Keren Shir, Hazan Itai, Ungar Omer J, Peled Chilaf, Gimmon Yoav, Abu Freh Ismael, Kaminer Benyamin, Kaplan Daniel M, Ziv Oren
Department of Otolaryngology-Head & Neck Surgery, Soroka University Medical Center, Beer-Sheva, Israel.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Laryngoscope. 2025 Mar;135(3):1177-1182. doi: 10.1002/lary.31857. Epub 2024 Oct 22.
To investigate the association between sleep deprivation and vestibular dysfunction by Video Head Impulse Test (vHIT).
This prospective clinical trial explores the impact of acute sleep deprivation on the vestibular-ocular reflex (VOR) in medical residents. The study involved healthy physicians from diverse medical disciplines. Participants underwent vHIT assessments before and after a 26-h shift. The examinations focused solely on the right lateral semicircular canal. Participants further completed a demographics and fatigue questionnaire, including the Fatigue Severity Scale (FSS) questionnaire and a Visual Analog Fatigue Score (VAFS).
The study involved 30 medical residents. Participants experienced a statistically significant decrease in VOR gain in the right horizontal semicircular canal during a 26-h shift (p < 0.01). While the FSS and VAFS questionnaires showed no significant difference before and after the shift, the analysis of ∆VOR gain indicated a statistically significant increase associated with decreased sleep time during the shift (p = 0.018, 95% Confidence Interval [0.08, 0.68]). The most substantial increase in ∆VOR occurred between 22-26 h of sleep deprivation. No significant differences were observed in ∆VOR between genders, ages, disciplines, department shifts versus emergency room shifts, or years of residency.
vHIT can be used as an objective, reliable screening tool for severe sleep deprivation among physicians. The decrease in the VOR gain may indicate that vestibular function is influenced by sleep deprivation. The clinical significance of these findings is still questioned, more studies may help to assess this effect.
3 Laryngoscope, 135:1177-1182, 2025.
通过视频头脉冲试验（vHIT）研究睡眠剥夺与前庭功能障碍之间的关联。
这项前瞻性临床试验探讨了急性睡眠剥夺对住院医师前庭眼反射（VOR）的影响。该研究纳入了来自不同医学学科的健康医生。参与者在连续工作26小时前后接受了vHIT评估。检查仅聚焦于右侧水平半规管。参与者还完成了一份人口统计学和疲劳调查问卷，包括疲劳严重程度量表（FSS）问卷和视觉模拟疲劳评分（VAFS）。
该研究纳入了30名住院医师。在连续工作26小时期间，参与者右侧水平半规管的VOR增益出现了具有统计学意义的下降（p < 0.01）。虽然FSS和VAFS问卷在工作前后没有显示出显著差异，但对VOR增益变化（∆VOR增益）的分析表明，其与工作期间睡眠时间减少存在统计学意义的增加相关（p = 0.018，95%置信区间[0.08, 0.68]）。∆VOR增益的最大增幅出现在睡眠剥夺22 - 26小时之间。在性别、年龄、学科、科室轮班与急诊室轮班之间，或住院年限方面，∆VOR增益均未观察到显著差异。
vHIT可作为一种客观、可靠的筛查工具，用于评估医生的严重睡眠剥夺情况。VOR增益的下降可能表明前庭功能受到睡眠剥夺的影响。这些发现的临床意义仍存在疑问，更多研究可能有助于评估这种影响。
《喉镜》第135卷，第1177 - 1182页，2025年。
