Postural stability and fall risk in patients with obstructive sleep apnea: a cross-sectional study

Gökmen, Gülhan Yılmaz; Gürses, Hülya Nilgün; Zeren, Melih; Ozyilmaz, Semiramis; Kansu, Abdullah; Akkoyunlu, Muhammed Emin

doi:10.1007/s11325-021-02322-2

Cited by 3 publications

(8 citation statements)

References 34 publications

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“…When severe obstructive sleep apnea-impaired static postural balance is compared to mild to moderate (non-severe) obstructive sleep apnea, there was no difference between them in terms of dynamic postural balance and the risk of fall ( Gokmen et al, 2021 ). Nocturnal hypoxia may cause deterioration in static postural balance as the apnea-hypopnea index increases and nocturnal blood oxygen saturation level decreases ( Gokmen et al, 2021 ). Sleep-disordered breathing severity, especially the mean nocturnal blood oxygen saturation level, is associated with impaired daytime postural balance ( Degache et al, 2016 ).…”

Section: Chronic Poor Sleep Quality and Postural Balancementioning

confidence: 99%

“…It is not clear whether daytime sleepiness, self-rated sleep quality, snoring or napping are associated with falls, as some, but not all, and studies show an association between these variables (Knechel and Chang, 2022). When severe obstructive sleep apnea-impaired static postural balance is compared to mild to moderate (non-severe) obstructive sleep apnea, there was no difference between them in terms of dynamic postural balance and the risk of fall (Gokmen et al, 2021). Nocturnal hypoxia may cause deterioration in static postural balance as the apneahypopnea index increases and nocturnal blood oxygen saturation level decreases (Gokmen et al, 2021).…”

Section: Chronic Poor Sleep Quality and Postural Balancementioning

confidence: 99%

“…Among the reasons for chronic poor sleep quality, obstructive sleep apnea is a major problem. Periodic collapse of the upper airway during sleep in patients with obstructive sleep apnea causes chronic intermittent hypoxia and sleep interruption ( Gokmen et al, 2021 ). Obstructive sleep apnea and insomnia are associated with an increased risk of falls ( Gokmen et al, 2021 ; Knechel and Chang, 2022 ).…”

Section: Chronic Poor Sleep Quality and Postural Balancementioning

confidence: 99%

“…Periodic collapse of the upper airway during sleep in patients with obstructive sleep apnea causes chronic intermittent hypoxia and sleep interruption ( Gokmen et al, 2021 ). Obstructive sleep apnea and insomnia are associated with an increased risk of falls ( Gokmen et al, 2021 ; Knechel and Chang, 2022 ). It is not clear whether daytime sleepiness, self-rated sleep quality, snoring or napping are associated with falls, as some, but not all, and studies show an association between these variables ( Knechel and Chang, 2022 ).…”

Section: Chronic Poor Sleep Quality and Postural Balancementioning

confidence: 99%

“… Degache et al (2016) suggested that hypoxemia would degrade postural balance at least partially by altering the muscle spindle reactivity so essential to postural regulation. Gokmen et al (2021) reported that hypoxia and sleep interruption are thought to provoke cardiovascular and cerebrovascular diseases and brain damage with oxidative stress, sympathetic activation, and systemic and vascular inflammation. All this damage and alterations related to the systems of information taking, the decision making and the motor execution of the postural and balance function are likely to degrade postural balance.…”

Section: Chronic Poor Sleep Quality and Postural Balancementioning

confidence: 99%

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Detrimental effects of sleep deprivation on the regulatory mechanisms of postural balance: a comprehensive review

Paillard

2023

Front. Hum. Neurosci.

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This review addresses the effects of sleep deprivation on postural balance based on a comprehensive search of articles dealing with this relationship in the electronic databases PubMed, Google Scholar, and ScienceDirect. Evidence suggests that postural balance is sensitive to acute and chronic sleep deprivation for everyone, including young and healthy subjects. Pathologies, aging and the circadian pattern aggravate and/or accentuate the effects of sleep deprivation on postural balance. It turns out that the different systems of information taking, decision making, and motor execution of the postural balance function are negatively affected by sleep deprivation. For example, regarding the information taking system, the sensitivity of visual perception and visuo-spatial performance and the oculomotricity are disrupted and the vestibulo-ocular reflex and the sensory reweighting are altered. Regarding the decision making system, the different brain areas activated for the regulation of postural balance are less active after sleep deprivation and the executive function and perception of verticality are impaired. Regarding the motor execution system, the agonist-antagonist muscle coordination can be modified. However, the different detrimental effects induced for each system of the postural balance function are not yet fully known and deserve further exploration in order to better understand them.

