Hearing Difficulties Research Articles

Exploring adult hearing aid user experiences: meaning extraction methods, content patterns, and associations with demographic and outcome variables

Objective Employing automated language analysis, specifically Meaning Extraction Method (MEM) and Principal Component Analysis (PCA), to identify key factors in open-text responses about hearing aid experiences. Design Exploratory, cross-sectional design, using an online questionnaire. Responses to a single open-ended question were analysed using MEM, PCA, regression, and correlation analyses. Study sample Participants (n = 538) included adult hearing aid users sampled from the Hearing Tracker website community and Lexie Hearing user databases in the United States. Results The MEM-derived items revealed six factors related to hearing aid experiences: (1) life change, (2) social situation, (3) quality of life, (4) impact and speech understanding, (5) communication and interaction, and (6) music and environmental sounds. IOI-HA item 3 had the most statistically significant correlations with PCA factors. Quantile regression revealed that factors one and two significantly predicted the IOI-HA total score. Positive correlations were observed between self-reported hearing difficulty and factors one, four, and five, as well as between factor one and general health and factor two and physical activity. Conclusion Natural language analysis of open-ended textual responses can offer valuable insights into hearing aid users’ experiences. Future studies should aim to refine this methodology to enhance clinical relevance and generalisability.

Increased listening effort and cochlear neural degeneration underlie behavioral deficits in speech perception in noise in normal hearing middle-aged adults.

Middle-age is a critical period of rapid changes in brain function that presents an opportunity for early diagnostics and intervention for neurodegenerative conditions later in life. Hearing loss is one such early indicator linked to many comorbidities later in life. However, current clinical tests fail to capture hearing difficulties for ∼10% of middle-aged adults seeking help at hearing clinics. Cochlear neural degeneration (CND) could play a role in these hearing deficits, but our current understanding is limited by the lack of objective diagnostics and uncertainty regarding its perceptual consequences. Here, using a cross-species approach, we measured envelope following responses (EFRs) - neural ensemble responses to sound originating from the peripheral auditory pathway - in young and middle-aged adults with normal audiometric thresholds, and compared these responses to young and middle-aged Mongolian gerbils, where CND was histologically confirmed. We observed near identical changes in EFRs across species that were associated with CND. Perceptual effects measured as behavioral readouts showed deficits in the most challenging listening conditions and were associated with CND. Additionally, pupil-indexed listening effort increased even at moderate task difficulties where behavioral outcomes were matched. Our results reveal perceptual deficits in middle-aged adults driven by CND and increases in listening effort, which may result in increased listening fatigue and conversational disengagement.

The Role of Hearing Difficulty: Cognitive-Communication and Speech-in-Noise Deficits in Adults Following Mild Traumatic Brain Injury

Purpose: Mild traumatic brain injury (TBI) has a high rate of occurrence across the lifespan. Following mild TBI (mTBI), perceived deficits in cognitive communication and hearing may be noted. This study aimed to determine if adults with a history of mTBI and hearing difficulty perceived greater degrees of cognitive-communication difficulty and performed poorer on a speech-in-noise task when compared to participants with mTBI and controls without reported hearing difficulty. Method: Adults aged 19–77 years with and without a history of mTBI were analyzed. Participants were divided into three groups: control ( n = 49), mTBI ( n = 22), and mTBI with hearing difficulty (mTBI-HD, n = 26). Perception of hearing difficulty was based on a score of ≥ 20 on the Hearing Handicap Inventory or a score ≥ 2 on the Adult Auditory Performance Scale. Self-perceived cognitive communication was measured using the Cognitive Difficulties Scale (CDS) and the La Trobe Communication Questionnaire (LCQ). Speech-in-noise performance was measured using the low-cue speech recognition threshold (SRT) from the Listening in Spatialized Noise–Sentences (LiSN-S) test. Results: Adults in the mTBI-HD group reported significantly greater degrees of cognitive-communication difficulties (higher CDS and LCQ scores) and exhibited significantly poorer speech-in-noise performance on the low-cue LiSN-S condition when compared to the control and mTBI groups. Results also revealed significant correlations between the LiSN-S low-cue SRT and perceived cognitive communication on the CDS. Conclusions: Results of the current study indicate that adults with a history of mTBI and hearing difficulty experience greater subjective cognitive-communication difficulties and perform more poorly on difficult speech-in-noise tasks than adults who do not experience self-perceived hearing difficulties. The results of this study support the consideration of hearing and cognitive-communication difficulties when determining appropriate speech, language, and hearing assessment, treatment, and intervention strategies for individuals following mTBI.

