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Sleep position and laterality of benign paroxysmal positional vertigo

Published online by Cambridge University Press:  03 April 2008

S G Korres ,
C E Papadakis ,
M G Riga ,
D G Balatsouras ,
D G Dikeos  and
C R Soldatos
S G Korres
Affiliation:
ENT Department of Hippokration Hospital, National University of Athens, Greece
C E Papadakis
Affiliation:
ENT Department of Hippokration Hospital, Chania General Hospital, Crete, Greece
M G Riga*
Affiliation:
ENT Department of Hippokration Hospital, National University of Athens, Greece
D G Balatsouras
Affiliation:
ENT Department of Hippokration Hospital, Tzanion General Hospital, PiraeusGreece
D G Dikeos
Affiliation:
Department of Psychiatry, Eginition Hospital, National University of Athens, Greece
C R Soldatos
Affiliation:
Department of Psychiatry, Eginition Hospital, National University of Athens, Greece
*
Address for correspondence: Dr Maria Riga, 35 Leoforos Makris, Nea Chili, 68100, Alexandroupolis, Greece. Fax: 0030 2551039986 E-mail: mariariga@hotmail.com
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Abstract

Objective:

The aim of this study was to investigate the frequency of posterior semicircular canal benign paroxysmal positional vertigo in each ear, and to assess the association between the ear affected by benign paroxysmal positional vertigo and the head-lying side during sleep onset. Based on a previous study which used objective methods to prove the preference of the elderly for the right head-lying side during sleep, we hypothesised that a predominance of the same head-lying side in benign paroxysmal positional vertigo patients may affect the pathophysiology of otoconia displacement.

Study design:

We conducted a prospective study of out-patients with posterior semicircular canal benign paroxysmal positional vertigo, confirmed by a positive Dix–Hallpike test.

Methods:

One hundred and forty-two patients with posterior semicircular canal benign paroxysmal positional vertigo were interviewed about their past medical history, focusing on factors predisposing to benign paroxysmal positional vertigo. All patients included in the study were able to define a predominant, favourite head-lying side, right or left, during sleep onset.

Results:

The Dix–Hallpike test was found to be positive on the right side in 82 patients and positive on the left side in 54; six patients were found to be positive bilaterally. During sleep onset, 97 patients habitually laid their head on the right side and the remaining 45 laid their head on the left. The association between the affected ear and the head-lying side during sleep onset was statistically significant (p < 0.001).

Conclusions:

Our study found a predominance of right-sided benign paroxysmal positional vertigo, a subjective preference amongst patients for a right head-lying position during sleep onset, and an association between the ear affected by benign paroxysmal positional vertigo and the preferred head-lying side during sleep onset. The clinical and therapeutical implications of this observation are discussed.

Keywords

Positional VertigoOtolithic MembraneSleep
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 12 , December 2008 , pp. 1295 - 1298
Copyright
Copyright © JLO (1984) Limited 2008

