Sleep in Different Types of Dizziness.
4 affiliations
- 1Department of Neurology, Universidade Federal Do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
- 2SENSE Research Unit, Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, London, UK.
- 3Department of Otolaryngology, Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil.
- 4Laboratório De Neurociência e Psicologia Social - LaNPSo, Universidade Federal do Delta do, Parnaíba - UFDPar, Rio de Janeiro, Brazil.
Abstract
Objective
Sleep disturbances and dizziness are frequently comorbid, yet the specific sleep profiles across different vestibular disorders remain poorly characterized. This study aimed to investigate distinct sleep signatures in patients with benign paroxysmal positional vertigo (BPPV), vestibular migraine (VM), and persistent postural-perceptual dizziness (PPPD) compared to healthy controls.Methods
We conducted a cross-sectional study with 90 participants: 24 healthy controls, 21 with BPPV, 23 with PPPD, and 22 with VM. Sleep was assessed using a multimodal approach: 14-day actigraphy, a single-night home sleep apnea test (Watch-PAT), and validated questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Dizziness Handicap Inventory (DHI), and Beck Anxiety/Depression Inventories.Results
All dizziness groups reported significantly worse subjective sleep quality and higher psychological burden than controls. However, each disorder presented a unique objective signature: BPPV: Characterized by objective sleep fragmentation and a markedly higher Apnea-Hypopnea Index (AHI: 31.5) and Oxygen Desaturation Index (ODI: 16). These patients also showed increased nocturnal restlessness (L5). PPPD: Demonstrated a "sleep paradox" with the highest objective sleep efficiency but the poorest subjective perception (PSQI: 11.0). Patients showed reduced daytime activity (M10) and rigid sleep routines with virtually no weekend-weekday get-up time difference. VM: Distinguished by the shortest total sleep time and pronounced, though not statistically significant, "social jetlag", reflected by a 120-min discrepancy between weekend and weekday get-up times.Conclusion
Dizziness is not a homogeneous entity regarding sleep. The distinct signatures found suggest that clinical management should be tailored: screening for sleep apnea in BPPV, addressing the objective-subjective disconnect in PPPD via cognitive-behavioral approaches, and managing sleep deprivation and circadian regularity in VM.
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BibTeX
@article{joffily2026sleep,
title = {{Sleep in Different Types of Dizziness.}},
author = {Lucia Joffily and Marco Antônio Sales Dantas de Lima and John Fontenele Araújo and Diego Kaski},
journal = {Brain and behavior},
year = {2026},
month = oct,
doi = {10.1002/brb3.71863},
url = {https://europepmc.org/article/MED/42902879},
note = {CC BY},
}
RIS
TY - JOUR
TI - Sleep in Different Types of Dizziness.
AU - Lucia Joffily
AU - Marco Antônio Sales Dantas de Lima
AU - John Fontenele Araújo
AU - Diego Kaski
PY - 2026
DA - 2026/10/01
JO - Brain and behavior
DO - 10.1002/brb3.71863
UR - https://europepmc.org/article/MED/42902879
AB - Objective Sleep disturbances and dizziness are frequently comorbid, yet the specific sleep profiles across different vestibular disorders remain poorly characterized. This study aimed to investigate distinct sleep signatures in patients with benign paroxysmal positional vertigo (BPPV), vestibular migraine (VM), and persistent postural-perceptual dizziness (PPPD) compared to healthy controls.Methods We conducted a cross-sectional study with 90 participants: 24 healthy controls, 21 with BPPV, 23 with PPPD, and 22 with VM. Sleep was assessed using a multimodal approach: 14-day actigraphy, a single-night home sleep apnea test (Watch-PAT), and validated questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Dizziness Handicap Inventory (DHI), and Beck Anxiety/Depression Inventories.Results All dizziness groups reported significantly worse subjective sleep quality and higher psychological burden than controls. However, each disorder presented a unique objective signature: BPPV: Characterized by objective sleep fragmentation and a markedly higher Apnea-Hypopnea Index (AHI: 31.5) and Oxygen Desaturation Index (ODI: 16). These patients also showed increased nocturnal restlessness (L5). PPPD: Demonstrated a "sleep paradox" with the highest objective sleep efficiency but the poorest subjective perception (PSQI: 11.0). Patients showed reduced daytime activity (M10) and rigid sleep routines with virtually no weekend-weekday get-up time difference. VM: Distinguished by the shortest total sleep time and pronounced, though not statistically significant, "social jetlag", reflected by a 120-min discrepancy between weekend and weekday get-up times.Conclusion Dizziness is not a homogeneous entity regarding sleep. The distinct signatures found suggest that clinical management should be tailored: screening for sleep apnea in BPPV, addressing the objective-subjective disconnect in PPPD via cognitive-behavioral approaches, and managing sleep deprivation and circadian regularity in VM.
SN - 2162-3279
ER -