May vestibular rehabilitation reduce apnea-hypopnea index in patients with obstructive sleep apnea? A pilot study

Introduction The vestibular system is essential for maintaining the perception of head orientation and acceleration in all directions. The Functional Head Impulse Test (fHIT) is a novel tool for assessing the vestibulo-ocular reflex (VOR) and forms the basis for a recently developed vestibular rehabilitation system. This pilot study aimed to determine whether vestibular rehabilitation alone could objectively improve clinical parameters in patients with obstructive sleep apnea (OSA). Methods Twenty male patients diagnosed with OSA underwent baseline polysomnography (PSG) and fHIT assessment. Participants then completed a 10-day vestibular rehabilitation program using the reHAB system, after which PSG and fHIT were repeated. Results Initial fHIT analysis indicated impaired vestibular function in 30% of patients. The Wilcoxon signed-rank test demonstrated a statistically significant reduction in the apneahypopnea index (AHI) following rehabilitation ( p = 0.003), while the change in oxygen desaturation index (ODI) did not reach statistical significance ( p = 0.082). Scatter plot analysis revealed a moderate positive correlation between changes in AHI and ODI pre-and post-rehabilitation. Discussion These preliminary findings suggest a functional connection between vestibular inputs and sleep–wake pathways, possibly mediated by parabrachial circuits and orexinergic modulation.