Association of Obstructive Sleep Apnea-Hypopnea Syndrome with hearing loss: A systematic review and meta-analysis

Association between obstructive sleep apnea and Tinnitus in the United States: NHANES 2005-2020

BACKGROUND

This study aimed to investigate the association between Obstructive Sleep Apnea (OSA) and Tinnitus using NHANES data from 2005 to 2020.

METHODS

This study analyzed data from NHANES (National Health and Nutrition Examination Surveys) conducted between 2005 and 2020, and included 4871 participants aged 16 or older. OSA was assessed using the Multivariate Apnea Prediction Index and the variables from the National Health and Nutrition Examination Survey. Tinnitus was defined as participants who reported being bothered by a ringing, roaring, or buzzing sound in the ears or head lasting 5 min or more during the past 12 months. Logistic regression models were employed to examine the association between OSA and Tinnitus.

RESULTS

The study cohort had an overall prevalence of Tinnitus of 16.5%, with 53.51% for males and 46.49% for females. After controlling for potential confounders, there was a significant association between Tinnitus and OSA (odds ratio = 1.43, 95% confidence interval = 1.05-1.94, P = 0.03).

CONCLUSION

These findings indicate that OSA is a risk factor for the development of Tinnitus.

Prevalence of Noise-Induced Hearing Loss among Truck Drivers: a Cross-Sectional Study in Lucknow

BACKGROUND

Noise pollution is a significant occupational hazard for heavy-vehicle drivers. This study aimed to determine the prevalence of hearing loss, specifically noise-induced hearing loss, among truck drivers.

METHODS

A total of 200 long-distance truck drivers based in Lucknow City were selected for this study. Pure tone audiometry was used to measure air conduction thresholds in each ear at frequencies ranging from 250 to 8000 Hz. The association of risk factors, such as sleep duration, work experience, age, alcohol drinking, and diabetes, with the prevalence of hearing loss among truck drivers was examined. Participants completed a structured questionnaire addressing hearing health and noise exposure. Data were analyzed using Python software, employing statistical tests such as the chi-square test, rank-sum test, and Wilcoxon signed-rank test.

RESULTS

Based on the World Health Organization guideline, the overall prevalence of hearing loss among 200 drivers was 50.5% in their better ear, with a higher hearing loss rate in the right ear (73.5%) than in the left ear (59.5%). The average hearing thresholds at 500, 1000, 2000, and 4000 Hz of the drivers' right and left ears were 32.61 ± 9.85 and 28.66 ± 8.88 dB, respectively. The audiometric analysis identified key risk factors for hearing loss, including shorter sleep duration (≤6 h), extended work experience (>10 years), older age (>40 years), and alcohol drinking, which were further confirmed as significant predictors through multivariate logistic analysis.

CONCLUSION

Hearing loss is highly prevalent among truck drivers, with the right ear being more affected. The study underscores the need for regular hearing assessments and protective measures to mitigate hearing impairment risks.

Assessing the impact of apnea duration on the relationship between obstructive sleep apnea and hearing loss

OBJECTIVES

The relationship between obstructive sleep apnea (OSA) and hearing loss (HL) remains uncertain. This study aimed to investigate the relationship between OSA and HL, and to identify which factors play a key role.

METHODS

A retrospective review was conducted of 90 subjects diagnosed with OSA. These subjects underwent overnight polysomnography (PSG) and pure-tone audiometry at a single institution from February 2014 to November 2023. Hearing evaluations involved the comparison of OSA subjects with a non-OSA group, identified through national data utilizing the STOP-BANG questionnaire (SBQ) and age-sex 1:1 matching. Subsequently, individuals with OSA were categorized into HL and non-HL groups. Comparisons were made to ascertain differences in PSG parameters, followed by regression analysis to assess their actual impact.

RESULTS

The OSA group exhibited elevated hearing thresholds across all frequencies compared to the non-OSA group. Furthermore, classification of OSA subjects into the HL and non-HL groups revealed a statistically significant increase in apnea duration in the HL group for all-frequency and high-frequency cases (p = 0.038, 0.006). Multiple linear regression analysis, adjusting for age and sex, revealed a significant influence of apnea duration on HL in both all-frequency and high-frequency cases (ß = 0.404, p = 0.002; ß = 0.425, p = 0.001).

CONCLUSION

These findings underscore the significant association between OSA and reduced auditory function, with apnea duration standing out as a crucial factor contributing to hearing loss. Our results suggest that prolonged apnea duration may be a marker of chronic hypoxic damage in patients with OSA, further clarifying its potential role in the development of hearing loss.

