Gender, nocturnal hypoxia, and arousal influence brainstem auditory evoked potentials in patients with obstructive sleep apnea

Wang, Wei; Su, Jiao; Kong, Delei; Pang, Junfeng; Kang, Jian

doi:10.1007/s11325-016-1346-8

Cited by 9 publications

(5 citation statements)

References 22 publications

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“…Since the pathophysiological changes caused by OSA are systemic, it was reasonable that bilateral vestibular impairments resulting from OSA were synchronous and no difference. In previously published research, hearing loss ( 18 ), inner ear function ( 19 ), and brainstem auditory evoked potential ( 20 ) had been found bilateral impairments in patients with OSA, which was consistent with our findings of bilateral dysfunction of otolithic organs.…”

Section: Discussionsupporting

confidence: 93%

Uneven Effects of Sleep Apnea on Semicircular Canals and Otolithic Organs

Chen

Sun

et al. 2022

Front. Neurol.

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ObjectiveThis study aimed to explore how obstructive sleep apnea (OSA) affects the function of each vestibular organ and to identify the correlations among them.MethodsA prospective study was conducted involving 32 healthy controls and 64 patients with OSA. The objective detection methods of the utricle and saccule are vestibular-evoked myogenic potentials (VEMPs). A combination of the caloric test and video head impulse test (vHIT) was used to comprehensively evaluate the objective function of semicircular canals.ResultsElevated thresholds (p < 0.001), decreased waveform amplitudes (p < 0.001), prolonged first wave latencies (p < 0.001), and shortened first interpeak latencies (p < 0.001) were observed in both ocular VEMP (oVEMP) and cervical VEMP (cVEMP). A significant difference was found in the caloric test comparison (χ2 = 4.030, p = 0.045) but not in the vHIT. The intergroup comparison of normal rates among the VEMPs, caloric test, and vHIT groups showed a significant difference (p < 0.001).ConclusionThe impairment of vestibular function in patients with OSA was uneven and biased. More attention should be given to vestibular dysfunction in the diagnosis and treatment of OSA.

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Section: Discussionsupporting

confidence: 93%

Uneven Effects of Sleep Apnea on Semicircular Canals and Otolithic Organs

Chen

Sun

et al. 2022

Front. Neurol.

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“…Considering the paucity of studies investigating the BR responses in patients with OSA, further studies are needed for reaching a unequivocal conclusion, that currently cannot be postulated. However, the present data, coupled with previous studies based on evoked potentials and peripheral nerve conduction recordings, may suggest the impairment in electrophysiological conduction in patients with OSA, and that it can be possibly attributed to a hypoxic mechanism inducing myelin damage and axonal alteration [ 31 – 37 ]. In particular, visual and auditory evoked potentials studies showed prolonged latency and reduced amplitude of the evoked responses [ 36 , 37 ], hypothesizing a myelin damage due to intermittent hypoxia and neuro-inflammation based on delayed latency, and the occurrence of microvascular events to explain the reduced amplitude.…”

Section: Discussionsupporting

confidence: 63%

Brainstem impairment in obstructive sleep apnoea and the effect of CPAP treatment: an electrophysiological blink reflex study

Liguori,

Fernandes,

Spanetta

et al. 2023

Sleep Breath

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Purpose This study aimed to evaluate the functionality of the brainstem structures through the blink reflex (BR) test in patients with obstructive sleep apnoea (OSA) and to assess the effects of continuous positive airway pressure (CPAP) treatment on BR responses. Methods Patients with moderate-severe OSA and controls underwent BR testing. Patients with OSA who were adherent to CPAP therapy repeated BR testing at 6 months follow-up. CPAP adherence was defined as CPAP use for ≥ 4 hour per night on > 5 nights per week with residual apnoea-hypopnea index less than 5 events per hour. Results A total of 22 patients with OSA (86% male, mean age 57.8 ± 10.6 years) and 20 controls (60% male, mean age 55.3 ± 9.3 years) were included. Patients with OSA showed longer right and left R1 latency, as well as delayed right ipsilateral and contralateral R2 latencies compared to controls. Patients with OSA who were compliant with CPAP treatment (n = 16; 88% men, mean age 58.8 ± 9.7 years) showed a significant decrease in latency of the right ipsilateral and contralateral R2 responses at 6 months. Conclusion This study showed an abnormal pattern of BR responses in patients with OSA, consistent with a significant impairment of brainstem functionality in OSA. CPAP treatment partially improved the BR responses, suggesting the importance of treating OSA.

