The impact of obstructive sleep apnoea on balance, gait and falls risk: a narrative review of the literature.
Identifieur interne : 000120 ( Main/Corpus ); précédent : 000119; suivant : 000121The impact of obstructive sleep apnoea on balance, gait and falls risk: a narrative review of the literature.
Auteurs : David Stevens ; Brianna Jackson ; Jayne Carberry ; James Mcloughlin ; Chris Barr ; Sutapa Mukherjee ; Aaron Oh ; R Doug Mcevoy ; Maria Crotty ; Andrew VakulinSource :
- The journals of gerontology. Series A, Biological sciences and medical sciences [ 1758-535X ] ; 2020.
Abstract
Falls related hospitalisation and injury rates are steadily increasing globally due to a growth in the aging population, and the associated health problems that increase risk of falls. One such associated health problem is sleep disturbances and disorders. Recent cohort studies have shown that subjectively reported poor quality sleep is associated with an increased risk of falls. Obstructive sleep apnoea (OSA) is a common sleep disorder characterised by the repetitive reductions, or cessation, of airflow. Some studies have shown that OSA impairs posture/balance and gait with nocturnal hypoxemia the likely main cause. Emerging evidence suggests that treating OSA by continuous positive airway pressure (CPAP) can improve gait, but no studies to date have examined the effect of CPAP on posture/balance. The overall control of balance relies on a complex interaction between several physiological functions including vestibular, muscle, visual and cognitive functions. We postulate that OSA impacts balance by affecting these different systems to various degrees, with the nocturnal hypoxic burden likely playing an important role. Importantly, these impairments in balance/posture and possible falls risk may be alleviated by OSA treatment. Larger mechanistic studies are needed to properly elucidate how OSA affects falls risk and future large-scale randomised control trials are needed to determine the effectiveness of OSA treatment in reducing the risk of falls.
DOI: 10.1093/gerona/glaa014
PubMed: 32039438
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Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Carberry, Jayne" sort="Carberry, Jayne" uniqKey="Carberry J" first="Jayne" last="Carberry">Jayne Carberry</name><affiliation><nlm:affiliation>Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, S.A., Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Mcloughlin, James" sort="Mcloughlin, James" uniqKey="Mcloughlin J" first="James" last="Mcloughlin">James Mcloughlin</name><affiliation><nlm:affiliation>College of Nursing and Health Science, Flinders University, S.A.., Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Barr, Chris" sort="Barr, Chris" uniqKey="Barr C" first="Chris" last="Barr">Chris Barr</name><affiliation><nlm:affiliation>College of Nursing and Health Science, Flinders University, S.A.., Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Mukherjee, Sutapa" sort="Mukherjee, Sutapa" uniqKey="Mukherjee S" first="Sutapa" last="Mukherjee">Sutapa Mukherjee</name><affiliation><nlm:affiliation>Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, S.A., Australia.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Sleep Health Service, Sleep and Respiratory Services, Flinders Medical Centre, Southern Adelaide Local Health Network, S.A., Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Oh, Aaron" sort="Oh, Aaron" uniqKey="Oh A" first="Aaron" last="Oh">Aaron Oh</name><affiliation><nlm:affiliation>Sleep Health Service, Sleep and Respiratory Services, Flinders Medical Centre, Southern Adelaide Local Health Network, S.A., Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Mcevoy, R Doug" sort="Mcevoy, R Doug" uniqKey="Mcevoy R" first="R Doug" last="Mcevoy">R Doug Mcevoy</name><affiliation><nlm:affiliation>Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, S.A., Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Crotty, Maria" sort="Crotty, Maria" uniqKey="Crotty M" first="Maria" last="Crotty">Maria Crotty</name><affiliation><nlm:affiliation>Department of Rehabilitation, Aged, and Extended Aged Care, College of Medicine and Public Health, Flinders University, S.A., Australia.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>4th Generation Rehabilitation Clinic, Flinders Medical Centre, Southern Adelaide Local Health Network, S.A., Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Vakulin, Andrew" sort="Vakulin, Andrew" uniqKey="Vakulin A" first="Andrew" last="Vakulin">Andrew Vakulin</name><affiliation><nlm:affiliation>Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, S.A., Australia.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Neurosleep CRE, Woolcock Institute of Medical Research, N.S.W., Australia.