Dizziness is not a homogeneous entity regarding sleep: BPPV, PPPD, and vestibular migraine each showed a distinct sleep signature, although all three groups reported worse subjective sleep quality and higher psychological burden than healthy controls.
All three dizziness groups (BPPV, PPPD, VM) reported significantly worse subjective sleep quality and higher psychological burden than healthy controls.
Despite shared subjective complaints, each vestibular disorder showed a unique objective sleep signature.
BPPV patients showed objective sleep fragmentation and markedly elevated sleep-disordered breathing indices.
PPPD patients displayed a 'sleep paradox': the highest objective sleep efficiency but the poorest subjective sleep perception.
Vestibular migraine patients had the shortest total sleep time and a pronounced but non-significant 'social jetlag' pattern.
The authors suggest sleep-related clinical management should be tailored to the type of dizziness disorder.
This study compared sleep in people with three different causes of dizziness—benign paroxysmal positional vertigo (BPPV), vestibular migraine (VM), and persistent postural-perceptual dizziness (PPPD)—and healthy volunteers. The 90 participants wore activity monitors for 14 days, did a one-night home sleep apnea test, and completed questionnaires about sleep, dizziness, anxiety, and depression. All three dizziness groups said they slept worse and had more anxiety and depression than healthy people. However, the objective measurements showed different patterns in each condition. People with BPPV had fragmented, restless sleep and high rates of breathing disruption during sleep (an apnea-hypopnea index of 31.5). People with PPPD actually had the most efficient sleep when measured objectively, yet rated their sleep as the worst, and they were less active during the day with very rigid schedules. People with vestibular migraine slept the shortest and tended to get up about two hours later on weekends, though that difference was not statistically significant. This research suggests that dizziness conditions are not all alike when it comes to sleep, and that sleep problems may need different approaches depending on the diagnosis—such as checking for sleep apnea in BPPV, addressing the mismatch between perceived and actual sleep in PPPD, and attention to sleep loss and regular timing in VM. Because the study was cross-sectional and fairly small, it cannot show cause and effect.
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Upload Your LabsJoffily L, de Lima M, Araújo J, Kaski D. (2026). Sleep in Different Types of Dizziness.. Brain and behavior. https://doi.org/10.1002/brb3.71863