Evaluation of Vestibular Function in Sleep Disorders
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Objectives: The aim of this study was to evaluate dizziness in patients with sleep disorders, objectively identify vestibular function through the vestibulo-ocular reflex (VOR) using the video Head Impulse Test (vHIT), and evaluate the association between these findings.Methods: Among the patients who visited the sleep clinic from June to October 2021, 69 who underwent both polysomnography (PSG) and vHIT were included. Participants completed questionnaires including the Dizziness Handicap Inventory (DHI), Beck Anxiety Inventory, Korean-Beck Depression Inventory-II, Epworth Sleepiness Scale, Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI). The subjects were classified into four groups: insomnia (n=4), rapid eye movement sleep behavior disorder (RBD) (n=13), obstructive sleep apnea syndrome (OSAS) (n=34), and RBD and OSAS (n=18). Moderate to severe OSAS (n=49) was compared with no OSAS and mild OSAS (n=20).Results: In comparison of the four groups according to sleep disorders, the OSAS patients showed the highest DHI scores and the lowest VOR gain, but statistical significance was not found. Although all VOR gains were within the normal range, the VOR gain of the left posterior semicircular canal was significantly lower in the moderate to severe OSA group than in the no OSA and mild OSA groups (1.02±0.18 vs. 0.94±0.10, <i>p</i>=0.019). DHI total scores showed no correlation with VOR gain but showed a positive correlation with ISI (r=0.422, <i>p</i>=0.001) and PSQI (r=0.287, <i>p</i>=0.022). Among PSG parameters, lowest oxygen saturation (SaO<sub>2</sub>) and percentage of time with SaO<sub>2</sub> less than 90% were correlated with the emotional score of DHI (r=-0.245, <i>p</i>=0.043 and r=0.311, <i>p</i>=0.010, respectively).Conclusions: Although our study could not objectively confirm vestibular dysfunction in patients with sleep disorders, we found that subjective sleep complaints were associated with dizziness and hypoxic conditions during sleep were associated with emotional aspects of dizziness. This suggests that the treatment of concomitant sleep disorders may improve dizziness.
Abstract
Objectives: The aim of this study was to evaluate dizziness in patients with sleep disorders, objectively identify vestibular function through the vestibulo-ocular reflex (VOR) using the video Head Impulse Test (vHIT), and evaluate the association between these findings.Methods: Among the patients who visited the sleep clinic from June to October 2021, 69 who underwent both polysomnography (PSG) and vHIT were included. Participants completed questionnaires including the Dizziness Handicap Inventory (DHI), Beck Anxiety Inventory, Korean-Beck Depression Inventory-II, Epworth Sleepiness Scale, Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI). The subjects were classified into four groups: insomnia (n=4), rapid eye movement sleep behavior disorder (RBD) (n=13), obstructive sleep apnea syndrome (OSAS) (n=34), and RBD and OSAS (n=18). Moderate to severe OSAS (n=49) was compared with no OSAS and mild OSAS (n=20).Results: In comparison of the four groups according to sleep disorders, the OSAS patients showed the highest DHI scores and the lowest VOR gain, but statistical significance was not found. Although all VOR gains were within the normal range, the VOR gain of the left posterior semicircular canal was significantly lower in the moderate to severe OSA group than in the no OSA and mild OSA groups (1.02±0.18 vs. 0.94±0.10, <i>p</i>=0.019). DHI total scores showed no correlation with VOR gain but showed a positive correlation with ISI (r=0.422, <i>p</i>=0.001) and PSQI (r=0.287, <i>p</i>=0.022). Among PSG parameters, lowest oxygen saturation (SaO<sub>2</sub>) and percentage of time with SaO<sub>2</sub> less than 90% were correlated with the emotional score of DHI (r=-0.245, <i>p</i>=0.043 and r=0.311, <i>p</i>=0.010, respectively).Conclusions: Although our study could not objectively confirm vestibular dysfunction in patients with sleep disorders, we found that subjective sleep complaints were associated with dizziness and hypoxic conditions during sleep were associated with emotional aspects of dizziness. This suggests that the treatment of concomitant sleep disorders may improve dizziness.
