Evaluation of Vestibular Function in Patients Affected by Obstructive Sleep Apnea Performing Functional Head Impulse Test (fHIT)

Abstract

Purpose

Obstructive sleep apnoea (OSA) is a common disease with significantly related complications. Since a connection between the vestibular nucleus and sleep regulator pathways has been demonstrated, vestibular evaluation in OSA patients was partially studied and none used functional head impulse test (fHIT) for this purpose. This paper aimed at evaluating the vestibular function in patients affected by OSA using fHIT, selecting patients who did not present any other related to cardiovascular, neurological, or metabolic diseases.

Patients and Methods

Patients enrolled had a diagnosis of OSA by polysomnography type III and were cataloged according to American Association of Sleep Medicine criteria. Each patient underwent fHIT. Statistical significance was set at 0.05.

Results

A total of 85 patients were enrolled in the study of which 50 had a diagnosis of OSA and were included in the case group, while 35 belonged to the control group. In 88.6% of subjects of the case group was evidenced a vestibular impairment with a substantial difference between the two study groups (p<0.05).

Conclusion

The results show that the incidence of vestibular lesions in patients with obstructive sleep apnoea is underestimated and that fHIT can identify these lesions early.

Keywords:

• obstructive sleep apnea
• vestibular system
• functional head impulse test
• vestibular ocular reflex
• sleep regulator pathways

Abbreviations

OSA, Obstructive Sleep Apnoea; VN, vestibular nucleus; vHIT, video Head Impulse Test; VEMPs, vestibular evoked myogenic potentials; fHIT, functional Head Impulse Test; ENT, Ear Nose Throat; BMI, body mass index; PSG, polysomnography; AASM, American Academy sleep medicine; AHI, Apnea-Hypopnea Index; ODI, Oxygen desaturation index; SCN, suprachiasmatic hypothalamic nucleus; VLPO, ventrolateral preoptic nucleus; VOR, Vestibular Ocular Reflex; ESS, Epworth sleepiness scale; DHI, Dizziness Handicap Inventory.

Acknowledgments

The authors thank the society Beon Solution Srl in Zero Branco (Treviso, Italy) for leading the functional head impulse test—fHIT 1.0 (www.beonsolutions.it) and in particular Alessandro Florian for the technical support during the experimentation.

Disclosure

The authors report no conflicts of interest in this work.