A descriptive epidemiological study of the prevalence of self-reported sensory difficulties by age group, sex, education, disability, and migration status in Sweden in 2020

BackgroundThe objective of this study is to estimate the prevalence of self-reported hearing difficulties, vision difficulties and combined vision and hearing difficulties in a Swedish adult population that varies according to migration status, sex, age, disability measured by ADL and IADL and educational attainment level.MethodsThe study utilised data from the Survey of Health, Ageing and Retirement in Europe, which consisted of 2257 individuals aged 60 and above that were interviewed in Sweden in the 2019/2020, SHARE wave 8. To determine the prevalence of sensory difficulties (hearing, vision and dual-sensory difficulties) among various subgroups of the population, a multinomial logistic regression was used. The results of these analyses are presented in terms of predicted probabilities.ResultsThe study findings indicate that foreign-born older adults experience a lower prevalence of visual difficulties (6.2% [3.3–11.5] in comparison to their Swedish-born counterparts. Moreover, older adults with higher levels of education tend to report a lower prevalence of sensory difficulties overall. Furthermore, sex differences are apparent, with males reporting a higher prevalence of hearing difficulties (18.9% [15.5–22.8] vs. 12.8% [10.7–15.3]) and females reporting a higher prevalence of vision difficulties (12.7% [10.7–15.1] vs. 8.5%[6.8–10.5]).ConclusionThe findings highlight disparities in the prevalence and type of perceived sensory difficulties experienced by older adults, by factors such as age, sex, education and migration status. It is important to consider these demographic factors in healthcare planning and interventions aimed at mitigating sensory difficulties in the older population.

Hidden hearing loss in a Charcot-Marie-Tooth type 1A mouse model.

Hidden hearing loss (HHL), a recently described auditory neuropathy characterized by normal audiometric thresholds but reduced sound-evoked cochlear compound action potentials, has been proposed to contribute to hearing difficulty in noisy environments in people with normal hearing thresholds and has become a widespread complaint. While most studies on HHL pathogenesis have focused on inner hair cell (IHC) synaptopathy, we recently showed that transient auditory nerve (AN) demyelination also causes HHL in mice. To test the effect of myelinopathy on hearing in a clinically relevant model, we studied a mouse model of Charcot-Marie-Tooth type 1A (CMT1A), the most prevalent hereditary peripheral neuropathy in humans. CMT1A mice exhibited the functional hallmarks of HHL together with disorganization of AN heminodes near the IHCs with minor loss of AN fibers. These results support the hypothesis that mild disruptions of AN myelination can cause HHL and that heminodal defects contribute to the alterations in the sound-evoked cochlear compound action potentials seen in this mouse model. Furthermore, these findings suggest that patients with CMT1A or other mild peripheral neuropathies are likely to suffer from HHL. Furthermore, these results suggest that studies of hearing in patients with CMT1A might help develop robust clinical tests for HHL, which are currently lacking.

Age-Related Listening Performance Changes Across Adulthood.

This study compares auditory processing performance across different decades of adulthood, including young adults and middle-aged individuals with normal hearing and no spontaneous auditory complaints. We assessed 80 participants with normal hearing, at least 10 years of education, and normal global cognition. The participants completed various auditory tests, including speech-in-noise, dichotic digits, duration, pitch pattern sequence, gap in noise, and masking level difference. In addition, we conducted working memory assessments and administered a questionnaire on self-perceived hearing difficulties. Our findings revealed significant differences in auditory test performance across different age groups, except for the masking level difference. The youngest group outperformed all other age groups in the speech-in-noise test, while differences in dichotic listening and temporal resolution emerged from the age of 40 and in temporal ordering from the age of 50. Moreover, higher education levels and better working memory test scores were associated with better auditory performance as individuals aged. However, the influence of these factors varied across different auditory tests. It is interesting that we observed increased self-reported hearing difficulties with age, even in participants without spontaneous auditory complaints. Our study highlights significant variations in auditory test performance, with noticeable changes occurring from age 30 and becoming more pronounced from age 40 onward. As individuals grow older, they tend to perceive more hearing difficulties. Furthermore, the impact of age on auditory processing performance is influenced by factors such as education and working memory.

Prevalence and Associated Factors of Depressive Symptoms among Older Adults in the Philippines.

