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Original Articles
The Influence of Sleep Position on Benign Paroxysmal Positional Vertigo
Yong Gook Shin, Jin Woo Park, Ja Won Gu, Mee Hyun Song, Dae Bo Shim
Res Vestib Sci. 2016;15(4):121-125.   Published online December 12, 2016
DOI: https://doi.org/10.21790/rvs.2016.15.4.121
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AbstractAbstract PDF
Objective: The purpose of this study was to identify the influence of sleep position on benign paroxysmal positional vertigo (BPPV).
Methods
Four hundred sixty patients diagnosed as posterior or horizontal canal BPPV were analyzed retrospectively. All patients were asked about their preferred sleep positions among the following four choices: supine, right or left lateral, or no predominant side via questionnaire at initial visit and after 1month. Patients were classified into two groups: affected side group meaning that the patient preferred to sleep ipsilateral to the affected ear and other position group including all positions other than lying lateral to the affected side after treatment. We analyzed the change in the sleep pattern after treatment and compared the recurrence rate between the two groups.
Results
Our study included 244 patients with posterior canal BPPV (PC-BPPV) and 216 patients with horizontal canal BPPV (HC-BPPV). Statistically significant correlation was demonstrated between sleep position side and the affected side by BPPV. The number of patients who slept on the affected side by BPPV decreased, while the number of patients who slept on the healthy side increased significantly after treatment. There was no statistically significant difference in the recurrence rate between the two groups.
Conclusion
There was significant correlation between the sleep position side and the affected side in PC-BPPV and HC-BPPV. The patient had a tendency to avoid lying lateral to the affected side by BPPV during sleep after treatment, however the change in sleep position did not influence the recurrence rate of BPPV.
Sleep and Vestibular Neuritis
Hyun Ah Kim, Hyung Lee
J Korean Bal Soc. 2006;5(1):44-48.
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AbstractAbstract PDF
Background
and Objectives: While it is known that sleep have influence on emergence of rapid eye movements(REMs), namely saccades including fast component of nystagmus, whether spontaneous nystagmus due to vestibular imbalance presents during sleep is still unclear. The purpose of our study was to investigate whether tonic vestibular imbalance appeared as spontaneous nystagmus during the wakeful state could present during REM sleep. Materials and Method: Overnight polysomnography (PSG) was performed in 7 patients with spontaneous nystagmus due to vestibular neuritis (VN) and 7 control patients without dizziness or any nystagmus. The numbers of horizontal saccades were counted, during 3 minutes samples of the alert state before and after the PSG and the first and last REM sleep.
Results
All patients with VN showed significantly more saccades (fast phases of spontaneous nystagmus) towards the side contralateral to their vestibular lesion in the awake state before and after the PSG compared with control group. By contrast, during REM sleep the patients with VN showed no preponderance in saccade direction (p<0.05). Some brief nystagmoid jerks showed during REM sleep in both patients and controls equally and also had no preponderance in direction.
Conclusion
The tonic vestibular imbalance at peripheral level observed during alert state does not appear at the brainstem level during REM sleep. It is suggested that a de-afferentation of the peripheral vestibular input to the REM sleep generating areas may explain an absence of nystagmus during REM sleep in patients with VN. Key Words : Vestibular imbalance, Nystagmus, REM sleep

Res Vestib Sci : Research in Vestibular Science