The Impact of Obstructive Sleep Apnea on Balance, Gait, and Falls Risk: A Narrative Review of the Literature

David Stevens, Brianna Jackson, Jayne Carberry, James McLoughlin, Chris Barr, Sutapa Mukherjee, Aaron Oh, R. Doug McEvoy, Maria Crotty, Andrew Vakulin

Research output: Contribution to journalReview articlepeer-review

22 Citations (Scopus)


Falls-related hospitalization and injury rates are steadily increasing globally due to a growth in the aging population, and the associated health problems that increase risk of falls. One such associated health problem is sleep disturbances and disorders. Recent cohort studies have shown that subjectively reported poor quality sleep is associated with an increased risk of falls. Obstructive sleep apnea (OSA) is a common sleep disorder characterized by the repetitive reductions, or cessation, of airflow. Some studies have shown that OSA impairs posture/balance and gait with nocturnal hypoxemia the likely main cause. Emerging evidence suggests that treating OSA by continuous positive airway pressure (CPAP) can improve gait, but no studies to date have examined the effect of CPAP on posture/balance. The overall control of balance relies on a complex interaction between several physiological functions including vestibular, muscle, visual, and cognitive functions. We postulate that OSA impacts balance by affecting these different systems to various degrees, with the nocturnal hypoxic burden likely playing an important role. Importantly, these impairments in balance/posture and possible falls risk may be alleviated by OSA treatment. Larger mechanistic studies are needed to properly elucidate how OSA affects falls risk and future large-scale randomized control trials are needed to determine the effectiveness of OSA treatment in reducing the risk of falls
Original languageEnglish
Article numberglaa014
Pages (from-to)2450-2460
Number of pages11
JournalJournals of Gerontology. Series A: Biological Sciences and Medical Sciences
Issue number12
Early online date10 Feb 2020
Publication statusPublished - Dec 2020


  • Vestibular organ
  • Posturography
  • Hypoxemia
  • sleep disordered breathing
  • Sleep disorders
  • Sleep disordered breathing


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