, J, Zhang, Q, Shen, J, Ma, X, Wang, W, et al. Effect of the course of posterior semicircular canal benign paroxysmal positional vertigo on residual symptoms after successful canalith repositioning procedure. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021;35:976–80Google Scholar
Tian, YS, Zhang, Y, Ma, R, Liu, P. Features of vestibular evoked myogenic potential in patients with residual dizziness after canalith repositioning procedures for benign paroxysmal positional vertigo. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018;32:845–9Google Scholar
Pollak, L, Davies, RA, Luxon, LL. Effectiveness of the particle repositioning maneuver in benign paroxysmal positional vertigo with and without additional vestibular pathology. Otol Neurotol 2002;23:79–83Google Scholar
Dispenza, F, Mazzucco, W, Mazzola, S, Martines, F. Observational study on risk factors determining residual dizziness after successful benign paroxysmal positional vertigo treatment: the role of subclinical BPPV. Acta Otorhinolaryngol Ital 2019;39:347–52Google Scholar
Faralli, M, Lapenna, R, Giommetti, G, Pellegrino, C, Ricci, G. Residual dizziness after the first BPPV episode: role of otolithic function and of a delayed diagnosis. Eur Arch Otorhinolaryngol 2016;273:3157–65Google Scholar
Teggi, R, Quaglieri, S, Gatti, O, Benazzo, M, Bussi, M. Residual dizziness after successful repositioning maneuvers for idiopathic benign paroxysmal positional vertigo. ORL J Otorhinolaryngol Relat Spec 2013;75:74–81Google Scholar
Wei, W, Sayyid, ZN, Ma, X, Wang, T, Dong, Y. Presence of anxiety and depression symptoms affects the first time treatment efficacy and recurrence of benign paroxysmal positional vertigo. Front Neurol 2018;9:178Google Scholar
Ke, Y, Ma, X, Jing, Y, Diao, T, Yu, L. Risk factors for residual dizziness in patients with benign paroxysmal positional vertigo after successful repositioning: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2022;279:3237–56Google Scholar