The association between snoring and hearing loss in patients with obstructive sleep apnoea.

Abstract

<b>Introduction:</b> Snoring occurs in 70-95% of patients with OSA; reaching 80dB, it approaches the level in which permanent hearing loss can occur. <b>Aim:</b> To explore whether daily exposure to snoring acoustics in patients with OSA contributes to hearing loss. <b>Methods:</b> Patients underwent overnight diagnostic polysomnography. Patients were excluded if there was a risk of pre-existing hearing loss. Calibrated and standardised sound-pressure meters recorded quantitative sound data. Participants then underwent full audiometric assessment. <b>Results:</b> 20 patients completed investigations. 60% male, age 32-82yr. 18/20 had hearing loss, 16 patients (80%) had a sensorineural hearing loss pattern deemed secondary to snore noise by audiometric assessment. This was statistically significant compared to the known incidence of age-related hearing loss in Australia (33%) using alpha 0.05, power 0.9. Maximum snore sound was 58.4-93.3dB (mean 73.5dB). Mean total snores during sleep time was 1667.1. Apnoea hypopnea index (AHI) range was 2.9-130.8, mean oxygen saturation nadir 76.6%. <b>Conclusions:</b> This study suggests a correlation between snoring in patients with OSA and hearing loss due to prolonged noise exposure. Snore volume exceeded levels known to cause noise related hearing loss.&nbsp;Findings were statistically significant compared to the incidence of age-related hearing loss. The age range indicates findings are not age-related. More severe hearing loss was associated with higher AHI. The reduced oxygen saturation nadir suggests a possible additional hypoxic mechanism of injury. Additional studies are required to investigate further. This study proposes early intervention for patients with snoring in OSA is important.