The Association between Sleep Duration and Dizziness in Korean Women: The Korea National Health and Nutrition Examination Survey

The relationship between dizziness and sleep: a review of the literature

Background

The relation between vestibular disorders and (quality of) sleep is underexplored scientifically and the complex interactions between vestibular and sleep disorders are far from being well understood. Some studies have been conducted on the association between patients with vestibular disorders and (the occurrence of) sleep disorders, other studies have been published on the prevalence of dizziness complaints in patients with sleep disorders. The quality of sleep in patients with vestibular disorders generally receives little attention in clinical practice.

Objective

To establish what is currently known about the mutual relationship between dizziness and sleep, and to assess whether or not there is evidence of causality with regard to this relationship.

Methods

After systematically searching four literature database up until 1 April 2024, selected studies were summarized and evaluated through a (critical) review.

Results

Ultimately, 42 studies were selected and evaluated. Patients with dizziness in general and patients with a specific vestibular disorder like Benign Paroxysmal Positional Vertigo, Vestibular Migraine, Meniere's disease, and vestibular hypofunction were significantly more likely to have sleep disorders than control groups. A causal relationship is not supported due to the nature of the studies. In patients with obstructive sleep apnea syndrome there were significantly more vestibular complaints, and more disorders in the vestibular system were identified.

Conclusion

Dizziness complaints often co-exist with a sleep disorder. To what extent this sleep disorder influences dizziness is not clear. Paying attention to the quality of sleep in patients with a vestibular disorder seems to be important. In patients with OSAS, consideration should be given to vestibular complaints and dysfunction.

Application of clinical indicators in evaluating vestibular compensation efficacy in benign recurrent vestibular vertigo patients with short-term personalized vestibular rehabilitation

BACKGROUND

Short-term personalized vestibular rehabilitation (ST-PVR) can establish stable vestibular compensation. However, there is a lack of a clear definition for clinical indicators that can dynamically reflect the progress of vestibular rehabilitation (VR).

OBJECTIVE

To explore the clinical indicators suitable for evaluating the effectiveness of ST-PVR in treating benign recurrent vertigo (BRV).

METHODS

In total, 50 patients diagnosed with BRV were enrolled. All patients received the ST-PVR treatment program. At 2 and 4 weeks after rehabilitation, subjective scales, including the visual analogue scale (VAS), dizziness handicap inventory scale (DHI), activities-specific balance confidence scale (ABC) and generalized anxiety disorder (GAD-7) were assessed. Objective vestibular function tests were performed. VR grading was determined.

RESULTS

At 2 weeks after rehabilitation, significant enhancements were observed in VAS, DHI, ABC, GAD-7, UW, vHIT results, and VR grading scores (p < 0.05). The sensory organization test (SOT) results demonstrated statistically significant improvements at 2 weeks and 4 weeks after rehabilitation (p < 0.05).

CONCLUSION AND SIGNIFICANCE

Both subjective scales and partial examination results in objective assessment can serve as indicators to dynamically monitor the compensatory process of vestibular function in patients with BRV. The VR efficacy grading score, which incorporates the above indicators, allows for quantification of the changes that occur during the vestibular rehabilitation process.

Risk of Obstructive Sleep Apnea, Chronic Dizziness, and Sleep Duration

BACKGROUND

Although it is recommended that obstructive sleep apnea (OSA) be screened for using a validated self-report questionnaire in patients experiencing dizziness, there is still a lack of research on the relationship between high risk of OSA and chronic dizziness.

OBJECTIVES

The study aimed to examine the relationship between the high risk of OSA and chronic dizziness and investigate how this relationship is affected by sleep duration.

METHODS

This cross-sectional study used data from the 8th Korea National Health and Nutrition Examination Survey (2019-2021). Adults aged 40 years or older were included and divided into two groups using the STOP-Bang Questionnaire (SBQ): a high-risk group for OSA or not. Complex samples logistic regression analyses were performed to examine the odds ratios of chronic dizziness based on the national population estimates.

