Uneven Effects of Sleep Apnea on Semicircular Canals and Otolithic Organs

Abstract

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.

Association of Night Hypoxia with Otolith Dysfunction Patients Having Obstructive Sleep Apnea

“…Possible explanation of present finding is that neural damage of vestibular nerve might be delayed the VEMP responses 9,10 . Hence, delayed or altered VEMP responses in OSA patients could be happen due to neuronal degeneration 9,[15][16][17][18] .…”

Exploring the relationship between sleep apnea and vestibular symptoms following traumatic brain injury

“…Although data are limited, there is evidence supporting a correlation between OSA and vestibular dysfunction in the general population 44,45 . A recent systematic review by Cheung et al 43,46,47 mentioned abnormalities such as vestibular canal paresis, reduced cervical and ocular vestibular evoked myogenic potentials, abnormal nystagmus, and decreased balance (as noted by posturography) in those with moderate to severe OSA. However, such studies have yet to be conducted in a TBI cohort despite rates of sleep apnea as high as 68% in TBI rehabilitation settings 48,49 …”

Video Head Impulse Test Changes Related to Obstructive Sleep Apnea: In Reply to the Work of Xin-Da Xu et al.

“…We read with interest the last issue of your Journal in which the following article has been published by Xin-Da Xu et al: "Uneven Effects of Sleep Apnea on Semicircular Canals and Otolithic Organs" (1). In their valuable work, the authors discussed different works depicting changes in vestibular evoked myogenic potentials and caloric testing in patients with obstructive sleep apnea (OSA).…”