Evaluation of vestibular evoked myogenic potentials responses in patients with severe obstructive sleep apnea before and after continuous positive airway pressure therapy.

Study objectives: We investigated the diagnostic role of vestibular evoked myogenic potential (VEMP) in detecting potential damage to the otolithic organs and brainstem in patients with obstructive sleep apnea syndrome (OSAS) and evaluated the effect of continuous positive airway pressure therapy on the vestibular system through VEMP measurements.

Methods: This single-center, prospective study included 51 patients with severe OSAS (102 ears) and 20 controls without OSAS (40 ears). Cervical and ocular VEMP tests were administered to both groups. For patients with OSAS, VEMP tests were repeated after 3-month continuous positive airway pressure therapy. Pre- and posttreatment VEMP data were compared between the groups.

Results: Patients with OSAS had significantly lower response rates of both ocular and cervical VEMP compared to controls (P = .003 and P = .027, respectively). In ocular VEMP, prolonged p1 and n1 latencies, shortened p1-n1 interpeak latencies, and decreased amplitudes were observed (P < .0001 for all). In cervical VEMP, prolonged n1 and p1-n1 interpeak latencies and reduced amplitudes were noted (P < .0001 for all), whereas no significant changes were observed in p1 latency. Significant posttreatment improvements were detected in ocular VEMP parameters, including n1 latency, p1-n1 latency, and amplitudes (P < .0001, P = .001, and P = .001, respectively). Similarly, significant posttreatment improvements were observed in cervical VEMP parameters, namely n1 latency, p1-n1 latency, and amplitudes (P < .0001, P < .0001, and P = .003, respectively). There was no significant change in p1 latency.

Conclusions: Subclinical abnormalities in otolithic organs and the brainstem in severe OSAS could be detected early using noninvasive VEMP testing. VEMP tests also revealed that a 3-month continuous positive airway pressure therapy ameliorated these vestibular system abnormalities.

Citation: Arslan İ, Güneş M, Selçuk ÖT, Eyigör H. Evaluation of vestibular evoked myogenic potentials responses in patients with severe obstructive sleep apnea before and after continuous positive airway pressure therapy. J Clin Sleep Med. 2025;21(9):1547-1556.