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The causal relationship between obstructive sleep apnea and otitis media: a bidirectional Mendelian randomization
Ruixin Guo1, Yifan Zhang1, Yijie Chen1
1Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Experimental Biology and Medicine (Maywood, N.J.)
|December 1, 2025
Summary
Obstructive sleep apnea (OSA) increases the risk of developing otitis media. This study found no evidence that otitis media causes obstructive sleep apnea, suggesting OSA management may aid otitis media treatment.
Area of Science:
- Otolaryngology
- Sleep Medicine
- Genetics
Background:
- Obstructive sleep apnea (OSA) involves upper airway collapse during sleep.
- Otitis media encompasses infectious and inflammatory middle ear diseases.
Purpose of the Study:
- To investigate the causal relationship between obstructive sleep apnea and otitis media using Mendelian randomization.
- To determine if OSA influences the risk of developing otitis media or vice versa.
Main Methods:
- A bidirectional, two-sample Mendelian randomization (MR) analysis was performed.
- Genome-wide association study data and OSA-related single-nucleotide polymorphisms (SNPs) were utilized as instrumental variables.
- Inverse-variance weighted (IVW) method and sensitivity analyses (MR-Egger, MR-PRESSO, leave-one-out) were employed.
Main Results:
- Forward MR analysis indicated a significant causal effect of OSA on increased risk of acute suppurative otitis media (OR=1.164) and suppurative/unspecified otitis media (OR=1.150).
- Reverse MR analyses demonstrated no significant causal effect of otitis media on OSA.
- Sensitivity analyses supported the robustness of the findings.
Conclusions:
- Obstructive sleep apnea is a contributing factor to the development of otitis media.
- Managing OSA may offer therapeutic benefits for patients with otitis media.
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