참고문헌 (37)
- Neuhauser HK, "Burden of dizziness and vertigo in the community", Arch Intern Med, 168, pp.2118~2124 (2008)[DOI]
- Neuhauser HK, "The epidemiology of dizziness and vertigo", Handb Clin Neurol, 137, pp.67~82 (2016)[DOI]
- Andrade Junior MC, "Individuals with peripheral vestibulopathy and poor quality of sleep are at a higher risk for falls", Braz J Otorhinolaryngol, 87, pp.440~446 (2021)[DOI]
- Bolton PS, "Response of pontomedullary reticulospinal neurons to vestibular stimuli in vertical planes. Role in vertical vestibulospinal reflexes of the decerebrate cat", J Neurophysiol, 67, pp.639~647 (1992)[DOI]
- Sugaya N, "The effect of sleep disturbance in patients with chronic dizziness", Acta Otolaryngol, 137, pp.47~52 (2017)[DOI]
- Albathi M, "Vestibular vertigo is associated with abnormal sleep duration", J Vestib Res, 27, pp.127~135 (2017)[DOI]
- 서일교, "수면의 질과 비현훈어지럼 간의 연관성: 병원기반 환자-대조군 연구", Journal of sleep medicine, 10(1), pp.15~19 (2013), 대한수면연구학회
- Tsai MS, "Sleep apnea and risk of vertigo : a nationwide population-based cohort study", Laryngoscope, 128, pp.763~768 (2018)[DOI]
- MacDougall HG, "The video head impulse test : diagnostic accuracy in peripheral vestibulopathy", Neurology, 73, pp.1134~1141 (2009)[DOI]
- Sateia MJ, "International classification of sleep disorders-third edition : highlights and modifications", Chest, 146, pp.1387~1394 (2014)[DOI]
- Jacobson GP, "The development of the dizziness handicap inventory", Arch Otolaryngol Head Neck Surg, 116, pp.424~427 (1990)[DOI]
- Whitney SL, "Usefulness of the dizziness handicap inventory in the screening for benign paroxysmal positional vertigo", Otol Neurotol, 26, pp.1027~1033 (2005)[DOI]
- Karapolat H, "Reliability, validity and sensitivity to change of Turkish dizziness handicap inventory(DHI)in patients with unilateral peripheral vestibular disease", Int Adv Otol, 5, pp.237~245 (2009)
- Yook SP, "A clinical study on the Korean version of beck anxiety inventory : comparative study of patient and non-patient", Korean J Clin Psychol, 16, pp.185~197 (1997)
- Beck AT, "An inventory for measuring clinical anxiety : psychometric properties", J Consult Clin Psychol, 56, pp.893~897 (1988)[DOI]
- Cho YW, "The reliability and validity of the Korean version of the Epworth sleepiness scale", Sleep Breath, 15, pp.377~384 (2011)[DOI]
- 조용원, "Validation of a Korean Version of the Insomnia Severity Index", Journal of Clinical Neurology, 10(3), pp.210~215 (2014), 대한신경과학회[DOI]
- Sohn SI, "The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index", Sleep Breath, 16, pp.803~812 (2012)[DOI]
- 성형모, "한국어판 백 우울 설문지 2판의 신뢰도 및 타당도 연구", 생물치료정신의학, 14(2), pp.201~212 (2008), 대한생물치료정신의학회
- Jo H, "Sleep disturbances and phenoconversion in patients with REM sleep behavior disorder", J Clin Med, 10, pp.4709~ (2021)[DOI]
- Chung YH, "Prevalence and predictive factors of nocturia in patients with obstructive sleep apnea syndrome : a retrospective cross-sectional study", PLoS One, 17, pp.e0267441~ (2022)[DOI]
- Berry RB, "AASM scoring manual updates for 2017(version 2. 4)", J Clin Sleep Med, 13, pp.665~666 (2017)[DOI]
- Alhabib SF, "Video head impulse test : a review of the literature", Eur Arch Otorhinolaryngol, 274, pp.1215~1222 (2017)[DOI]
- Yang CJ, "Quantitative analysis of gains and catch-up saccades of video-head-impulse testing by age in normal subjects", Clin Otolaryngol, 41, pp.532~538 (2016)[DOI]
- MacDougall HG, "Application of the video head impulse test to detect vertical semicircular canal dysfunction", Otol Neurotol, 34, pp.974~979 (2013)[DOI]
- Macdougall HG, "The video head impulse test(vHIT)detects vertical semicircular canal dysfunction", PLoS One, 8, pp.e61488~ (2013)[DOI]
- Drummond S, "The effects of total sleep deprivation on cerebral responses to cognitive performance", Neuropsychopharmacol, 25(Suppl 1), pp.S68~S73 (2001)[DOI]
- Quarck G, "Total sleep deprivation can increase vestibulo-ocular responses", J Sleep Res, 15, pp.369~375 (2006)[DOI]
- Oliveira P, "Impact of rapid eye movement sleep behavior disorder and autonomic disorders on Parkinson’s disease : a review", Arq Neuropsiquiatr, 79, pp.156~166 (2021)[DOI]
- Boeve BF, "Pathophysiology of REM sleep behaviour disorder and relevance to neurodegenerative disease", Brain, 130(Pt 11), pp.2770~2788 (2007)[DOI]
- Xie WY, "REM sleep without atonia and vestibular-evoked myogenic potentials : clinical brainstem dysfunction in early-stage Parkinson’s disease and isolated REM sleep behavior disorder", Sleep Med, 89, pp.122~129 (2022)[DOI]
- Gallina S, "Obstructive sleep apnoea syndrome(OSAS) : effects on the vestibular system", Acta Otorhinolaryngol Ital, 30, pp.281~284 (2010)
- Kayabasi S, "Vestibular functions were found to be impaired in patients with moderate-to-severe obstructive sleep apnea", Laryngoscope, 125, pp.1244~1248 (2015)[DOI]
- Mutlu M, "Vestibular evoked myogenic potential responses in obstructive sleep apnea syndrome", Eur Arch Otorhinolaryngol, 272, pp.3137~3141 (2015)[DOI]
- Micarelli A, "Integrating postural and vestibular dimensions to depict impairment in moderate-to-severe obstructive sleep apnea syndrome patients", J Sleep Res, 26, pp.487~494 (2017)[DOI]
- Birk R, "Nightly hypoxia does not seem to lead to otolith dysfunction in patients with obstructive sleep apnea", Ear Nose Throat J, 100, pp.667~672 (2021)[DOI]
- Alessandrini M, "Postural and vestibular changes related to CPAP treatment in moderate-to-severe OSA patients : a 12-month longitudinal study", Sleep Breath, 23, pp.665~672 (2019)[DOI]