Background Sleep characteristics might be associated with hearing loss through disturbed energy metabolism and disrupted cochlear blood flow, but prior evidence is limited. This study aims to investigate cross-sectional associations of sleep duration and signs/symptoms of sleep-disordered breathing with hearing in a nationally representative cohort of U.S. older adults aged 70 and over. Methods We studied 632 older adults aged 70+ years from the 2005-2006 cycle of National Health and Nutrition Examination Survey (NHANES). Hearing thresholds were measured using pure-tone audiometry and were averaged to create speech-frequency (0.5-4 kHz), low-frequency (0.5-2 kHz) and high-frequency (4-8 kHz) pure-tone averages (PTAs) in better-hearing ear, with higher values indicate worse hearing. Sleep duration and signs/symptoms of sleep-disordered breathing (snoring, snorting/stopping breathing, excessive sleepiness) were collected through questionnaire. Multivariable-adjusted spline models with knots at 6 and 8 hours were fitted for associations between sleep duration and PTAs. Multivariable-adjusted linear regression was used for associations between sleep-disordered breathing and PTAs. Primary models adjusted for demographic and lifestyle factors, secondary models additionally adjusted for cardiovascular factors. Results When sleep duration exceeded 8 hours, every additional hour of sleep duration was marginally associated with higher(poorer) high-frequency PTA (Primary:2.45 dB HL, 95% CI:-0.34, 5.24; Secondary:2.89 dB HL, 95% CI:0.02, 5.76). No associations were observed between sleep-disordered breathing and hearing. Conclusions Longer sleep duration is marginally associated with poorer high-frequency hearing among older adults sleeping more than 8 hours. However, we cannot infer temporality given the cross-sectional design. Future longitudinal studies are needed to establish temporality and clarify mechanisms.

This study assesses the association of audiometric hearing loss and hearing aid use with dementia among community-dwelling older US Medicare beneficiaries.

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BackgroundEstablished associations between hearing loss and cognitive decline were primarily defined by pure-tone audiometry, which reflects peripheral hearing ability. Speech-in-noise performance, which reflects central hearing ability, is more limited in prior literature. We examined the longitudinal associations of audiometric hearing and speech-in-noise performance with cognitive decline.MethodsWe studied 702 participants aged ≥60 years in the Baltimore Longitudinal Study of Aging 2012–2019. Global and domain-specific (language, memory, attention, executive function, visuospatial ability) cognitive performance were assessed by the cognitive assessment battery. Hearing thresholds at 0.5, 1, 2, and 4 kilohertz obtained from pure-tone audiometry were averaged to calculate better-ear pure-tone average (PTA) and participants were categorized as having hearing loss (>25 decibels hearing level [dB HL]) or normal hearing (≤25 dB HL). Speech-in-noise performance was assessed by the Quick Speech-in-Noise (QuickSIN) test, and participants were categorized as having below-median (worse) or above-median performance. Linear mixed effects models with random intercepts and slopes were used to assess baseline cognitive performance and cognitive decline by hearing status. Models adjusted for demographic, lifestyle and disease factors.ResultsParticipants with audiometric hearing loss showed similar baseline cognitive performance but faster decline in global cognitive function, language, executive function, and attention. Participants with below-median QuickSIN score showed worse baseline cognitive performance in all domains and faster decline in global cognitive function, language, memory, executive function and attention.ConclusionsAudiometric hearing might be targeted to delay cognitive decline. Speech-in-noise performance might be a novel marker and might be more sensitive to memory decline.