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

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.