Association Between Sleep and Vertigo Severity in Benign Paroxysmal Positional Vertigo: Mediating Role of Psychological Factors
Juanli Xing,1,* Xinyu Xu,2– 4,* Hongying Shan,2 Jiaqian Wu,4 Peiyu Liu,5 Wenyan Shi,4 Peihua Ren,2 JinLing Liu,4 Yuge Huang,2 Baibing Mi2 1Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2025-06-01
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| Series: | Nature and Science of Sleep |
| Subjects: | |
| Online Access: | https://www.dovepress.com/association-between-sleep-and-vertigo-severity-in-benign-paroxysmal-po-peer-reviewed-fulltext-article-NSS |
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| Summary: | Juanli Xing,1,&ast; Xinyu Xu,2– 4,&ast; Hongying Shan,2 Jiaqian Wu,4 Peiyu Liu,5 Wenyan Shi,4 Peihua Ren,2 JinLing Liu,4 Yuge Huang,2 Baibing Mi2 1Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 2Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, People’s Republic of China; 3Department of Occupational and Environmental Health, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 4Department of Health Science Center, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 5Department of Health Science Center, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Baibing Mi, Department of Epidemiology and Biostatistics Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, People’s Republic of China, Email xjtu.mi@xjtu.edu.cnObjective: To investigate the relationship between sleep quality and vertigo severity among patients with benign paroxysmal positional vertigo (BPPV) and to elucidate the mediating effects of anxiety and depression on this association.Methods: We analyzed baseline data from an ongoing cohort study of 1056 BPPV patients in Northwest China. Vertigo severity was assessed using the Dizziness Handicap Inventory (DHI), sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI), and psychological states were evaluated using the Hospital Anxiety and Depression Scale (HADS), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). Multiple regression and mediation analysis were conducted to explore the relationships between sleep quality, psychological factors, and vertigo severity.Results: Robust correlations were demonstrated between total PSQI scores and all DHI subscales (p < 0.001). Multivariate ordered logistic regression revealed that patients exhibiting sleep disorders manifested a substantially elevated risk of severe vertigo compared to those without (OR: 2.024; 95% CI: 1.571– 2.608). Psychological factors emerged as significant mediators in this relationship, with anxiety accounting for 28.5% of the mediation effect, depression contributing 38%, and HADS mediating 37.7% of the association. A pronounced dose-response relationship was noted, with increased risk of vertigo severity as PSQI scores exceeded 7.Conclusion: This study shows a strong correlation between poor sleep quality and increased vertigo severity in BPPV patients, with anxiety and depression as significant mediators. These findings emphasize the need to address sleep-related factors and psychological symptoms in BPPV management, suggesting integrated sleep therapy and psychological interventions.Plain Language Summary: Current Knowledge/Study Rationale: Benign paroxysmal positional vertigo (BPPV) is strongly linked to sleep disorders and psychological comorbidities, yet the mediating role of psychological factors in exacerbating vertigo severity remains underexplored. This study investigates how anxiety and depression modulate the relationship between poor sleep quality and vestibular disability in BPPV patients.Study Impact: The results reveal that anxiety and depression mediate over one-third of the association between sleep disorders and vertigo severity, establishing a bidirectional pathway between psychological distress and vestibular dysfunction. These findings advocate for integrated clinical strategies targeting both sleep health and psychological well-being to optimize BPPV management and reduce vertigo-related disability. Keywords: benign paroxysmal positional vertigo, sleep medicine, otology, neurotology, anxiety, depression |
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| ISSN: | 1179-1608 |