Acute Stress Induces Hyperacusis in Women with High Levels of Emotional Exhaustion

Dan Hasson,Töres Theorell,Jonas Bergquist,Barbara Canlon,Berthold Langguth

doi:10.1371/journal.pone.0052945

Dan Hasson, Töres Theorell + Show 3 more

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https://doi.org/10.1371/journal.pone.0052945

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Abstract

BackgroundHearing problems is one of the top ten public health disorders in the general population and there is a well-established relationship between stress and hearing problems. The aim of the present study was to explore if an acute stress will increase auditory sensitivity (hyperacusis) in individuals with high levels of emotional exhaustion (EE).MethodsHyperacusis was assessed using uncomfortable loudness levels (ULL) in 348 individuals (140 men; 208 women; age 23–71 years). Multivariate analyses (ordered logistic regression), were used to calculate odds ratios, including interacting or confounding effects of age, gender, ear wax and hearing loss (PTA). Two-way ANCOVAs were used to assess possible differences in mean ULLs between EE groups pre- and post-acute stress task (a combination of cold pressor, emotional Stroop and Social stress/video recording).ResultsThere were no baseline differences in mean ULLs between the three EE groups (one-way ANOVA). However, after the acute stress exposure there were significant differences in ULL means between the EE-groups in women. Post-hoc analyses showed that the differences in mean ULLs were between those with high vs. low EE (range 5.5–6.5 dB). Similar results were found for frequencies 0.5 and 1 kHz. The results demonstrate that women with high EE-levels display hyperacusis after an acute stress task. The odds of having hyperacusis were 2.5 (2 kHz, right ear; left ns) and 2.2 (4 kHz, right ear; left ns) times higher among those with high EE compared to those with low levels. All these results are adjusted for age, hearing loss and ear wax.ConclusionWomen with high levels of emotional exhaustion become more sensitive to sound after an acute stress task. This novel finding highlights the importance of including emotional exhaustion in the diagnosis and treatment of hearing problems.

Highlights

Hearing problems constitute one of the top ten public health disorders in the general population affecting more than 30% of the population when evaluated with self-reported questionnaires [1,2]
There were no baseline differences in mean uncomfortable loudness levels (ULL) levels between the three emotional exhaustion (EE) groups, except for the left ear 4 kHz where there was a mean difference of 6 dB between the low and high EE-groups (p = 0.035, one-way ANOVA with Bonferroni post-hoc test)
Bonferroni post-hoc analyses showed that the differences in mean ULLs were between those with high vs. low EE

Summary

Introduction

Hearing problems constitute one of the top ten public health disorders in the general population affecting more than 30% of the population when evaluated with self-reported questionnaires [1,2]. While there is increasing evidence for a relationship between stress and hearing problems its causality is not well-established. It was shown that emotional exhaustion is the variable that is the most strongly associated with tinnitus prevalence, more strongly associated than traditional risk factors such as hearing loss, noise-exposure, smoking and hypertension [10]. It is not known whether stress induces the hearing problems or if stress is a consequence of them. The aim of the present study was to explore if an acute stress will increase auditory sensitivity (hyperacusis) in individuals with high levels of emotional exhaustion (EE)

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