open access
Evaluation of postural balance in patients with obstructive sleep apnoea syndrome
- Cukurova University Facultyof Health Science, Cukurova University Balcalı Kampus Sarıcam, 01330 ADANA, Türkiye
open access
Abstract
Introduction. Patients with obstructive sleep apnoea syndrome (OSAS) can be more prone to accidents due to excessive daytime sleepiness which can lead to attention deficits and thereby cause balance problems. One of the tests evaluating postural balance is static posturography (SPG). In this study, we aimed to evaluate postural balance with SPG in OSAS patients.
Methods. Patients who were referred to a sleep disorders outpatient clinic of a tertiary health care centre with snoring, daytime sleepiness or witnessed apnoea were enrolled consecutively in this cross-sectional study. They were grouped as the OSAS group and the control group according to the apnoea-hypopnoea index. Posturographic analyses were carried out in all subjects on a SPG platform under five different conditions: eyes open (EO), eyes closed (EC), head rotated to left (HL), head rotated to right (HR), and tandem Romberg.
Results. A total of 95 patients and 23 controls were included in the study. In EO conditions, there was no difference between the OSAS group and the control group in any of the posturographic parameters. In EC conditions, change in lateral sway was significantly higher in the OSAS group which also correlated negatively with SaO2(min). HR conditions caused an i ncrease in anterior-posterior (A-P) sway velocity, and HL conditions led to an increase in change in lateral and A-P sways, sway area, and sway area velocity in the OSAS group.
Conclusions. Our findings suggest that postural balance in OSAS patients is impaired even in the very first hours of the day, and that the severity of the disease has an impact on postural balance.
Abstract
Introduction. Patients with obstructive sleep apnoea syndrome (OSAS) can be more prone to accidents due to excessive daytime sleepiness which can lead to attention deficits and thereby cause balance problems. One of the tests evaluating postural balance is static posturography (SPG). In this study, we aimed to evaluate postural balance with SPG in OSAS patients.
Methods. Patients who were referred to a sleep disorders outpatient clinic of a tertiary health care centre with snoring, daytime sleepiness or witnessed apnoea were enrolled consecutively in this cross-sectional study. They were grouped as the OSAS group and the control group according to the apnoea-hypopnoea index. Posturographic analyses were carried out in all subjects on a SPG platform under five different conditions: eyes open (EO), eyes closed (EC), head rotated to left (HL), head rotated to right (HR), and tandem Romberg.
Results. A total of 95 patients and 23 controls were included in the study. In EO conditions, there was no difference between the OSAS group and the control group in any of the posturographic parameters. In EC conditions, change in lateral sway was significantly higher in the OSAS group which also correlated negatively with SaO2(min). HR conditions caused an i ncrease in anterior-posterior (A-P) sway velocity, and HL conditions led to an increase in change in lateral and A-P sways, sway area, and sway area velocity in the OSAS group.
Conclusions. Our findings suggest that postural balance in OSAS patients is impaired even in the very first hours of the day, and that the severity of the disease has an impact on postural balance.
Keywords
balance, obstructive sleep apnoea, static posturography, postural stability
Title
Evaluation of postural balance in patients with obstructive sleep apnoea syndrome
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Research Paper
Pages
83-89
Published online
2019-12-02
Page views
1460
Article views/downloads
441
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2020;54(1):83-89.
Keywords
balance
obstructive sleep apnoea
static posturography
postural stability
Authors
Turgay Demir
Kezban Aslan
Meltem Demirkiran
- Spicuzza L, Caruso D, Di Maria G. Obstructive sleep apnoea syndrome and its management. Ther Adv Chronic Dis. 2015; 6(5): 273–285.
- Heinzer R, Vat S, Marques-Vidal P, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med. 2015; 3(4): 310–318.
- Peppard PE, Young T, Barnet JH, et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013; 177(9): 1006–1014.
- Archbold KH, Borghesani PR, Mahurin RK, et al. Neural activation patterns during working memory tasks and OSA disease severity: preliminary findings. J Clin Sleep Med. 2009; 5(1): 21–27.