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References

1Epley, JM. The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 1992;107:399–404CrossRefGoogle ScholarPubMed
2Hornubia, V, Baloh, RW, Harris, MR, Jacobson, AM. Paroxysmal positional vertigo syndrome. Am J Otol 1999;40:465–70Google Scholar
3Korres, S, Balatsouras, DG, Ferekidis, E. Prognosis of patients with benign paroxysmal positional vertigo treated with repositioning procedures. J Laryngol Otol 2006;120:528–33CrossRefGoogle Scholar
4Korres, SG, Balatsouras, DG. Diagnostic, pathophysiologic, and therapeutic aspects of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2004;131:438–44CrossRefGoogle ScholarPubMed
5Haynes, DS, Resser, JR, Labadie, RF, Girasole, CR, Kovach, BT, Scheker, LE et al. Treatment of benign positional vertigo using the Semont maneuver: efficacy in patients presenting without nystagmus. Laryngoscope 2002;112:796–801CrossRefGoogle ScholarPubMed
6Katsarkas, A. Benign paroxysmal positional vertigo (BPPV): idiopathic versus post-traumatic. Acta Otolaryngol 1999;119:745–9CrossRefGoogle ScholarPubMed
7Korres, S, Balatsouras, DG, Kamberos, A, Economou, C, Kandiloros, D, Ferekidis, E. Occurrence of semicircular canal involvement in benign paroxysmal positional vertigo. Otol Neurotol 2002;23:926–32CrossRefGoogle ScholarPubMed
8Serafini, G, Palmieri, AM, Simincelli, C. Benign paroxysmal positional vertigo of posterior semicircular canal: results in 160 cases treated with Semont's maneuver. Ann Otol Rhinol Laryngol 1996;105:770–5CrossRefGoogle ScholarPubMed
9Wolf, JS, Boyev, KP, Manokey, J, Mattox, DE. Success of the modified Epley maneuver in treating benign paroxysmal positional vertigo. Laryngoscope 1999;109:900–3CrossRefGoogle ScholarPubMed
10De Koninck, J, Lorrain, D, Gagnon, P. Sleep positions and position shifts in five age groups: an ontogenetic picture. Sleep 1992;15:143–9CrossRefGoogle ScholarPubMed
11Cakir, BO, Ercan, I, Cakir, ZA, Civelek, S, Turgut, S. Relationship between the affected ear in benign paroxysmal positional vertigo and habitual head-lying side during bed-rest. J Laryngol Otol 2006;120:534–6CrossRefGoogle Scholar
12Lopez-Escamez, JA, Gamiz, MJ, Finana, MG, Perez, AF, Canet, IS. Position in bed is associated with left or right location in benign paroxysmal positional vertigo of the posterior semicircular canal. Am J Otolaryngol 2002;23:263–6CrossRefGoogle ScholarPubMed
13Dix, R, Hallpike, CS. The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol 1952;6:987–1016CrossRefGoogle Scholar
14Roberts, RA, Gans, RE, Kastner, AH. Differentiation of migrainous positional vertigo (MPV) from horizontal canal benign paroxysmal positional vertigo (HC-BPPV). Int J Audiol 2006;45:224–6CrossRefGoogle ScholarPubMed
15Beynon, GJ. A review of management of benign paroxysmal positional vertigo by exercise therapy and by repositioning manoeuvers. Br J Audiol 1997;31:11–26CrossRefGoogle Scholar
16Bronstein, AM. Vestibular reflexes and positional maneuvers. J Neurol Neurosurg Psychiatry 2003;74:289–93Google Scholar
17Semont, A, Freyss, E, Vitte, P. Curing the BPPV with a liberatory maneuver. Adv Otorhinolaryngol 1988;42:290–3Google ScholarPubMed
18Epley, JM. Positional vertigo related to semicircular canalithiasis. Otolaryngol Head Neck Surg 1995;112:154–61Google ScholarPubMed
19Ishiyama, A, Jacobson, KM, Baloh, RW. Migraine and benign positional vertigo. Ann Otol Rhinol Laryngol 2000;109:377–80Google ScholarPubMed
20Del Rio, M, Arriaga, MA. Benign positional vertigo: prognostic factors. Otolaryngol Head Neck Surg 2004;130:426–9Google ScholarPubMed
21Gyo, K. Benign paroxysmal positional vertigo as a complication of postoperative bed-rest. Laryngoscope 1988;98:332–3CrossRefGoogle Scholar
22von Brevern, M, Seelig, T, Neuhauser, H, Lempert, T. Benign paroxysmal positional vertigo predominantly affects the right labyrinth. J Neurol Neurosurg Psychiatry 2004;75:1487–8CrossRefGoogle ScholarPubMed
23Martin-Du Pan, RC, Benoit, R, Ginardier, L. The role of body position and gravity in the symptoms and treatment of various medical diseases. Swiss Med Wkly 2004;134:543–51Google ScholarPubMed
24Korres, S, Balatsouras, DG, Ferekidis, E. Electronystagmographic findings in benign paroxysmal positional vertigo. Ann Otol Rhinol Laryngol 2004;113:313–18CrossRefGoogle ScholarPubMed
25Squires, TM, Weidman, MS, Hain, TC, Stone, HA. A mathematical model for top-shelf vertigo: the role of sedimenting otoconia in BPPV. J Biomech 2004;37:1137–46CrossRefGoogle ScholarPubMed