RESULTS

Our findings showed that individuals in the high-risk group for OSA were significantly more likely to experience chronic dizziness. Specifically, among subgroups based on sleep duration, the high-risk group for OSA with a short sleep duration of ≤5 hours demonstrated the highest odds of chronic dizziness, showing a significantly 2.48-fold increased likelihood compared to the non-high risk for OSA with a sleep duration of 5-9 hours.

DISCUSSION

The SBQ can be beneficial when other causes do not explain chronic dizziness, helping to rule in the possibility of OSA. Educating individuals suspected of having OSA or who have been diagnosed with OSA about the importance of adequate sleep duration may help reduce the risk of chronic dizziness.

Psychosocial Factors Associated with dizziness and chronic dizziness: a nationwide cross-sectional study

BACKGROUND

Dizziness is a common symptom in adults, and chronic dizziness, such as persistent postural-perceptual dizziness, is also frequently reported and affects the quality of life of patients. This study aimed to identify psychosocial factors related to dizziness and chronic dizziness in a large-scale nationwide cohort.

METHODS

This population-based cross-sectional study used the database of the Eighth Korea National Health and Nutrition Examination Survey in 2020. Data from 4,147 adults over 40 years old were analyzed, and 1,102 adults who experienced dizziness were included in the dizziness cohort. Demographic data, medical conditions, comorbidities, functional status variables, nutritional variables and psychological variables were collected. The pattern of depressive symptoms according to the severity of dizziness was analyzed by network analysis.

RESULTS

The prevalence rate of dizziness was 24.6% in the general population, and chronic dizziness (≥ 3 months) developed in 210 of 1,102 (17.1%) individuals who experienced dizziness. Multiple logistic regression analysis revealed that female sex, stress, and depression were associated with dizziness. Chronic dizziness was related to tympanic abnormalities, diabetes, short sleep duration, and higher levels of stress and depression. Psychomotor retardation/agitation was a central symptom of depression in patients with chronic dizziness.

CONCLUSIONS

This study found sex differences in factors associated with dizziness and identified psychosocial factors linked to chronic dizziness. Focusing on somatic factors rather than depressive symptoms may benefit patients with chronic dizziness.

Effects of poly-gamma-glutamic acid and vitamin B6 supplements on sleep status: a randomized intervention study

BACKGROUD/OBJECTIVES

Data regarding the effects of poly-γ-glutamic acid (γ-PGA) on sleep status are limited. This study aimed to test whether γ-PGA and vitamin B₆ (VitB6) supplements improve sleep duration and quality.

SUBJECTS/METHODS

A factorial randomized, double-blinded, placebo-controlled crossover study included 47 adults (25 men and 22 women) who were free of chronic disease. Stratified randomized allocation considered age and gender for three interventions, group A (supplementation with γ-PGA 600 mg; n = 16), group B (supplementation with VitB6 100 mg; n = 14), and group C (dual supplementation of both γ-PGA 600 mg and VitB6 100 mg; n = 17). Participants underwent a 1-mon intervention period, followed by a 1-mon washout period, and then a second 1-mon intervention period. Differences (mean ± SD) in nighttime sleep status before and after supplementation were compared between the placebo and intervention groups using nonparametric tests.

RESULTS

Significant changes in sleep duration (0.27 ± 0.98 h, P < 0.05) and the Pittsburgh Sleep Quality Index global score (−0.52 ± 1.58, P < 0.05) indicating improved sleep status were observed in the intervention compared with the placebo of group C while no significant changes were observed in groups A and B. No statistical significance was detected between the intervention and the placebo; however, there was a greater increase in the group C intervention (4.59 ± 38.5 ng/mL) in serum serotonin concentrations than the groups A and B interventions. No side effects were observed.

CONCLUSIONS

On the basis of these findings, the dual supplementation of γ-PGA and VitB6 may be effective as functional food components to improve nighttime sleep status.

Trial Registration

Clinical Research Information Service Identifier: KCT0005083