by Elana Gotkine

For benign paroxysmal positional vertigo (BPPV), the overall positive rate for positional tests is significantly higher in the morning than in the evening, according to a studypublishedonline Oct. 6 inFrontiers in Neurology.

Qiuping Lu, from the Southern Medical University in Foshan, China, and colleagues conducted a retrospective analysis of clinical records from 929 patients with a medical history consistent with BPPV diagnosis to examine timing of examinations and diagnostic findings. Morning examinations were initiated from 8 a.m. to 12 p.m., while afternoon examinations were performed between 2 p.m. and 5 p.m.

Overall, 590 and 339 individuals were examined in the morning and afternoon (63.51% and 36.49%, respectively). The researchers found that the positive rate of BPPV testing was 72.54% and 64.01% in the morning and afternoon groups, respectively. The percentage of posterior semicircularcanalBPPV was 52.20% in the morning and 45.43% in the afternoon.

For horizontal semicircular canal BPPV, the corresponding percentages were 19.49% and 17.70%. For both canal types, the highest positive rate was seen between 8:00 a.m. and 8:59 a.m. and lowest was seen between 2:00 p.m. and 2:59 p.m. (74.6% and 51.9%, respectively). A strong association was seen for examination timing in a multivariate analysis, with no correlation seen between age/gender and positive testing.

"From a clinical point of view, these findings highlight the importance of optimizing examination schedules to improve diagnostic andtreatment strategiesfor BPPVpatients," the authors write.

One author disclosed ties to the biopharmaceutical industry.

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More information: Qiuping Lu et al, Positive diagnostic positional tests in BPPV are higher in the morning than in the afternoon: a retrospective study, Frontiers in Neurology (2025). DOI: 10.3389/fneur.2025.1689672 Journal information: Frontiers in Neurology