Affiliations: [a]
Departments of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| [b]
Department of HY-KIST Bio-convergence, College of Medicine, Hanyang University, Seoul, Republic of Korea
| [c]
Biostatistical Consulting and Research Laboratory, Medical Research Collaborating Center, Hanyang University, Seoul, Republic of Korea
Correspondence:
[*]
Corresponding author: Jae Ho Chung, MD, PhD., Department of Otolaryngology-Head and Neck Surgery, Department of HY-KIST Bio-convergence, School of Medicine, Hanyang University, 222-Wangshimni-ro, Seongdong-gu, Seoul, 04763, Korea. Tel.: +82 31 560 2298; Fax: +82 31 560 2176; E-mail: jaeho.chung.md@gmail.com.
Abstract: BACKGROUND:Obstructive sleep apnea (OSA) could influence peripheral vestibular function adversely via intermittent hypoxia and its consequences. OBJECTIVE:This study aimed to evaluate the risk of peripheral vestibular disorders in OSA using a nationwide population-based retrospective cohort study. METHODS:The National Health Insurance Service–National Sample Cohort represents the entire Korean population from 2002 to 2015. OSA was defined as individuals who had used medical services twice or more under a diagnosis of OSA(G47.33 in ICD-10). A comparison cohort consisted of socio-demographically matched non-OSA subjects in a ratio of 1:4. The incidences of benign paroxysmal positional vertigo(BPPV), Meniere’s disease, and vestibular neuritis were evaluated in each cohort. RESULTS:A total of 2,082 individuals with OSA and 8,328 matched non-OSA subjects were identified. The incidence rates(IRs) of peripheral vertigo in OSA and non-OSA were 149.86 and 23.88 per 10,000 persons, respectively (Ratio of IR, IRR = 6.28, 95%CI 4.89 to 8.08). In multivariable analysis, the risk of peripheral vertigo was significantly higher in OSA(adjusted HR = 6.64, 95%CI 5.20 to 8.47), old age(adjusted HR = 1.03, 95%CI 1.02 to 1.04), female sex(adjusted HR = 1.92, 95%CI 1.48 to 2.50), and comorbidities(adjusted HR = 1.09, 95%CI 1.003 to 1.19). The IRRs of each vestibular disorder in the two groups were 7.32(95%CI 4.80 to 11.33) for BPPV, 3.61(95%CI 2.24 to 5.81) for Meniere’s disease, and 9.51(95%CI 3.97 to 25.11) for vestibular neuritis. CONCLUSIONS:Subjects diagnosed with OSA had a higher incidence of peripheral vestibular disorders than those without OSA, according to national administrative claims data. It is recommended to take peripheral vertigo into account when counseling OSA.
