Obstructive Sleep Apnea Common Among Patients With Idiopathic Intracranial Hypertension: Study
Researchers have found a significant association between idiopathic intracranial hypertension (IIH) and obstructive sleep apnea (OSA) in a new systematic review and meta-analysis of 11 studies. Approximately 44% of patients with IIH also had OSA, although substantial variation existed among the studies. Because both conditions share obesity as an important risk factor and benefit from timely diagnosis, the researchers recommend considering sleep studies for patients with IIH to facilitate early detection and treatment of OSA. The study was published in the Canadian Journal of Ophthalmology by Abu Bakar B. and colleagues.
To appropriately estimate the pooled prevalence rate of respiratory obstruction in the targeted neurological population, a prospectively registered systematic review and meta-analysis were carried out under the PROSPERO tracking number of CRD420251132794. The research group searched for exhaustive electronic literature from major databases such as MEDLINE, Embase, and CENTRAL, where all required data from database inception to August 23, 2025, was collected, and finally analyzed in 2026.
The study considered clinical trials and cohorts, which showed objective PSG-confirmed sleep apnea or subjective high-risk status through the Berlin Questionnaire in adult IIH patients. The methodological risk of bias in the selected studies was assessed through ROBINS-I and RoB-2 tools, whereas the overall certainty of evidence was determined by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Random-effect proportion meta-analyses were done to obtain pooled prevalence estimates.
Key findings:
- The comprehensive systematic review identified and extracted data from precisely 11 clinical studies conforming to all rigorous inclusion criteria.
- In a total number of 9 different polysomnography-based studies, the meta-analysis recorded and analyzed data from a total sample of 299 adult patients.
- Based on the random-effects model, the objective prevalence of sleep apnea in IIH patients came to precisely 0.44 (95% CI: 0.26 to 0.63), exhibiting extremely high heterogeneity (I2 = 90.5%).
- The leave-one-out sensitivity models proved the robustness of the main dataset, ensuring narrow range of pooled prevalence variations from 39% to 50%.
- Total exclusion of high-risk datasets resulted in a subgroup of 4 reliable studies (n = 132), producing a more significant pooled prevalence of 0.53 (95% CI: 0.32 to 0.74).
- The subgroup of 4 studies applying Berlin Questionnaire (n = 154) produced the highest pooled prevalence of 0.65 (95% CI: 0.54 to 0.74), recording absolutely zero heterogeneity (I2 = 0%).
- The assessment of standardized funnel plot showed obvious structural asymmetry indicating the presence of publication bias, as well as very low certainty of evidence according to GRADE.
In conclusion, OSA is common among patients with IIH, supporting routine objective sleep evaluation. Prospective studies are needed to clarify this association. These meta-analytical statistics provide an indispensable empirical foundation for modern clinical neurology, proving that treating vision-threatening brain conditions requires a comprehensive approach that includes tracking nighttime breathing health.
Reference:
Butt, A. B., Ahmad, A., Pandya, B., Tien, C.-W., Tao, B. K., Rastogi, A., & Sharma, R. A. (2026). Obstructive sleep apnea and idiopathic intracranial hypertension: a systematic review and meta-analysis. Canadian Journal of Ophthalmology. https://doi.org/10.1016/j.jcjo.2026.04.011