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Section: Chronic Poor Sleep Quality and Postural Balancementioning

confidence: 99%

Section: Chronic Poor Sleep Quality and Postural Balancementioning

confidence: 99%

Section: Chronic Poor Sleep Quality and Postural Balancementioning

confidence: 99%

Section: Chronic Poor Sleep Quality and Postural Balancementioning

confidence: 99%

Section: Chronic Poor Sleep Quality and Postural Balancementioning

confidence: 99%

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Detrimental effects of sleep deprivation on the regulatory mechanisms of postural balance: a comprehensive review

Paillard

2023

Front. Hum. Neurosci.

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Clinical characteristics and positive airway pressure adherence among elderly European sleep apnoea patients from the ESADA cohort

et al. 2023

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BackgroundThe prevalence of obstructive sleep apnoea (OSA) is growing as the population is ageing. However, data on the clinical characteristics of elderly OSA patients and their adherence to positive airway pressure (PAP) treatment are scarce.MethodsData of 23,418 30–79-year-old OSA patients prospectively collected into the ESADA database during the period 2007 to 2019 were analysed. Information on PAP use (h·day−1) in association with a first follow-up visit was available for 6547 patients. The data was analysed according to ten-year age-groups.ResultsThe oldest age-group was less obese, less sleepy, and had a lower AHI compared to middle-aged patients. The insomnia-phenotype of OSA was more prevalent in the oldest age group than in the middle-aged group (36%, 95% CI 34–38versus26%, 95% CI 24–27, p<0.001). The 70–79-year-old group adhered to PAP therapy equally well as the younger age groups with a mean PAP use of 5.59 h·day−1(95% CI 5.44–5.75). PAP adherence did not differ between clinical phenotypes based on subjective daytime sleepiness and sleep complaints suggestive of insomnia in the oldest age-group. A higher score on the Clinical Global Impression Severity (CGI-S) scale predicted poorer PAP adherence.ConclusionThe elderly patient group was less obese, less sleepy, had more insomnia symptoms, and less severe OSA, but rated to be more ill compared with the middle-aged patients. Elderly OSA patients adhered to PAP therapy equally well as the middle-aged. Low global functioning (measured by CGI-S) in the elderly patient predicted poorer PAP adherence.

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Vestibular symptoms are related to the proportion of REM sleep in people with sleep complaints: A preliminary report

Altena

Buguet

Higginson

et al. 2023

VES

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OBJECTIVE/BACKGROUND: Though sleep problems (apnea, insomnia) and related daytime symptoms (fatigue, anxiety, depression) have been associated with vestibular problems (falls, dizziness), it is not well known which particular sleep features relate to vestibular problems. We thus assessed symptoms of vestibular problems in patients visiting a sleep clinic and evaluated how they were associated with objective sleep parameters derived from polysomnography and relevant daytime symptoms. PATIENTS/METHODS: The polysomnography data of thirty-one patients (61% female, between 20 and 79 years of age) who were referred for clinical sleep assessment was collated with subjective measures of symptoms linked to vestibular problems (rated on the Situational Characteristics Questionnaire), as well as fatigue, anxiety and depression symptoms. Multiple linear regression was used to identify factors associated with vestibular symptoms, including analyses adjusted for age, sex, medication use and total sleep time. RESULTS: A higher percentage of REM sleep and more severe anxiety symptoms were independently associated with more severe vestibular symptoms, which survived adjusted analyses. Other sleep stages, as well as as sleep efficiency, apnea-hypopnea index and oxygen saturation were not significantly related to vestibular symptoms. CONCLUSIONS: These results point at vestibular symptoms as possible important and overlooked correlates of variations in sleep architecture in individuals with sleep complaints. Though replication is needed to confirm findings from this limited sample, the results highlight the importance of assessing vestibular symptoms in people with sleep complaints. In particular, further investigations will need to address the potential implication of REM sleep for vestibular functions and the directionality of this relation.

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Postural stability and fall risk in patients with obstructive sleep apnea: a cross-sectional study

Cited by 3 publications

References 34 publications

Detrimental effects of sleep deprivation on the regulatory mechanisms of postural balance: a comprehensive review

Detrimental effects of sleep deprivation on the regulatory mechanisms of postural balance: a comprehensive review

Clinical characteristics and positive airway pressure adherence among elderly European sleep apnoea patients from the ESADA cohort

Vestibular symptoms are related to the proportion of REM sleep in people with sleep complaints: A preliminary report

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