CPAP Treatment Improves Pure Tone Audiometry Threshold in Sensorineural Hearing Loss Patients with Sleep-Disordered Breathing

Abstract

This article investigates the effects of continuous positive airway pressure (CPAP) on hearing impairment in sensorineural hearing loss (SNHL) patients with sleep-disordered breathing (SDB). This retrospective and observational study took place from September 2016 to February 2021, accumulating 77 subjects with SNHL and SDB (60.7 ± 11.1 years). Of which, 28 received CPAP treatment (63.0 ± 8.5 years). In our methodology, hearing thresholds at low, medium, high, and average frequencies are assessed by pure-tone audiometry at baseline (BL), three (3 m), six (6 m), and 12 (12 m) months. Our results show that the BL of at least three frequencies in all subjects is positively associated with old age, males, smoking, alcohol, coronary artery disease, hypertension, and apnea-hypopnea index [AHI] (all p < 0.05). Moreover, low, medium, and average frequencies are negatively correlated at CPAP-6 m (−5.60 ± 2.33, −5.82 ± 2.56, and −5.10 ± 2.26 dB; all p < 0.05) and CPAP-12 m (−7.97 ± 2.74, −8.15 ± 2.35, and −6.67 ± 2.37 dB; all p < 0.01) against corresponding measures of CPAP-BL. High, medium, and average frequencies positively correlated with age (p < 0.001 for high and average frequencies and <0.01 for medium frequencies). We conclude that in SNHL patients with SDB, hearing thresholds at low and medium frequencies improves under CPAP use after six months, which persists at least to the end of one year.

Obstructive Sleep Apnea and Sensorineural Hearing Loss: A Systematic Review and Meta‐analysis

“…There were 2 population‐based studies 9,46 with large sample sizes (13,967 and 19,152 participants); the remaining studies had sample sizes <100. Most enrolled age‐matched participants for the OSA and control groups; the majority included participants aged 40 to 60 years (middle‐aged adults), except 4 studies with those aged <40 years (young adults) 37,39,43,48 and 3 studies with those aged >60 years (older adults) 10,47,49 . The mean AHI and oxygen desaturation index were 30.8 ± 16.2 and 29.1 ± 22.7 events/h, respectively.…”

“…One study 10 involving 56 participants compared the mean HTL at midfrequency before treatment with the corresponding values at 3 and 12 months after CPAP treatment. The data did not show any significant differences between the groups (at 3 months: MD, 2.40 dB; 95% CI, –8.47 to 13.27; at 12 months: MD, 7.30 dB; 95% CI, –2.69 to 17.29).…”

“…However, we did not find any statistical improvement in mean HTL after CPAP therapy. 10,47 Subgroup analyses of mean HTLs at mid-and high frequency according to OSA severity classification demonstrated that the severe OSA subgroup had a significantly worse threshold than the mild and moderate OSA subgroups. This finding supports the hypothesis that more apneas and hypopneas result in more frequent intracochlear oxygen reduction and worsening HTL.…”

“…The data did not show any significant differences between the groups (at 3 months: MD, 2.40 dB; 95% CI, -8.47 to 13.27; at 12 months: MD, 7.30 dB; 95% CI, -2.69 to 17.29). In addition, 2 studies 10,47 with a total of 96 participants compared the mean HTLs at midfrequency before and 6 months after CPAP treatment. There was also no significant difference in such values (MD, 4.04 dB; 95% CI, -5.67 to 13.77).…”

“…Nevertheless, the results were somewhat inconsistent, and no definitive conclusions have yet been reached 5–9 . Furthermore, the effects of continuous positive airway pressure (CPAP), as the first‐line OSA therapy to improve hearing impairment in these patients, are still unclear 10 …”