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手法复位后睡眠体位对良性阵发性位置性眩晕复发的影响

Impact of postmaneuver sleep position on recurrence of benign paroxysmal positional vertigo.

作者信息

Li Shufeng, Tian Liang, Han Zhao, Wang Jing

机构信息

Department of Otolaryngology - Head and Neck Surgery, EYE & ENT Hospital of Fudan University, Shanghai, China.

出版信息

PLoS One. 2013 Dec 18;8(12):e83566. doi: 10.1371/journal.pone.0083566. eCollection 2013.

Abstract

BACKGROUND

The necessity of postural restriction to patients suffering from benign paroxysmal positional vertigo is controversial.

OBJECTIVE

To investigate the impact of the sleep position after the repositioning maneuver on BPPV recurrence.

METHODS

150 unilateral BPPV patients who were treated by repositioning maneuver were distributed into two groups. The patients in group A were instructed to sleep in a semi-sitting position at an angle of approximately 30 degrees and refrain from sleeping on their BPPV affected side for one week. The patients in group B were told to sleep in any preferred position. The comparison of recurrence rates according to different actual sleep positions in one week and one month was performed.

RESULTS

There was a statistically significant correlation between the sleeping side and the side affected by BPPV. Without instructions on postural restriction, most patients (82.9%, 73/88) avoided sleeping on their affected side. The patients sleeping on their affected side had a higher recurrence rate (35.3%) than ones sleeping in other positions in the first week after the repositioning maneuver (p<0.05, Chi-square test and Fisher's exact test). The patients sleeping randomly in following 3 weeks had a lower recurrence rate than ones sleeping in other position (p<0.05, Fisher's exact test).

CONCLUSIONS

BPPV patients had a poor compliance to postural instructions. The habitual sleep side was associated with the side affected by BPPV. The patients sleeping on their affected side had a higher recurrence rate than those sleeping in other positions in first week after the repositioning maneuver.

摘要

背景

对于良性阵发性位置性眩晕患者进行体位限制的必要性存在争议。

目的

探讨复位手法后睡眠体位对良性阵发性位置性眩晕复发的影响。

方法

将150例接受复位手法治疗的单侧良性阵发性位置性眩晕患者分为两组。A组患者被要求以大约30度的半卧位睡眠,且在一周内避免患侧卧位睡眠。B组患者被告知可采用任何喜欢的体位睡眠。对一周和一个月内不同实际睡眠体位的复发率进行比较。

结果

睡眠侧与良性阵发性位置性眩晕患侧之间存在统计学显著相关性。在没有体位限制指导的情况下,大多数患者(82.9%,73/88)避免患侧卧位睡眠。复位手法后第一周,患侧卧位睡眠的患者复发率(35.3%)高于其他体位睡眠的患者(p<0.05,卡方检验和Fisher精确检验)。在接下来的3周内随机睡眠的患者复发率低于其他体位睡眠的患者(p<0.05,Fisher精确检验)。

结论

良性阵发性位置性眩晕患者对体位指导的依从性较差。习惯性睡眠侧与良性阵发性位置性眩晕患侧相关。复位手法后第一周,患侧卧位睡眠的患者复发率高于其他体位睡眠的患者。

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