Twistable and Stretchable Nasal Patch for Monitoring Sleep-Related Breathing Disorders Based on a Stacking Ensemble Learning Model

Obstructive sleep apnea syndrome disrupts sleep, destroys the homeostasis of biological systems such as metabolism and the immune system, and reduces learning ability and memory. The existing polysomnography used to measure sleep disorders is executed in an unfamiliar environment, which may result in sleep patterns that are different from usual, reducing accuracy. This study reports a machine learning-based personalized twistable patch system that can simply measure obstructive sleep apnea syndrome in daily life. The stretchable patch attaches directly to the nose in an integrated form factor, detecting sleep-disordered breathing by simultaneously sensing microscopic vibrations and airflow in the nasal cavity and paranasal sinuses. The highly sensitive multichannel patch, which can detect airflow at the level of 0.1 m/s, has flexibility via a unique slit pattern and fabric layer. It has linearity with an R2 of 0.992 in the case of the amount of change according to its curvature. The stacking ensemble learning model predicted the degree of sleep-disordered breathing with an accuracy of 92.9%. The approach demonstrates high sleep disorder detection capacity and proactive visual notification. It is expected to help as a diagnostic platform for the early detection of chronic diseases such as cerebrovascular disease and diabetes.

Comparative Efficacy of Different Therapeutic Interventions in Eustachian Tube Dysfunctions: A Cross-Sectional Analysis

Eustachian tube dysfunction (ETD) affects a significant portion of the population, manifesting symptoms that impact the quality of life. Despite the prevalence of ETD, there remains a notable gap in comprehensive studies exploring the condition's dynamics within specific demographic contexts, particularly within Saudi Arabia. This study aimed to assess the prevalence and severity of ETD across different demographic groups, to evaluate the efficacy of various treatment modalities, and to identify key predictors of treatment response in a Saudi Arabian cohort. A cross-sectional study was conducted from June 2022 to May 2023 in tertiary care hospitals in the Aseer region, Saudi Arabia. Participants included adults diagnosed with ETD, assessed through clinical symptoms, otoscopic examinations, audiometric evaluations, tympanometry, and the ETDQ-7 questionnaire. The study incorporated advanced diagnostics such as nasopharyngoscopy and pressure equalization tube function tests and involved 154 participants, revealing significant variations in ETD severity, with the 46-60 age group exhibiting the highest mean ETDQ-7 score of 4.85, and urban residents displaying lower severity scores compared to rural counterparts. Pharmacological interventions were most effective, achieving the highest symptom relief and audiological improvement rates of 87.78%. Multivariate regression highlighted age, geographic location, and treatment modality as key predictors of treatment efficacy, with notable interaction effects between climate conditions and treatment types influencing outcomes. The findings underscore the heterogeneity in ETD presentation and the differential efficacy of treatment modalities.

Association of Sleep Characteristics with Tinnitus and Hearing Loss

Objective

The impact of poor sleep on tinnitus has been mainly attributed to central processes. There is an association between sleep disorders and hearing loss, but whether hearing levels mediate the association between sleep disorders and tinnitus is unknown. This study investigates the association between sleep characteristics, tinnitus, and hearing loss.

Study Design

Cross-sectional.

Setting

National Health and Nutrition Examination Survey (NHANES).

Methods

Study cohort includes 9693 adults (≥20 years) from the NHANES 2005 to 2018 who completed audiometric testing and questionnaires on tinnitus and sleep characteristics. Multivariable regression analyses were performed to quantify associations between sleep characteristics, tinnitus, and hearing loss.

Results

In this cohort, 29% (95% confidence interval [CI]: 28%-31%) reported trouble sleeping and 9% (95% CI: 8%-10%) reported being diagnosed with sleep disorders. Negative sleep characteristics (less hours of sleep, diagnosis of a sleep disorder, trouble sleeping, or OSA symptoms) were not associated with audiometry-measured hearing loss in multivariable models adjusted for demographics and comorbidities but were significantly associated with bothersome tinnitus. This association remained significant without substantial attenuation in multivariable models additionally adjusting for hearing levels: sleeping <8 h/day (vs ≥8) (odds ratio [OR]: 1.28 [95% CI: 1.08-1.52]), trouble sleeping (OR: 1.78 [95% CI: 1.45-2.19]), diagnosis of sleep disorders (OR: 1.57 [95% CI: 1.14-2.15]), and report of OSA symptoms (OR: 1.42 [95% CI: 1.08-1.88]).

Conclusion

Negative sleep characteristics were associated with tinnitus while there was no clinically meaningful association between sleep and hearing loss. Our findings suggest that the relationship between poor sleep and tinnitus is likely contributed by central processes without a major role of mediation via the peripheral auditory system.