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“…However, there was no correlation between AHI, mean SpO2, and auditory data as hearing threshold, TEOAe, and brainstem auditory evoked potential data. Wang et al [32], in a cross-sectional study to value the effects of sex, hypoxia, and arousal in the brainstem auditory evoked potential of OSAS patients, selected 118 individuals, of which 40 (32 males and 8 females) were affected by moderate OSAS, 44 (36 males and 8 females) were affected by severe OSAS, and 34 (22 males and 12 females) were healthy patients. Compared to the control group, women with moderate and severe OSAS had a longer latency of waves I and V, and men with moderate OSAS also had a longer latency of waves I and V, whereas men with severe OSAS had a longer latency of waves I, III, and V. Furthermore, all the possible correlations between BAEPs data with sex, age, ESS (European Social Survey) questionnaire score, AHI, ODI, MSpO2, MmSpO2, SIT90, and AI in OSAS patients have been analyzed.…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, Iriz et al [33] showed that repeated hypoxic events can cause multisystemic disorders in OSAS patients, even in the hearing system. Wang et al [32] evidenced some abnormalities in the brainstem auditory evoked potentials in patients with moderate and severe OSAS, obtaining longer latencies of waves I, III, and V, especially in the right ear of male patients. Ultimately, Deniz and Ersozlu [34] have demonstrated that CPAP does not improve the hearing function of OSAS patients, but it has no negative effects too, due to a possible barotrauma.…”

Section: Oxidative Stress and Auditory Systemmentioning

confidence: 99%

Oxidative Stress in Obstructive Sleep Apnea Syndrome: Putative Pathways to Hearing System Impairment

et al. 2023

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Introduction: OSAS is a disease that affects 2% of men and 4% of women of middle age. It is a major health public problem because untreated OSAS could lead to cardiovascular, metabolic, and cerebrovascular complications. The more accepted theory relates to oxidative stress due to intermittent hypoxia, which leads, after an intense inflammatory response through multiple pathways, to endothelial damage. The objective of this study is to demonstrate a correlation between OSAS and hearing loss, the effect of the CPAP on hearing function, and if oxidative stress is also involved in the damaging of the hearing system. Methods: A review of the literature has been executed. Eight articles have been found, where seven were about the correlation between OSAS and the hearing system, and only one was about the CPAP effects. It is noted that two of the eight articles explored the theory of oxidative stress due to intermittent hypoxia. Results: All studies showed a significant correlation between OSAS and hearing function (p < 0.05).Conclusions: Untreated OSAS affects the hearing system at multiple levels. Oxidative stress due to intermittent hypoxia is the main pathogenetic mechanism of damage. CPAP has no effects (positive or negative) on hearing function. More studies are needed, with the evaluation of extended high frequencies, the execution of vocal audiometry in noisy environments, and the evaluation of potential biomarkers due to oxidative stress.

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Gender, nocturnal hypoxia, and arousal influence brainstem auditory evoked potentials in patients with obstructive sleep apnea

Abstract: Moderate and severe OSAS patients showed abnormal BAEP which could be influenced by gender, nocturnal hypoxia, and arousal.

Cited by 9 publications

References 22 publications

Uneven Effects of Sleep Apnea on Semicircular Canals and Otolithic Organs

Uneven Effects of Sleep Apnea on Semicircular Canals and Otolithic Organs

Brainstem impairment in obstructive sleep apnoea and the effect of CPAP treatment: an electrophysiological blink reflex study

Oxidative Stress in Obstructive Sleep Apnea Syndrome: Putative Pathways to Hearing System Impairment

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