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Prevalence and risk factors of obstructive sleep apnea in patients with unexplained dizziness: A real‑world study

  • Authors:
    • Norapat Limsirorat
    • Sitta Suntrawanichakul
    • Watchara Boonsawat
    • Sittichai Khamsai
    • Kittisak Sawanyawisuth
  • View Affiliations / Copyright

    Affiliations: Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University Hospital, Khon Kaen University, Khon Kaen 40002, Thailand
    Copyright: © Limsirorat et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 173
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    Published online on: September 8, 2025
       https://doi.org/10.3892/br.2025.2051
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Abstract

Obstructive sleep apnea (OSA) is a globally prevalent sleep disorder linked to a wide range of systemic conditions, including cardiovascular and vestibular dysfunction. Dizziness is frequently encountered in clinical practice but underexplored on causes and relationship with OSA. The present study aimed to assess the prevalence of OSA among patients with unexplained dizziness and identify associated risk factors and potential links between these conditions. A retrospective analytical study was conducted at a tertiary care University Hospital over a two‑year period, from November 2022 to November 2024. The inclusion criteria were adult patients (aged ≥18 years) who had unexplained dizziness and underwent overnight polysomnography. Those who were pregnant or had identifiable cause of dizziness such as upper respiratory tract infection, anemia, hypoglycemia, anxiety, depression, postural hypotension, or hypertensive emergency were excluded. Eligible patients were evaluated for OSA by baseline characteristics, comorbidities, STOPBang score and physical examination. The overnight home sleep apnea test was used in all eligible patients. The diagnosis of OSA was defined by an apnea‑hypopnea index (AHI) of 5 or more events/h. The primary outcome was the prevalence of OSA in patients with dizziness. Risk factors of OSA were also analyzed by using the multivariable logistic regression analysis. During the study period, 81 patients met the study criteria. Of those, 76 patients (93.83%) diagnosed as OSA with a median AHI of 23 events/h (IQR of 11.5‑33.5). Patients with OSA had significantly larger neck circumferences than their non‑OSA counterparts (37.63 vs. 33.25 cm; P=0.042). The STOPBang score was also higher in OSA group (3.95 vs. 2.40; P=0.026). There was no significant difference among other factors between both groups including demographic variables, clinical symptoms, other anatomical variants and comorbidities. There were four factors remaining in the model by stepwise logistic regression analysis. Only STOPBang score was independently associated with OSA with an adjusted odds ratio of 2.115 (95% confidence interval of 1.048, 4.268). The cut point of STOPBang score of 3 or over had sensitivity of 82.89% and specificity of 40.00% for OSA. OSA was extremely prevalent in patients with unexplained dizziness. The STOPBang questionnaire may be used as a screening tool to detect OSA in this setting with high sensitivity.
View Figures

Figure 1

A ROC curve of the STOPBang score for
diagnosis of obstructive sleep apnea in patients with unexplained
dizziness; area under the ROC curve 75.39% (95% confidence interval
of 57.50-93.29%). The cut point of STOPBang score of 3 or over had
sensitivity of 82.89% and specificity of 40.00% for obstructive
sleep apnea. ROC, receiver operating characteristic.
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Copy and paste a formatted citation
Spandidos Publications style
Limsirorat N, Suntrawanichakul S, Boonsawat W, Khamsai S and Sawanyawisuth K: Prevalence and risk factors of obstructive sleep apnea in patients with unexplained dizziness: A real‑world study. Biomed Rep 23: 173, 2025.
APA
Limsirorat, N., Suntrawanichakul, S., Boonsawat, W., Khamsai, S., & Sawanyawisuth, K. (2025). Prevalence and risk factors of obstructive sleep apnea in patients with unexplained dizziness: A real‑world study. Biomedical Reports, 23, 173. https://doi.org/10.3892/br.2025.2051
MLA
Limsirorat, N., Suntrawanichakul, S., Boonsawat, W., Khamsai, S., Sawanyawisuth, K."Prevalence and risk factors of obstructive sleep apnea in patients with unexplained dizziness: A real‑world study". Biomedical Reports 23.5 (2025): 173.
Chicago
Limsirorat, N., Suntrawanichakul, S., Boonsawat, W., Khamsai, S., Sawanyawisuth, K."Prevalence and risk factors of obstructive sleep apnea in patients with unexplained dizziness: A real‑world study". Biomedical Reports 23, no. 5 (2025): 173. https://doi.org/10.3892/br.2025.2051
Copy and paste a formatted citation
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Spandidos Publications style
Limsirorat N, Suntrawanichakul S, Boonsawat W, Khamsai S and Sawanyawisuth K: Prevalence and risk factors of obstructive sleep apnea in patients with unexplained dizziness: A real‑world study. Biomed Rep 23: 173, 2025.
APA
Limsirorat, N., Suntrawanichakul, S., Boonsawat, W., Khamsai, S., & Sawanyawisuth, K. (2025). Prevalence and risk factors of obstructive sleep apnea in patients with unexplained dizziness: A real‑world study. Biomedical Reports, 23, 173. https://doi.org/10.3892/br.2025.2051
MLA
Limsirorat, N., Suntrawanichakul, S., Boonsawat, W., Khamsai, S., Sawanyawisuth, K."Prevalence and risk factors of obstructive sleep apnea in patients with unexplained dizziness: A real‑world study". Biomedical Reports 23.5 (2025): 173.
Chicago
Limsirorat, N., Suntrawanichakul, S., Boonsawat, W., Khamsai, S., Sawanyawisuth, K."Prevalence and risk factors of obstructive sleep apnea in patients with unexplained dizziness: A real‑world study". Biomedical Reports 23, no. 5 (2025): 173. https://doi.org/10.3892/br.2025.2051
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