{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T14:45:03Z","timestamp":1763045103009,"version":"3.45.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["ebm-journal.org"],"crossmark-restriction":true},"short-container-title":["Exp. Biol. Med."],"abstract":"<jats:p>\n                    Obstructive sleep apnea (OSA) is manifested as periodic collapse of the upper airway during sleep. Otitis media is a spectrum of infectious and inflammatory diseases involving the middle ear. In this study, we sought to determine the causal effect of OSA on otitis media using a bidirectional, two-sample Mendelian randomization (MR) analysis. We analyzed the data from two different, extensive genome-wide association studies (GWAS) and selected OSA-related single-nucleotide polymorphisms (SNPs) as instrumental variables (IVs). Bidirectional MR analysis was conducted using the inverse-variance weighted (IVW) method. To ensure the robustness of the results, alternative sensitivity analysis procedures were performed, including MR-Egger, the MR pleiotropy residual sum and outlier (MR-PRESSO), and leave-one-out analysis. In the forward MR analysis, OSA was correlated with an increased risk of acute suppurative otitis media (odds ratio, 1.164; 95% confidence interval, 1.056\u20131.283;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.002) and suppurative and unspecified otitis media (odds ratio, 1.150; 95% confidence interval, 1.059\u20131.249;\n                    <jats:italic>P &amp;lt;<\/jats:italic>\n                    0.001). All reverse MR analyses showed that otitis media had no causal effect on OSA (\n                    <jats:italic>P<\/jats:italic>\n                    &amp;gt; 0.05). The MR analysis supports that OSA contributes to the development of otitis media. Thus, managing OSA may be beneficial in treating otitis media.\n                  <\/jats:p>","DOI":"10.3389\/ebm.2025.10540","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T14:40:50Z","timestamp":1763044850000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The causal relationship between obstructive sleep apnea and otitis media: a bidirectional Mendelian randomization 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