ORIGINAL RESEARCH article
Front. Neurol.
Sec. Sleep Disorders
May Vestibular Rehabilitation Reduce Apnea-Hypopnea Index in Patients with Obstructive Sleep Apnea? A pilot study
Provisionally accepted
Annalisa Pace1
GIANNICOLA IANNELLA1
Saverio Nicoletti1*
Paola Di Mauro2
Francesca Mattioli1
Salvatore Cocuzza2
Antonino Maniaci2
Danilo Alunni Fegatelli1
Annarita Vestri1
Giuseppe Magliulo1- 1Universita degli Studi di Roma La Sapienza, Rome, Italy
- 2Universita degli Studi di Catania, Catania, Italy
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The vestibular system is essential for maintaining the perception of head orientation and acceleration in all directions. The Functional Head Impulse Test (fHIT) is a novel tool for assessing the vestibulo-ocular reflex (VOR) and forms the basis for a recently developed vestibular rehabilitation system. This pilot study aimed to determine whether vestibular rehabilitation alone could objectively improve clinical parameters in patients with obstructive sleep apnea (OSA). Twenty male patients diagnosed with OSA underwent baseline polysomnography (PSG) and fHIT assessment. Participants then completed a 10-day vestibular rehabilitation program using the reHAB system, after which PSG and fHIT were repeated. Initial fHIT analysis indicated impaired vestibular function in 30% of patients. The Wilcoxon signed-rank test demonstrated a statistically significant reduction in the apnea-hypopnea index (AHI) following rehabilitation (p = 0.003), while the change in oxygen desaturation index (ODI) did not reach statistical significance (p = 0.082). Scatter plot analysis revealed a moderate positive correlation between changes in AHI and ODI pre-and post-rehabilitation. These preliminary findings suggest a functional connection between vestibular inputs and sleep–wake pathways, possibly mediated by parabrachial circuits and orexinergic modulation.
Keywords: vestibular system, obstructive sleep apnea, Vestibular Rehabilitation, apnea-hypopnea index, functional Head Impulse Test, Polysomnography
Received: 12 Jul 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Pace, IANNELLA, Nicoletti, Di Mauro, Mattioli, Cocuzza, Maniaci, Alunni Fegatelli, Vestri and Magliulo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Saverio Nicoletti, saverio.nicoletti@uniroma1.it
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