Sleep apnea and risk of vertigo: A nationwide population-based cohort study.

OBJECTIVE: To investigate the risk of vertigo in patients with sleep apnea.

STUDY DESIGN: Retrospective cohort study.

METHODS: This study used data from the National Health Insurance Research Database of Taiwan, a population-based database. A total of 5,025 patients who were newly diagnosed with sleep apnea between January 1, 1997, and December 31, 2012, were identified from the Longitudinal Health Insurance Database 2000, a nationally representative database of 1 million randomly selected patients. Moreover, 20,100 patients without sleep apnea were matched at a 1:4 ratio by age, sex, socioeconomic status, and urbanization level. Patients were followed up until death or the end of the study period (December 31, 2013). The primary outcome was the occurrence of vertigo.

RESULTS: Patients with sleep apnea had a significantly higher cumulative incidence of vertigo than those without sleep apnea (P < 0.001). The adjusted Cox proportional hazard model showed that sleep apnea was significantly associated with a higher incidence of vertigo (hazard ratio, 1.71; 95% confidence interval [CI], 1.48-1.97; P < 0.001). Sensitivity and subgroup analyses were performed to adjust for confounders, including head trauma, diabetes mellitus, hypertension, stroke, and obesity. Sleep apnea was demonstrated to be an independent risk factor for vertigo.

CONCLUSION: This is the first nationwide population-based cohort study to investigate the association between sleep apnea and vertigo. The findings strongly support that sleep apnea is an independent risk factor for vertigo. Based on the study results, physicians should be aware of potential vertigo occurrence following sleep apnea.

LEVEL OF EVIDENCE: 4. Laryngoscope, 128:763-768, 2017.