- Iber C. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications 1st ed. : Wectchester, Illınois: American Academy of Sleep Medicine. ; 2007.
- Dawson D, Reid K. Fatigue, alcohol and performance impairment. Nature. 1997; 388(6639): 235.
- Redfern MS, Yardley L, Bronstein AM. Visual influences on balance. J Anxiety Disord. 2001; 15(1-2): 81–94.
- Morad Y, Azaria B, Avni I, et al. Posturography as an indicator of fatigue due to sleep deprivation. Aviat Space Environ Med. 2007; 78(9): 859–863.
- Bougard C, Davenne D. Morning/Evening differences in somatosensory inputs for postural control. Biomed Res Int. 2014; 2014: 287436.
- Czisch M, Wehrle R, Harsay HA, et al. The effects of total sleep deprivation on cerebral responses to cognitive performance. Neuropsychopharmacology. 2001; 25(5 Suppl): S68–S73.
- Quarck G, Ventre J, Etard O, et al. Total sleep deprivation can increase vestibulo-ocular responses. J Sleep Res. 2006; 15(4): 369–375.
- Vališ M, Dršata J, Kalfeřt D, et al. Computerized static posturography in Neurology. Central European J of Med. 2012; 7(3): 317–22.
- Periodic limb movement disorder. In: The International Classification of Sleep Disorders, Revised Diagnostic and Coding Manual 2rd ed. Westchester, Illinois: American Academy of Sleep Medicine, 2005; pp 65-8.
- Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991; 14(6): 540–545.
- Izci B, Ardic S, Firat H, et al. Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale. Sleep Breath. 2008; 12(2): 161–168.
- Degache F, Goy Y, Vat S, et al. Sleep-disordered breathing and daytime postural stability. Thorax. 2016; 71(6): 543–548.
- Nardone A, Tarantola J, Giordano A, et al. Fatigue effects on body balance. Electroencephalogr Clin Neurophysiol. 1997; 105(4): 309–320.
- Howcroft J, Lemaire ED, Kofman J, et al. Elderly fall risk prediction using static posturography. PLoS One. 2017; 12(2): e0172398.
- Kayabasi S, Iriz A, Cayonu M, et al. Vestibular functions were found to be impaired in patients with moderate-to-severe obstructive sleep apnea. Laryngoscope. 2015; 125(5): 1244–1248.
- Gallina S, Dispenza F, Kulamarva G, et al. Obstructive sleep apnoea syndrome (OSAS): effects on the vestibular system. Acta Otorhinolaryngol Ital. 2010; 30(6): 281–284.
- Avni N, Avni I, Barenboim E, et al. Brief posturographic test as an indicator of fatigue. Psychiatry Clin Neurosci. 2006; 60(3): 340–346.
- Gribble PA, Hertel J. Changes in postural control during a 48-hr. sleep deprivation period. Percept Mot Skills. 2004; 99(3 Pt 1): 1035–1045.
- Liu Y, Higuchi S, Motohashi Y. Changes in postural sway during a period of sustained wakefulness in male adults. Occup Med (Lond). 2001; 51(8): 490–495.
- Nakano T, Araki K, Michimori A, et al. Nineteen-hour variation of postural sway, alertness and rectal temperature during sleep deprivation. Psychiatry Clin Neurosci. 2001; 55(3): 277–278.
- Haeggstrom E, Forsman P, Wallin A, et al. Evaluating sleepiness using force platform posturography. IEEE Trans Biomed Eng. 2006; 53(8): 1578–1585.
- Loram ID, Maganaris CN, Lakie M. Paradoxical muscle movement during postural control. Med Sci Sports Exerc. 2009; 41(1): 198–204.
- Delliaux S, Jammes Y. Effects of hypoxia on muscle response to tendon vibration in humans. Muscle Nerve. 2006; 34(6): 754–761.
- Alessandrini M, Liguori C, Viziano A, et al. Postural and vestibular changes related to CPAP treatment in moderate-to-severe OSA patients: a 12-month longitudinal study. Sleep Breath. 2019; 23(2): 665–672.