Skip to main content
Top
Published in: Sleep and Breathing 2/2019

01-06-2019 | Basic Science • Original Article

Postural and vestibular changes related to CPAP treatment in moderate-to-severe OSA patients: a 12-month longitudinal study

Authors: Marco Alessandrini, Claudio Liguori, Andrea Viziano, Francesca Izzi, Donatella Capoccia, Alessia Lanzillotta, Fabio Placidi, Nicola Biagio Mercuri, Alessandro Micarelli

Published in: Sleep and Breathing | Issue 2/2019

Login to get access

Abstract

Purpose

To assess whether vestibulo-ocular reflex (VOR) gain, posturography parameters and related clinical outcomes can improve in OSA patients after 12 months of CPAP treatment, taking into consideration that a certain degree of vestibular dysfunction has been identified in these subjects.

Methods

Vestibular, postural, clinical, and polygraphic parameters were assessed in 32 OSA patients before and after beneficial CPAP treatment by means of video head impulse test (vHIT), static posturography (SP), Dizziness Handicap Inventory (DHI), Epworth Sleepiness Scale (ESS), and Apnea–Hypopnea Index (AHI), respectively, and were compared by means of a “within-subject” ANOVA model and Spearman’s rank correlation.

Results

After the 12-month period of treatment, OSA patients demonstrated a significant reduction in AHI values, in both opened and closed eyes conditions of surface and length as well as in power spectra recorded in low, middle, and high frequency interval. Although a significant improvement was also recorded among DHI and ESS scores, VOR gain increase did not survive to post-hoc corrections. Finally, positive correlations between the differences between pre- and post-treatment AHI, ESS, and PS values were found.

Conclusions

The present work highlighted that postural instability and dizziness-related conditions due to OSA may improve after 12 months of CPAP treatment. Although VOR gain did not demonstrate significant improvement, this study might open future perspectives directed to assessing VOR gain changes after longer periods of CPAP treatment.
Literature
2.
go back to reference Archbold KH, Borghesani PR, Mahurin RK, Kapur VK, Landis CA (2009) Neural activation patterns during working memory tasks and OSA disease severity: preliminary findings. J Clin Sleep Med 5(1):21–27PubMedPubMedCentral Archbold KH, Borghesani PR, Mahurin RK, Kapur VK, Landis CA (2009) Neural activation patterns during working memory tasks and OSA disease severity: preliminary findings. J Clin Sleep Med 5(1):21–27PubMedPubMedCentral
5.
go back to reference Morad Y, Azaria B, Avni I, Barkana Y, Zadok D, Kohen-Raz R, Barenboim E (2007) Posturography as an indicator of fatigue due to sleep deprivation. Aviat Space Environ Med 78(9):859–863PubMed Morad Y, Azaria B, Avni I, Barkana Y, Zadok D, Kohen-Raz R, Barenboim E (2007) Posturography as an indicator of fatigue due to sleep deprivation. Aviat Space Environ Med 78(9):859–863PubMed
11.
go back to reference Gallina S, Dispenza F, Kulamarva G, Riggio F, Speciale R (2010) Obstructive sleep apnoea syndrome (OSAS): effects on the vestibular system. Acta Otorhinolaryngol Ital 30(6):281–284PubMedPubMedCentral Gallina S, Dispenza F, Kulamarva G, Riggio F, Speciale R (2010) Obstructive sleep apnoea syndrome (OSAS): effects on the vestibular system. Acta Otorhinolaryngol Ital 30(6):281–284PubMedPubMedCentral
18.
go back to reference Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, Marcus CL, Mehra R, Parthasarathy S, Quan SF, Redline S, Strohl KP, Davidson Ward SL, Tangredi MM (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. Deliberations of the sleep apnea definitions task force of the American Academy of sleep medicine. J Clin Sleep Med 8(5):597–619. https://doi.org/10.5664/jcsm.2172 CrossRefPubMedPubMedCentral Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, Marcus CL, Mehra R, Parthasarathy S, Quan SF, Redline S, Strohl KP, Davidson Ward SL, Tangredi MM (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. Deliberations of the sleep apnea definitions task force of the American Academy of sleep medicine. J Clin Sleep Med 8(5):597–619. https://​doi.​org/​10.​5664/​jcsm.​2172 CrossRefPubMedPubMedCentral
25.
go back to reference Nola G, Mostardini C, Salvi C, Ercolani AP, Ralli G (2010) Validity of Italian adaptation of the Dizziness Handicap Inventory (DHI) and evaluation of the quality of life in patients with acute dizziness. Acta Otorhinolaryngol Ital 30(4):190PubMedPubMedCentral Nola G, Mostardini C, Salvi C, Ercolani AP, Ralli G (2010) Validity of Italian adaptation of the Dizziness Handicap Inventory (DHI) and evaluation of the quality of life in patients with acute dizziness. Acta Otorhinolaryngol Ital 30(4):190PubMedPubMedCentral
26.
go back to reference Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545CrossRefPubMed Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545CrossRefPubMed
28.
go back to reference Yoneda S, Tokumasu K (1986) Frequency analysis of body sway in the upright posture. Statistical study in cases of peripheral vestibular disease. Acta Otolaryngol 102(1–2):87–92CrossRefPubMed Yoneda S, Tokumasu K (1986) Frequency analysis of body sway in the upright posture. Statistical study in cases of peripheral vestibular disease. Acta Otolaryngol 102(1–2):87–92CrossRefPubMed
32.
go back to reference Wu JC, Gillin JC, Buchsbaum MS, Hershey T, Hazlett E, Sicotte N, Bunney WE Jr (1991) The effect of sleep deprivation on cerebral glucose metabolic rate in normal humans assessed with positron emission tomography. Sleep 14(2):155–162PubMed Wu JC, Gillin JC, Buchsbaum MS, Hershey T, Hazlett E, Sicotte N, Bunney WE Jr (1991) The effect of sleep deprivation on cerebral glucose metabolic rate in normal humans assessed with positron emission tomography. Sleep 14(2):155–162PubMed
Metadata
Title
Postural and vestibular changes related to CPAP treatment in moderate-to-severe OSA patients: a 12-month longitudinal study
Authors
Marco Alessandrini
Claudio Liguori
Andrea Viziano
Francesca Izzi
Donatella Capoccia
Alessia Lanzillotta
Fabio Placidi
Nicola Biagio Mercuri
Alessandro Micarelli
Publication date
01-06-2019
Publisher
Springer International Publishing
Published in
Sleep and Breathing / Issue 2/2019
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-018-1754-z

Other articles of this Issue 2/2019

Sleep and Breathing 2/2019 Go to the issue

Sleep Breathing Physiology and Disorders • Letter to the Editors

Sleep quality in survivors of critical illness: practical shortcomings unresolved

Sleep Breathing Physiology and Disorders • Original Article

Sleep quality in survivors of critical illness