Depressive symptoms may increase with age, potentially influenced by sociodemographic characteristics, stressors and support, health status, and health behaviour. It is unclear if this is the case among older adults in the Philippines. Therefore, the aim of this study is to estimate the prevalence and associated factors of depressive symptoms among older adults in the Philippines. In all, 5209 items of cross-sectional nationally representative data from older adults (≥60 years) participating in the 2018 Longitudinal Study on Ageing and Health in the Philippines (LSAHP) were analysed. Depressive symptoms were assessed using the 11-item 3-response category Center for Epidemiological Studies Depression (CES-D) Scale. The overall prevalence of depressive symptoms was 32.1%, with 25.6% among older men and 36.5% among older women. In the final adjusted models, overall, widowed (Adjusted Odds Ratio (AOR): 1.52, 95% Confidence Interval (CI): 1.00 to 2.30), hunger (AOR: 2.22, 95% CI: 1.40 to 3.51), living alone (AOR: 1.61, 95% CI: 1.00 to 2.59), not satisfied with present life (AOR: 2.04, 95% CI: 1.09 to 3.81), body pain (AOR: 2.39, 95% CI: 1.73 to 3.31), and insomnia (AOR: 1.69, 95% CI: 1.24 to 2.31) were positively associated, while working (AOR: 0.55, 95% CI: 0.37 to 0.80) was negatively associated with depressive symptoms. In addition, among men, older age (80 years and above) (AOR: 1.95, 95% CI: 1.06 to 3.58), unmet healthcare needs (AOR: 2.19, 95% CI: 1.07 to 4.47), and hearing difficulty (AOR: 2.41, 95% CI: 1.06 to 5.52) were positively associated poor childhood health (AOR: 0.12, 95% CI: 0.04 to 0.36), while social network (AOR: 0.94, 95% CI: 0.90 to 0.99) was negatively associated. Among women, loss of bladder control (AOR: 1.69, 95% CI: 1.03 to 2.77) was positively associated with depressive symptoms. One in three older adults participating in this study exhibited depressive symptoms. Sociodemographic factors, stressors, and health status factors were positively associated, and support factors were negatively associated with depressive symptoms.

Assessment of annoyance from traffic noise in a school and a hospital

Traffic noise can cause significant annoyance. We administered noise annoyance surveys in two Florida facilities located near a highway and a busy road while traffic noise levels were being measured. In Trilogy school, thirty middle & high school students rated the annoyance caused by traffic noise inside the school to be an average of 1.9 (SD 2.0) on a scale from 0 to 10. Traffic noise was just as disturbing as other sounds inside the school. However, the fraction of students reporting any level of traffic noise disturbance was significantly higher outdoors (80%) than indoors (48%). Additionally, traffic noise caused some difficulty hearing the teacher for 9.7% of students. In Shands Hospital, the average ratings of annoyance from traffic noise given by 107 staff (M=1.1, SD=2.0) and 104 patients (M=1.2, SD=1.4) were not higher in areas of the hospital that were closer to the road or the helicopter landing pad compared to the other areas of the hospital. Traffic noise was substantially less disturbing than other noise inside the hospital, e.g., tube station. However, traffic noise caused moderate to extreme annoyance for 12.4% of patients and some degree of sleep disruption for 27.9% of patients.

Hearing and vision rehabilitation for people with dementia in five European countries (SENSE-Cog): a randomised controlled trial