</nlm:affiliation></affiliation></author></analytic><series><title level="j">The journals of gerontology. Series A, Biological sciences and medical sciences</title><idno type="eISSN">1758-535X</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Falls related hospitalisation and injury rates are steadily increasing globally due to a growth in the aging population, and the associated health problems that increase risk of falls. One such associated health problem is sleep disturbances and disorders. Recent cohort studies have shown that subjectively reported poor quality sleep is associated with an increased risk of falls. Obstructive sleep apnoea (OSA) is a common sleep disorder characterised by the repetitive reductions, or cessation, of airflow. Some studies have shown that OSA impairs posture/balance and gait with nocturnal hypoxemia the likely main cause. Emerging evidence suggests that treating OSA by continuous positive airway pressure (CPAP) can improve gait, but no studies to date have examined the effect of CPAP on posture/balance. The overall control of balance relies on a complex interaction between several physiological functions including vestibular, muscle, visual and cognitive functions. We postulate that OSA impacts balance by affecting these different systems to various degrees, with the nocturnal hypoxic burden likely playing an important role. Importantly, these impairments in balance/posture and possible falls risk may be alleviated by OSA treatment. Larger mechanistic studies are needed to properly elucidate how OSA affects falls risk and future large-scale randomised control trials are needed to determine the effectiveness of OSA treatment in reducing the risk of falls.</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32039438</PMID><DateRevised><Year>2020</Year><Month>02</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1758-535X</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Feb</Month><Day>10</Day></PubDate></JournalIssue><Title>The journals of gerontology. Series A, Biological sciences and medical sciences</Title><ISOAbbreviation>J Gerontol A Biol Sci Med Sci</ISOAbbreviation></Journal><ArticleTitle>The impact of obstructive sleep apnoea on balance, gait and falls risk: a narrative review of the literature.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">glaa014</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1093/gerona/glaa014</ELocationID><Abstract><AbstractText>Falls related hospitalisation and injury rates are steadily increasing globally due to a growth in the aging population, and the associated health problems that increase risk of falls. One such associated health problem is sleep disturbances and disorders. Recent cohort studies have shown that subjectively reported poor quality sleep is associated with an increased risk of falls. Obstructive sleep apnoea (OSA) is a common sleep disorder characterised by the repetitive reductions, or cessation, of airflow. Some studies have shown that OSA impairs posture/balance and gait with nocturnal hypoxemia the likely main cause. Emerging evidence suggests that treating OSA by continuous positive airway pressure (CPAP) can improve gait, but no studies to date have examined the effect of CPAP on posture/balance. The overall control of balance relies on a complex interaction between several physiological functions including vestibular, muscle, visual and cognitive functions. We postulate that OSA impacts balance by affecting these different systems to various degrees, with the nocturnal hypoxic burden likely playing an important role. Importantly, these impairments in balance/posture and possible falls risk may be alleviated by OSA treatment. Larger mechanistic studies are needed to properly elucidate how OSA affects falls risk and future large-scale randomised control trials are needed to determine the effectiveness of OSA treatment in reducing the risk of falls.</AbstractText><CopyrightInformation>© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Stevens</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, S.A., Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jackson</LastName><ForeName>Brianna</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, S.A., Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Carberry</LastName><ForeName>Jayne</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, S.A., Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McLoughlin</LastName><ForeName>James</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>College of Nursing and Health Science, Flinders University, S.A.., Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Barr</LastName><ForeName>Chris</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>College of Nursing and Health Science, Flinders University, S.A.., Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mukherjee</LastName><ForeName>Sutapa</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, S.A., Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Sleep Health Service, Sleep and Respiratory Services, Flinders Medical Centre, Southern Adelaide Local Health Network, S.A., Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Oh</LastName><ForeName>Aaron</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Sleep Health Service, Sleep and Respiratory Services, Flinders Medical Centre, Southern Adelaide Local Health Network, S.A., Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McEvoy</LastName><ForeName>R Doug</ForeName><Initials>RD</Initials><AffiliationInfo><Affiliation>Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, S.A., Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Crotty</LastName><ForeName>Maria</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Rehabilitation, Aged, and Extended Aged Care, College of Medicine and Public Health, Flinders University, S.A., Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>4th Generation Rehabilitation Clinic, Flinders Medical Centre, Southern Adelaide Local Health Network, S.A., Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vakulin</LastName><ForeName>Andrew</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, S.A., Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Neurosleep CRE, Woolcock Institute of Medical Research, N.S.W., Australia.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>02</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Gerontol A Biol Sci Med 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