Obstructive Sleep Apnea as a Hidden Cause of Dizziness: A Report of Two Non-obese Patients

Dizziness is a common complaint in emergency medicine. Algorithms such as the standing assessment (STANDING) and head impulse, nystagmus, and distortion tests (Head Impulse, Nystagmus, and Test of Skew (HINTS)) are used as "diagnostic aids" and "initial assessment tools". However, obstructive sleep apnea (OSA) is often excluded from these paradigms, despite evidence showing an association between OSA and dizziness. We report two patients with unexplained dizziness in whom conventional evaluations were non-diagnostic. Both exhibited sleep-related symptoms, and simplified polysomnography revealed moderate OSA. Mandibular advancement devices led to symptom resolution. OSA may underlie dizziness when standard assessments are inconclusive. Screening for sleep-related symptoms is essential. We suggest targeted OSA screening in patients with unexplained dizziness and relevant risk factors.