Uneven Effects of Sleep Apnea on Semicircular Canals and Otolithic Organs.

Xin-Da Xu,Bin-Jun Chen,Qing Zhang,Jing Yu,Dong-Dong Ren,An-Rong Sun,Hui-Ping Luo,Ying Cheng

doi:10.3389/fneur.2022.819721

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.

Highlights

Patients with obstructive sleep apnea (OSA) repeatedly suffer from soft tissue collapse of the upper airway during sleep, resulting in a nocturnal low oxygen desaturation condition at night, which, in turn, leads to sympathetic nervous system hyperactivity and impaired neurocognitive function
Comparing asymmetric ratios (AR) of vestibular-evoked myogenic potentials (VEMPs) in the study group with the controls, there was no statistical difference in ocular VEMP (oVEMP) (26.03 ± 20.29% vs. 20.93 ± 13.75%, t = 1.132, p = 0.263) or cervical VEMP (cVEMP) (26.84 ± 16.95% vs. 22.88 ± 17.32%, t = 0.903, p = 0.369)
The results showed that the normal rates of VEMPs in the study group were significantly lower than those in the control group

Summary

Introduction

Patients with obstructive sleep apnea (OSA) repeatedly suffer from soft tissue collapse of the upper airway during sleep, resulting in a nocturnal low oxygen desaturation condition at night, which, in turn, leads to sympathetic nervous system hyperactivity and impaired neurocognitive function. Studying the status and change pattern of vestibular function in patients with OSA is of great significance. The objective detection methods of the utricle and saccule are vestibular-evoked myogenic potentials (VEMPs), namely, ocular VEMP (oVEMP) and cervical VEMP (cVEMP) [4, 5]. The objective detection methods of semicircular canal function include the caloric test [6] and video head impulse test (vHIT) [7, 8]. The combination of the caloric test and vHIT can comprehensively reflect the objective function of semicircular canals at different frequency ranges of stimulation [7]

Results

Discussion

Conclusion