The effect of hearing and vision difficulties on the risk of developing dementia and worsening outcomes in people already living with dementia is well established. We evaluated the clinical impact of a hearing and vision rehabilitation and support programme on quality of life in people with mild-to-moderate dementia and concurrent sensory difficulties. We conducted a parallel-group, multicentre, observer-blind, superiority randomised controlled trial in seven older adult clinics in five European countries (Cyprus, France, Greece, Ireland, and the UK). People with mild-to-moderate dementia with adult-acquired hearing difficulties, vision difficulties, or both were randomly assigned (1:1) along with their care partner to an 18-week home-basedsensory support intervention (SSI) of tailored hearing and vision rehabilitation and support, or to care as usual. Randomisation was blocked (block size of four, six, or eight) and stratified by country, with allocation assigned via a remote web-based system. The SSI included: full hearing assessment, vision assessment, or both; fitting of hearing aids, glasses, or other sensory aids; and home-based support from a sensory support therapist to assist adherence and uptake of sensory aids, foster social networking, and optimise the home sensory environment. Care as usual involved no additional intervention beyond services normally available to people with dementia at the respective sites. The primary outcome was health-related quality of life (Dementia Quality of Life Instrument [DEMQoL]) score at 36weeks, reported as an adjusted mean difference. Analyses were done according to the intention-to-treat principle. This trial is registered with the ISRCTN Registry, ISRCTN17056211. Between May 4, 2018, and May 6, 2021, 252people with mild-to-moderate dementia were randomly assigned, of whom 251 (n=126in the SSI group and n=125in the care as usual group) were included in the analysis. The mean age of participants was 79·6years (SD 5·8), and 132 (53%) were women. After a median follow-up time of 37·7weeks (IQR 36·2-39·0), the mean DEMQoL score was 92·8 (SD 15·2) in the SSI group and 92·8 (14·0) in the care as usual group (adjusted difference 0·18, 95% CI -2·13to 2·30, p=0·87). Among 114adverse events reported for 56 (44%) participants in the SSI group, ten events in nine participants were related or possibly related to the intervention (medical device pain or discomfort n=6, ear pain n=1, scratch to the ear n=1, sore eye n=1, redness n=1; all of grade 1). Serious adverse events were reported for 25 (20%) participants in the SSI group and 16 (13%) in the care as usual group. Six (5%) participants in the SSI group and five (4%) in the care as usual group died. None of the serious adverse events or deaths were related to the study intervention or procedures. This study showed no improvement in quality in life in participants who received the intervention in thelonger term. Sensory difficulties are common in people with dementia and interventions aimed at improving sensory-cognitive health should be explored further. EU Horizon2020.

Risk factors for antenatal anxiety: a cross-sectional study in field antenatal clinics in Sri Lanka

ObjectivesWe aimed to determine the prevalence and factors affecting antenatal anxiety (AA) among Sri Lankan women.DesignWe conducted a cross-sectional analysis of first trimester data from a population-based cohort of antenatal...

Understanding People with Disabilities in a Local Government Arena: A Limpopo Dilemma

ABSTRACT People with disabilities face discrimination or exclusion from social services such as health care, education and employment opportunities, despite the existence of anti-discrimination statutory frameworks asserting their rights. The difficulties that persons with disabilities confront as a result of a lack of understanding of disability have not received enough attention. Therefore, the purpose of this paper is to assess the influence of understanding of disability on the livelihoods of people with disabilities. The paper used a mixed research methodology (qualitative and quantitative). The quantitative data was analysed using the Statistical Package for Social Sciences (SPSS), while the qualitative research data was analysed using NVivo. The findings of the study revealed that a disproportionately high percentage of participants (70%) perceive disability as difficulty in walking, 60% as difficulty in hearing, and 59% as virtual impairments. This study came to the conclusion that misconceptions can result in exclusion and discrimination, which can have a long-term effect on the lives of people with disabilities. This research makes contribution to theory, policy and practice by demonstrating the significant role that disability knowledge and understanding plays in the lives of persons with disabilities, and how this can lead to improved quality of life and wellbeing.

Cochlear Synaptopathy Evaluation With Electrocochleography in Patients With Hearing Difficulty in Noise Despite Normal Hearing Levels.

This study examined patients with normal hearing thresholds who had trouble understanding speech in noise. We used electrocochleography (ECochG) to detect and compare SP/AP amplitude area ratios, a potential indicator of cochlear synaptopathy, and investigate speech perception disorder in noise. The study included 68 people aged between 18 and 65 years, 35 patients and 33 healthy volunteers, who applied to the otorhinolaryngology clinic between November 2023 and March 2024 with a 2-month history of difficulty understanding speech in noisy environments. Everyone was given a tiptrode electrode ECochG test, and the results were compared between groups. An ECochG test was recorded with tiptrode electrodes and was performed on all participants, and the results were compared between groups. In the ECochG test, the summation potential/action potential (SP/AP) amplitude and area ratios of patients who had difficulty understanding speech in a noisy environment were statistically higher than those of the control group. ECochG testing may provide additional evidence to evaluate auditory nerve pathways.

Audiological Characteristics of a Sample of Adults With Misophonia.