Extracellular ATP accelerates cell death and decreases tight junction protein ZO-1 in hypoxic cochlear strial marginal cells in neonatal rats

In the cochlear, extracellular ATP (eATP) plays an important role in both physiological and pathological processes, but its role in the hypoxic cochlear remains unclear. The present study aims to investigate the relationship between eATP and hypoxic marginal cells (MCs) in the stria vascularis in cochlear. Combining various methodologies, we found that eATP accelerates cell death and decreases tight junction protein zonula occludens-1 (ZO-1) in hypoxic MCs. Flow cytometry and western blot analyses revealed an increase in apoptosis levels and suppression of autophagy, indicating that eATP causes additional cell death by increasing the apoptosis of hypoxic MCs. Given that autophagy inhibits apoptosis to protect MCs under hypoxia, apoptosis is probably enchanced by suppressing autophagy. Interleukin-33(IL-33)/suppression of tumorigenicity-2(ST-2)/matrix metalloprotein 9(MMP9) pathway activation was also observed during the process. Further experiments involving the use of additional IL-33 protein and an MMP9 inhibitor indicated that this pathway is responsible for the damage to the ZO-1 protein in hypoxic MCs. Our study revealed the adverse effect of eATP on the survival and ZO-1 protein expression of hypoxic MCs, as well as the underlying mechanism.

Is sleep apnea truly associated with hearing loss? A nationwide, population-based study with STOP-BANG questionnaire

Objectives

We aimed to investigate the effect of obstructive sleep apnea (OSA) on hearing ability.

Methods

We retrospectively reviewed the population-based survey data collected by the Korean National Health and Nutrition Examination Survey between January 1, 2019 and December 31, 2020. The data included 3,575 participants who completed the STOP-BANG questionnaire (SBQ) and pure-tone audiometry. OSA risk was assessed using the SBQ, and the hearing level was compared between the risk groups.

Results

Among the 3,575 participants, 2,152 (60.2%), 891 (24.9%), and 532 (14.9%) were classified as being low, intermediate, and high risk, respectively. The intermediate- and high-risk groups showed significantly worse hearing levels than the low-risk group. When age and sex were adjusted, the hearing level did not differ between the risk groups.

Conclusion

The study found that the presence of OSA minimally affected hearing level. Because hearing loss due to hypoxic damage develops over a long period of time, further research on the association between the duration of OSA, rather than the presence or severity of OSA, and hearing loss is needed.

Association of nocturnal sleep duration and midday napping with subjective poor hearing among middle-aged and older adults in China

Background

Hearing loss has occurred as a critical concern for aging and health. However, it remains unknown whether nocturnal sleep and midday napping duration are associated with hearing loss in middle-aged and older adults.

Methods

The study comprised 9,573 adults from China Health and Retirement Longitudinal Study, who have completed the survey for sleep characteristics and subjective functional hearing. We collected self-reported nocturnal sleep duration (<5, 5 to <6, 6 to <7, 7 to <9, ≥9 h/night) and midday napping duration (≤5, 5 to ≤30, and >30 min). The sleep information was classified into different sleep patterns. The primary outcome was self-reported hearing loss events. Multivariate Cox regression models and restricted cubic splines were used to investigate the longitudinal association of sleep characteristics with hearing loss. We applied Cox generalized additive models and bivariate exposure-response surface diagrams to visualize the effects of different sleep patterns on hearing loss.

Results

We confirmed 1,073 cases of hearing loss (55.1% female) during the follow-up. After adjusting for demographic characteristics, lifestyle factors and health condition, nocturnal sleep with < 5 h was positively associated with hearing loss [hazard ratio (HR): 1.45, 95% confidence interval [CI]: 1.20, 1.75]. Individuals with napping for 5 to ≤30 min had a 20% (HR: 0.80, 95%CI: 0.63, 1.00) lower risk of hearing loss compared with those with napping ≤ 5 min. Restrictive cubic splines showed the reverse J-shaped association between nocturnal sleep and hearing loss. Moreover, we found significant joint effects of sleeping < 7 h/night and midday napping ≤ 5 min (HR: 1.27, 95% CI: 1.06, 1.52) on hearing loss. Bivariate exposure-response surface diagrams also reflected the finding that short sleep without napping existed the highest risk of hearing loss. Compared with persistently sleeping moderately (7-9 h/night), those who persistently slept < 7 h/night or shifted from < 7 h/night to moderate or > 9 h/night had higher risks of hearing loss.

Conclusion

Inadequate nocturnal sleep was associated with an elevated risk of poor subjective hearing in middle-aged and older adults, while moderate napping decreased the risk of hearing loss. Keeping sleep stable within recommendation duration may be a useful strategy for preventing poor hearing loss.