Sleep Characteristics and Hearing Loss in Older Adults: The National Health and Nutrition Examination Survey 2005–2006

Abstract

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.

Association of sleep duration and noise exposure with hearing loss among Chinese and American adults: two cross-sectional studies

“…However, research on the associations between sleep characteristics and HL is rare. Only three cross-sectional studies have evaluated the associations between sleep disturbance and hearing in adults [23][24][25] ; in a recent analysis, they included 632 older adults (aged >70 years) from the National Health and Nutrition Examination Survey (NHANES) (2005)(2006) and found that >8 hours of sleep was associated with a higher threshold of hearing. 25 The small sample size limited the potential to explore the associations between SPD and HL.…”

“…Only three cross-sectional studies have evaluated the associations between sleep disturbance and hearing in adults [23][24][25] ; in a recent analysis, they included 632 older adults (aged >70 years) from the National Health and Nutrition Examination Survey (NHANES) (2005)(2006) and found that >8 hours of sleep was associated with a higher threshold of hearing. 25 The small sample size limited the potential to explore the associations between SPD and HL. Additionally, none of these studies included the Chinese population, nor did they consider the potential impact of factors such as noise.…”

Associations Between Sleep Duration and Sensory Impairments Among Older Adults in China

“…A casecontrol study using pooled controls in Japan reported that short sleep duration might be a risk factor for idiopathic sudden deafness (Nakamura et al, 2001). The 2005-2006 cycle of the National Health and Nutrition Examination Survey (NHANES) in the United States suggested that longer sleep duration (≥ 8 h per day) was marginally associated with poorer hearing function (Jiang et al, 2021). However, this study was weak in representativeness due to the relatively small sample size of fewer than 1,000 individuals (632 older adults aged 70 years and older).…”

“…As for hearing impairment, little is known about its associations with sleep duration. A study of 632 adults aged 70 years or above in the United States reported that longer sleep duration exceeding 8 h was linked with poorer high-frequency hearing (Jiang et al, 2021). Another study of 48,091 adults aged 20-79 years in Japan suggested that individuals with sleep duration exceeding 8 h had a higher risk of hearing loss (Nakajima et al, 2014).…”

Effects of Diet and Lifestyle on Audio-Vestibular Dysfunction in the Elderly: A Literature Review

“…Approximately half of the older population complains of sleep disturbances [161]. A marginal association exists between achieving over eight hours of sleep and impaired highfrequency hearing [162]; however, no evidence of the association between sleep quality and hearing loss has been reported. Nevertheless, several studies have suggested an association between sleep-disordered breathing (SDB) and worse cardiovascular, cognitive, and functional outcomes.…”