The aim of this study was to describe the audiological test results from a sample of 60 adults with self-reported misophonia. Audiological testing was completed prior to participant randomization in a controlled trial for misophonia treatment. Participants completed the Inventory of Hyperacusis Symptoms Survey (IHS), the Tinnitus and Hearing Survey (THS), the Misophonia Questionnaire (MQ), and behavioral and objective audiometric measures. Hearing thresholds were less than 25 dBHL for 97% of the participants. Loudness discomfort levels for tonal stimuli suggested hyperacusis in 25% of the sample. Total scores on the IHS indicated that 12% met the clinical cutoff for hyperacusis, and, on the THS, 27% experienced problems with tinnitus, 77% experienced problems with hearing, and 53% experienced problems with sound tolerance. On the MQ, 37% indicated mild levels of misophonia and 58% indicated moderate levels. For speech-in-noise testing, a mild signal-to-noise ratio loss was present for 15% of participants. Most of the participants had present distortion product otoacoustic emissions (DPOAEs). Audiological data on individuals with misophonia are lacking. In this article, we present results from audiological testing on 60 adults with self-reported misophonia. Most had normal peripheral hearing sensitivity based on pure-tone audiometry and DPOAE measures; some had difficulties with sound sensitivities and understanding speech-in-noise, self-report indicated problems with hyperacusis, tinnitus, and hearing difficulty.

Psychosocial Issues Related to Speech and Hearing in Patients With Clefts.

Individuals with cleft lip and palate often face persistent challenges related to speech and hearing disorders, impacting various aspects of their lives. These challenges can lead to additional mental health issues such as attention-deficit/hyperactivity disorder, anxiety, and depression, as well as heightened psychosocial challenges, including appearance-related issues, bullying, workplace discrimination, and impaired social interactions. Children and adolescents with these disorders commonly experience loneliness, peer rejection, and challenges in forming friendships, particularly during adolescence, while voice disorders can diminish the quality of life in older individuals. This case study focuses on a 17-year-old male with unilateral cleft lip and palate undergoing treatment in Medellin, Colombia, aiming to provide insights into the intricate psychosocial challenges linked to speech and hearing difficulties in individuals with cleft conditions. Clinical evaluations identified significant challenges concerning speech difficulties and self-perception, influenced by the patient's cleft condition, which impacts his self-esteem, confidence, and social skills development. The interconnectedness between speech and hearing challenges underscores the necessity for comprehensive care to address the multifaceted psychosocial aspects experienced by individuals with cleft conditions. This case study used as an example, indicates that speech difficulties and psychosocial challenges related to cleft conditions are experienced from childhood and may persist into adulthood. These challenges can have profound effects on various aspects of life, including school, social interactions, family dynamics, and even romantic relationships. Consequently, the lack of confidence, social isolation, and limited social skills may delay patients from reaching their fullest potential.

Changes in participatory and societal outcomes during the waiting period for cochlear implantation - an observational study.

Various factors, including an aging population and expanding eligibility criteria, may increase the demand for cochlear implants (CIs), potentially resulting in longer waiting times. In most Dutch CI centers, the time between referral and surgery exceeds 6 months. Clinical experience suggests that during the waiting period for cochlear implantation, hearing and communication difficulties increase. Simultaneously, there is an interest in outcomes more closely aligned with patient values and needs, which resulted in the SMILE (Societal Merit of Interventions on hearing Loss Evaluation) study. This paper presents results on observed changes in societal and participatory outcomes during waiting time in participants with a time to CI surgery exceeding 6 months. SMILE is a prospective multi-center study including 232 individuals who were referred for unilateral CI. Continuous and nominal data from multiple questionnaires, sent immediately after referral and shortly before surgery, were analyzed by computing differences, Cohen's D, and odds ratios. Of the total 232 participants, 102 had a time between inclusion and surgery exceeding 6 months. Of these, 89 had (partially) filled out surveys at both time points. Of all the domain scores 55% did not show differences between timepoints. All Cohen's D estimates were relatively small, ranging from - 0.298 to 0.388 for those outcomes that showed noteworthy changes. Waiting time from referral to surgery, even though exceeding 6 months, was observed to not seriously affect non-clinically-prioritized patients in an adverse way. Future investigations should identify subgroups on tolerable waiting times regarding short- and long-term outcomes. Trial registration number at ClinicalTrials.gov: NCT05525221, 25-8-2022.

Perceptions of Health Care Provider Interactions Among Medicare Beneficiaries With Hearing Trouble and the Role of an Accompanying Companion.

Hearing trouble (HT) impairs communication with health care providers (HCPs) and may lead to negative care experiences that impact health outcomes. The current study aimed to examine how HT influences patient perceptions of provider interactions and whether having an accompanying companion during health care visits modifies perceptions of provider interactions. This cross-sectional study analyzed 9,104 responses from the 2016 Medicare Current Beneficiary Survey. Compared to beneficiaries without HT, those with HT had greater odds of negative perceptions of HCP interactions. Beneficiaries with HT had greater odds of disagreeing with positive statements about care, including provider competence, provider cares to check everything, provider response, and provider rarely in a hurry. Having an accompanying companion during health care visits was not found to significantly modify perceptions of interactions. Findings suggest HT is a modifiable factor impacting health care communication. Implementing simple accommodation strategies in clinical practice can improve nursing care for older adults with HT. [Journal of Gerontological Nursing, xx(xx), xx-xx.].

