Impact of obstructive sleep apnea syndrome on postural stability in patients with chronic cerebral ischemia

Objective: to analyze postural balance parameters in the quiet standing position in patients with chronic cerebral ischemia (CCI) using stabilometric assessment and to evaluate the impact of moderate to severe obstructive sleep apnea syndrome on postural control regulation. Material and methods. Ninety-four patients diagnosed with CCI stage 1-2 were examined. All participants underwent stabilometric testing and cardiorespiratory monitoring with calculation of the apnea — hypopnea index (AHI). Patients were divided into two groups: Group 1 — CCI with AHK15 (n=44); Group 2 — CCI with AHI>15 (n=50). Balance assessment in quiet standing was performed using the MBN-Stabilo system (MBN, Russia). Results. In patients with CCI, the quiet standing posture was characterized by asymmetry in the frontal plane and an anterior shift of the center of pressure (CoP). In Group 2, this forward displacement was more pronounced (p=0.004) and accompanied by significantly greater CoP sway area (p=0.03), amplitude (p=0.001), and velocity (p<0.001). A positive correlation was observed between AHI and anterior CoP displacement (rs=0.44; p=0.02). Conclusion. Patients with CCI exhibit postural instability in quiet standing, including anterior CoP displacement and instability in the sagittal plane. The presence of obstructive sleep apnea syndrome with AHI>15 is associated with more pronounced forward CoP shift and increased amplitude, velocity, and area of postural sway.