Altered cervical proprioception and biomechanics in obstructive sleep apnea: a case-control study

Area of Science:

• Neurology
• Physiotherapy
• Sleep Medicine

Background:

• Obstructive Sleep Apnea (OSA) is a prevalent condition affecting respiratory control during sleep.
• Cervical proprioception, the sense of joint position and movement, plays a crucial role in head and neck stability.
• Potential links between OSA and musculoskeletal dysfunction, particularly in the cervical region, are increasingly recognized.

Purpose of the Study:

• To investigate and compare cervical proprioception and associated biomechanical factors in individuals with Obstructive Sleep Apnea (OSA) versus healthy controls.
• To identify potential differences in cervical joint position sense, range of motion, posture, and muscle function between the two groups.

Main Methods:

• A case-control study involving 59 male participants, comparing 29 with OSA and 30 asymptomatic controls.
• Cervical proprioception was assessed using a laser pointer for joint repositioning error during rotational movements.
• Cervical range of motion (ROM), cranio-cervical (CVA) and thoracic posture (TKA), neck flexor muscle endurance, and trapezius pain pressure thresholds (PPT) were also measured.

Main Results:

• Patients with OSA exhibited significantly poorer cervical proprioception compared to controls, with larger effect sizes for both sides of cervical rotation (p < 0.05).
• Significant differences were observed in cervical ROM, CVA, TKA, neck flexor muscle endurance, and PPT between the OSA group and controls (p < 0.05).
• The OSA group had a mean apnea-hypopnea index (AHI) of 26.06 events/hour, with varying severity levels (mild, moderate, severe).

Conclusions:

• Impaired cervical proprioception appears to be a previously unrecognized factor associated with Obstructive Sleep Apnea.
• These findings suggest a potential mechanism linking OSA to cervical musculoskeletal changes and highlight the importance of postural control.
• The results may inform the development of targeted interventions and exercise programs for individuals with OSA, focusing on improving neck proprioception and stability.