Analysis of the Spanish Auditory Test of Speech in Noise (PAHRE) in a Population with Hearing Loss.

Speech recognition in noise is one of the difficulties faced by people with hearing loss that increases with age. The recently developed Spanish Auditory Test of Speech in Noise (Prueba Auditiva de Habla en Ruido en Español, PAHRE) allows for the identification of these intelligibility difficulties in noise. The aim of this study was to assess speech recognition in noise in people with hearing loss and to test the benefits of the Lombard effect. The participants were 104 people with hearing difficulties, ranging in age from 37 to 98 years. The variables age, degree of hearing loss, presence of high-frequency dropout, and years of formal education were assessed. Psychometric curves were obtained as a function of signal-to-noise ratio as well as threshold values of speech reception as a function of age group for mild and moderate hearing loss. The results indicated that the speech reception threshold increased with both age and the degree of hearing loss, becoming particularly significant after the age of 70. Furthermore, it was found that the combined factors of age, degree of hearing loss, and educational level predicted a high percentage of the variability in the speech reception threshold. Therefore, the Spanish Auditory Test of Speech in Noise could be a useful clinical tool for diagnosis, monitoring, auditory rehabilitation planning, and hearing aid fitting.

Reflective Story on Diversity and Inclusive Education

This reflective article explores the current scenario of diversity and inclusion through the narration of a deaf ethnic child. Self-reflection is taken as an instrument for behavioural modification since the author is aware of its significance in education. This study aims to explore the experiences and implementation of inclusive education through the author's personal teaching experiences. The article employs a reflective narration of the author working as a novice teacher in a school exercising to incorporate deaf children into mainstream courses. The emphasis is on Krishna, a Dalit youngster with hearing difficulties, who had challenges in adaptation owing to cultural, social and educational obstacles. The results showed the obstacles encountered by such children who had to face social isolation, communication obstacles and insufficient educator training. The author's intervention in Krishna's metamorphosis underscores the necessity of helpful learning environments. The article links Krishna's experiences to wider socio-economic and cultural challenges, indicating that inclusive education is necessary for structural reforms in teacher training, cultural sensitivity and familial support. The results underscore the necessity of embracing diversity and enacting effective inclusive education policies to cultivate equal learning environments for all children.

An Adult with Congenital Aural Atresia, Amplification, and Exaggerated Hearing Difficulty with Use of Hearing Protection

An Adult with Congenital Aural Atresia, Amplification, and Exaggerated Hearing Difficulty with Use of Hearing Protection

Disparities in Spatial Access to Sleep Health Care in the United States: A Population-Based Geospatial Analysis

ObjectivesTo examine spatial access to sleep health care in the United States and investigate associations with demographic and socioeconomic characteristics, thereby identifying high-risk communities with limited spatial access to sleep health service. DesignA cross-sectional population-based geospatial analysis. Settings and ParticipantsResidents in US Census tracts across the 48 contiguous states, Alaska, and Hawaii. MethodsThe 2020 American Community Survey 5-year estimates, 2010 rural-urban commuting area codes, 2020 Area Deprivation Index, and sleep care provider locations from the National Provider Identifier file were used to assess the spatial access and related demographic/socioeconomic characteristics. Spatial access was measured by spatial access ratio using enhanced 2-step floating catchment area methods. The associations were investigated using logistic regression analysis and multivariate linear regression analysis. ResultsA total of 45.8 million residents experienced low spatial access to sleep health care. Spatial access decreased in rural and high Area Deprivation Index areas, and in areas characterized by higher population with uninsured status, vehicle unavailability, internet unavailability, cognitive difficulties, and hearing difficulties. With a 10% increase in the percentage of the racial minority (non-white) population, metropolitan census tracts experienced an increase in spatial access (3.268%), whereas micropolitan (−1.526%) and rural (−4.493%) areas experienced a decrease in spatial access. Similar findings were observed within the ethnic minority (Hispanic or Latino) population. Conclusions and ImplicationsDisparities exist in spatial access to sleep health care across the United States, especially for disadvantaged individuals. Racial/ethnic minorities exhibit contrasting spatial access patterns in urban and rural areas, with those in rural areas facing more challenges in spatial access to sleep health care.