Changes in sleep performance and chronotype behaviour after vestibular rehabilitation in unilateral vestibular hypofunction

Abstract

Objective This study aimed to investigate changes in sleep parameters and self-perceived sleep quality in unilateral vestibular hypofunction participants after vestibular rehabilitation. Method Forty-six unilateral vestibular hypofunction participants (before and after vestibular rehabilitation) along with a control group of 60 healthy patients underwent otoneurological examination, a one-week actigraphy sleep analysis and a series of self-report and performance measures. Results After vestibular rehabilitation, unilateral vestibular hypofunction participants showed a significant score decrease in the Pittsburgh Sleep Quality Index, a self-rated reliable questionnaire depicting sleep quality during the last month, as well as a reduction in sleep onset latency and an increase in total sleep time, indicating an objective improvement in sleep quality as measured by actigraphy analysis. However, after vestibular rehabilitation, unilateral vestibular hypofunction participants still showed statistically significant differences with respect to the control group in both self-rated and objective measurements of sleep quality. Conclusion Vestibular rehabilitation may impact on sleep performance and chronotype behaviour, possibly by opposing long-term structural changes along neural pathways entangled in sleep activity because of the deafferentation of the vestibular nuclei.

Chronic Vestibular Hypofunction Is Associated with Impaired Sleep: Results from the DizzyReg Patient Registry

“…Moreover, these combined findings lead to the hypothesis that chronic or long-term vestibular disorders such as unilateral vestibular hypofunction have an even greater negative impact on sleep quality than acute vestibular problems [ 19 ]. Conversely, interventions of vestibular rehabilitation improved sleep parameters in patients with unilateral vestibular hypofunction [ 20 ].…”

Spatial anxiety contributes to the dizziness-related handicap of adults with peripheral vestibular disease

“…In humans, epidemiologic evidence supports that adults with vertigo have a higher risk for abnormal sleep duration ( 85 ); conversely, in patients with sleep complains, sleep architecture variation has been associated with vestibular symptoms ( 86 ). Additionally, clinical studies have shown that persistent sleep disturbance after vestibular rehabilitation is related to handicap severity ( 87 ), while rehabilitation for unilateral vestibular disease is associated to improvement of the quality of sleep ( 88 ). However, these variables interact with stress, with a bidirectional relation between stress and sleep quantity, in which worse sleep quantity and continuity may predict higher next-day stress ( 89 ).…”