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Integrating postural and vestibular dimensions to depict impairment in moderate‐to‐severe obstructive sleep apnea syndrome patients
Author(s) -
Micarelli Alessandro,
Liguori Claudio,
Viziano Andrea,
Izzi Francesca,
Placidi Fabio,
Alessandrini Marco
Publication year - 2017
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/jsr.12516
Subject(s) - audiology , balance (ability) , medicine , posturography , vestibular system , vestibulo–ocular reflex , epworth sleepiness scale , obstructive sleep apnea , correlation , physical medicine and rehabilitation , hypoxemia , cardiology , physical therapy , apnea , polysomnography , geometry , mathematics
Summary Vestibular dysfunction was linked to moderate‐to‐severe obstructive sleep apnea syndrome ( OSAS ) patients in literature. However, due to a lack of knowledge among valid and recent implementations conceived to study postural control on static posturography ( SP ) and vestibulo‐ocular reflex ( VOR ) gain under physiological conditions (video Head Impulse Test; vHIT ), the aim of this work was to integrate (i) VOR changes via vHIT implementation, (ii) postural arrangement by studying both classical parameters and frequency spectra ( PS ) and (iii) correlation between these findings, polygraphic ( PG ) and subjective scores along Dizziness Handicap Inventory ( DHI ) and Epworth Sleepiness Scale ( ESS ). Thus, 32 moderate‐to‐severe OSAS patients and 32 healthy subjects – studied by using PG , DHI and ESS – underwent vHIT and SP posturographic assessment. Analysis of variance was performed to disclose between‐group effects and correlation analysis was implemented between otoneurological, PG , DHI and ESS values. OSAS group demonstrated a significant decay of VOR gain and an increase in both frequency spectra PS values, especially within the low‐frequency interval, and in classical posturographic SP parameters. Further, positive and negative correlations between mean SaO 2 and gain and low frequency interval spectra PS were found, respectively. Strengthening previous hypothesis related to brainstem chronic hypoxemia phenomena affecting vestibular network, implementation of these data could generate future attentions (i) for screening under physiological conditions postural and vestibular detriments in OSAS subjects, especially exposed at risk settings, and (ii) among PG parameters, such as mean SaO 2 , to propose further reliable tools in monitoring postural and vestibular decay in these patients demonstrating PG parameters detriments.