Association of vertigo with adult obstructive sleep apnea: A systematic review and meta-analysis

Background

Several studies have demonstrated a relationship between vertigo and obstructive sleep apnea (OSA) in adults. This review examined the association between vertigo and OSA and investigated the effects of OSA treatment on vestibular function.

Methods

Searches were conducted in PubMed, MEDLINE, EMBASE, Cochrane, Scopus, and Web of Science databases. Two authors independently searched the databases up to November 2023. Meta-analysis of caloric test, cervical vestibular evoked myogenic potential (cVEMP), and ocular vestibular evoked myogenic potential (oVEMP), between adults with and without OSA was done.

Results

Overall, 28 studies were identified, and most of which focused on vestibular dysfunction in the OSA group. Compared with controls, adults with OSA had an increased risk of abnormal caloric test results (odds ratio [OR] = 4.8), absence of cVEMP (OR = 7.9), absence of oVEMP (OR = 6.2), decreased n1p2 amplitude (standardized mean difference [SMD] = −0.78), decreased p1n1 amplitude (SMD = −0.92), decreased p1n1 interval (SMD = −2.37) in cVEMP testing and prolonged n1 latency (SMD = 0.81) and decreased p1n1 amplitude (SMD = −0.51) in oVEMP testing. Three population-based studies implied a high risk of vertigo in adult OSA, although not statistically significant (OR = 2.53, 95 % confidence interval = 0.97 to 6.61). According to 3 studies, OSA is relatively prevalent among patients with vertigo. Another 3 studies regarding OSA treatment on vestibular functions revealed inconsistent findings.

Conclusion

Adults with OSA exhibit abnormalities in caloric, cVEMP, and oVEMP test results, indicating impairments in the semicircular canal, saccule, and utricle.