Implementing lifestyle modifications and restful sleep can decrease and significantly improve vestibular migraine symptoms, according to findings presented in a poster session at the 2022 American Association of Nurse Practitioners (AANP) National Conference held June 21 to June 26, 2022, in Orlando, Florida.

Vestibular migraine is a common cause of vertigo and can significantly impact quality of life, the study authors explained. Interventions to treat vestibular migraine include lifestyle modifications as well as prophylactic and rescue medications. While lifestyle modifications can improve symptoms of other forms of migraine, these strategies have yet to be studied as an approach to manage vestibular migraine.


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The study included 28 patients at a single otolaryngology tertiary care center with vestibular migraine as defined by ICHD-3 criteria. All participants agreed to be treated without pharmacological intervention. Participant were asked to adhere to the following lifestyle modifications for 60 days:  

  • Restful sleep
  • Mealtime regularity
  • Exercise
  • Elimination of dietary triggers.

Dizziness Handicap Inventory (DHI) and headache disability inventory (HDI) were used to calculate results. Questions were also used to evaluate compliance with lifestyle factors.

Effects of the Lifestyle Intervention

Dizziness scores improved by a mean of 14 points overall and 39.2% of patients experienced an 18-point or greater decrease in DHI score postintervention. Headache scores also decreased by a mean of 14 points with 17.9% of the group experiencing a 29-point or greater decrease in HDI score.

“Vertigo can be one of the most debilitating features of vestibular headaches. While medication can be helpful not all patients may want to take medication regularly and still, others can find the medications difficult to afford,” commented Mary Koslap-Petraco, DNP, PPCNP-BC, CPNP, FAANP, clinical assistant professor at Stony Brook University School of Nursing in Stony Brook, New York.

“This NP-led project determined that lifestyle changes can have a positive effect on the quality of life. High-quality sleep was particularly effective in improving these symptoms,” Dr Koslap-Petraco added. “Keeping a routine schedule for eating, sleeping, exercise, and eliminating dietary triggers has now been shown through this project to decrease the incidence of vestibular migraine. These findings are very similar to the implementation of these interventions for other forms of migraine. This is an easy-to-implement cost-effective treatment for an often debilitating condition.”

The sleep intervention appeared to be linked to the greatest improvement in symptoms, according to the researchers. “Participants who reported a larger increase in restful sleep were more likely to also report larger improvements in dizziness handicap and headache disability,” they wrote.

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References

Brignola E, Roberts R, Watfors K, et al. Implementing lifestyle changes in patients with vestibular migraine. Poster presented at: AANP 2022; June 21-26, 2022; Orlando, Fl. 

Roberts RA, Watford KE, Picou EM, Hatton K, Trone TH, Brignola EY. Effects of lifestyle modification on vestibular migraine. Otol Neurotol. 2021;42(10):e1537-e1543. doi:10.1097/MAO.0000000000003297