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Objective To evaluate sleep behavior and its relation to otoneurological parameters in a group of patients with chronic unilateral vestibular hypofunction (UVH) without self-reported sleep disturbances when compared with healthy subjects serving as a control group (CG). Methods Fifty-one patients affected by UVH underwent a retrospective clinical and instrumental otoneurological examination, a 1-week actigraphy sleep analysis, and a series of self-report and performance measures (SRM/PM). A CG of 60 gender- and age-matched healthy subjects was also enrolled. A between-group analysis of variance was performed for each variable, while correlation analysis was performed in UVH patients between otoneurological, SRM/PM, and actigraphy measure scores. Results When compared with CG subjects, UVH patients were found to be spending less time sleeping and taking more time to go from being fully awake to asleep, based on actigraphy-based sleep analysis. Also, SRM/PM depicted UVH patients to have poor sleep quality and to be more prone to an evening-type behavior. Correlations were found between vestibular-related functionality indexes and subjective sleep quality, as well as between longer disease duration and reduced sleep time. Conclusion For the first time, a multiparametric sleep analysis was performed on a large population-based sample of chronic UVH patients. While a different pattern in sleep behavior was found, the cause is still unclear. Further research is needed to expand the extent of knowledge about sleep disruption in vestibular disorders. Level of evidence Level 3 Laryngoscope, 2021.

The vestibular system has been found to affect energy homeostasis and body composition, due to its extensive connections to the brainstem and melanocortin nuclei involved in regulating the metabolism and feeding behavior. The aim of this study was to evaluate - by means of a wrist-worn physical activity tracker and bioelectrical impedance analysis (BIA) - the energy expenditure (EE) in resting (REE) and free-living conditions and movement behavior in a group of chronic unilateral vestibular hypofunction (UVH) patients when compared with a control group (CG) of healthy participants. Forty-six chronic UVH and 60 CG participants underwent otoneurological (including video-Head Impulse Test [vHIT] for studying vestibulo-ocular reflex [VOR] and static posturography testing [SPT]), and EE and movement measurements and self-report (SRM) andperformance measures (PM). As well as significant (p 0.001) changes in SPT variables (area and path length) and SRM/PM, UVH participants also demonstrated significantly (p 0.001) lower values in REE, movement EE, hours/day spent upright, number of strides and distance covered and total daily EE (p = 0.007) compared to the CG. UVH patients consumed significantly lower Kcal/min in sweeping (p = 0.001) and walking upstairs and downstairs (p 0.001) compared to the CG. Multiple correlations were found between free-living and resting EE and neuro-otological parameters in UVH participants. Since the melanocortin system could be affected along the central vestibular pathways as a consequence of chronic vestibular deafferentation, data collected by reliable wearables could reflect the phenomena that constitute an increased risk of falls and sedentary lifestyle for patients affected by UVH, and could improve rehabilitation stages.

The male-specific northern African genetic pool is characterised by a high frequency of the E-M81 haplogroup, which expanded in very recent times (2-3 kiloyears ago). As a consequence of their recent coalescence, E-M81 chromosomes often cannot be completely distinguished on the basis of their Y-STR profiles, unless rapidly-mutating Y-STRs (RM Y-STRs) are analysed. In this study, we used the Yfiler® Plus kit, which includes 7 RM Y-STRs and 20 standard Y-STR, to analyse 477 unrelated males coming from 11 northern African populations sampled from Morocco, Algeria, Libya and Egypt. The Y chromosomes were assigned to monophyletic lineages after the analysis of 72 stable biallelic polymorphisms and, as expected, we found a high proportion of E-M81 subjects (about 46%), with frequencies decreasing from west to east. We found low intra-population diversity indexes, in particular in the populations that experienced long-term isolation. The AMOVA analysis showed significant differences between the countries and between most of the 11 populations, with a rough differentiation between northwestern Africa and northeastern Africa, where the Egyptians Berbers from Siwa represented an outlier population. The comparison between the Yfiler® and the Yfiler® Plus network of the E-M81 Y chromosomes confirmed the high power of discrimination of the latter kit, thanks to higher variability of the RM Y-STRs: indeed, the number of chromosomes sharing the same haplotype was drastically reduced from 201 to 81 and limited, in the latter case, to subjects from the same population.