Don’t Be Deaf to Sleep Apnea!

The quality of your sleep may be affected by a recently discovered link to hearing loss. A Study suggests that hypoxia may link sleep apnea to auditory dysfunction.  Hypoxia brought on by obstructive sleep apnea could represent a risk to the auditory pathway, suggests a study in the May issue of the Journal of Clinical Sleep Medicine. According to the authors, the lowest oxyhemoglobin saturation measured during polysomnography could predict possible hearing loss in patients with severe OSA.

Sleep apnea was found to be associated with hearing impairment at both high and low frequencies, even after the researchers adjusted data for other possible causes of noise-related hearing loss. The authors of this study set out to determine if there is a correlation between the severity levels for obstructive sleep apnea syndrome (OSAS) and auditory dysfunction. They did so using polysomnography or PSG tests which measure various aspects, including oxygen intake during sleeping hours.

The researchers found that sleep apnea was often a sign of other underlying health conditions. The primary risk factors for sleep apnea include being overweight or obese. Still, it can also develop in people with a history of loud snoring that prevents them from getting comfortable rest.

The hearing system is affected to varying degrees in patients with OSAS. If hearing loss is detected in patients presenting at otolaryngology clinics due to snoring, then assessing these subjects in terms of risk of OSAS is essential to reduce mortality and morbidity that may develop at later stages in association with OSAS.

Risk Factors for Sleep Apnea

Just like with hearing loss, several risk factors contribute to the condition of sleep apnea. Similar to hearing loss, those over 40 years old have a greater likelihood of experiencing the ailment. Males, particularly those who are overweight, also increase their risk. Those with large tonsils, large tongues, small jawbones, or large necks also are at risk because of their difficulties with airflow. Other problems like nasal obstructions, allergies, deviated septum, or general sinus problems may also contribute to breathing difficulties. Finally, those with gastroesophageal reflux, or GERD, should be careful.

Intersection with Hearing Loss

Because of the similar groups that experience hearing loss and sleep apnea, it would be logical to think there could be a correlation. Sleep apnea can cause inflammation within the bloodstream and brain. The cochlea within the ear depends on that blood flow to properly function, so with the constriction, hearing abilities decrease. Those with sleep apnea were found to suffer from high-frequency hearing loss (31%), low-frequency hearing loss (90%), and an increase in combined hearing loss (38%).

While researchers are still studying whether sleep apnea causes hearing problems or if the reverse is true, there’s no doubt there’s a connection. Because sleep apnea causes inflammation throughout the body, a reduction in blood flow to organs like the heart and even the ears occurs. This can damage the tiny hairs in the inner ear, known as the cochlea, that are responsible for sending electrical signals from the ear’s nerve to the brain. When this occurs, the result is hearing loss and/or tinnitus.

Moreover, because sleep apnea produces loud snoring, an individual may experience hearing loss from the noisy, sustained sounds they produce. It is widely known that prolonged exposure to high decibels of sound can contribute to hearing loss.

Why look at the association between snoring and hearing?

Hearing loss may occur when disease in the blood vessels supplying the inner ear, such as arteriosclerosis. The ear’s nerves can be damaged by excessive vibration, such as chronic loud noise. Damage may also occur from the toxic effects of certain drugs such as antibiotics. Since sleep apnea increases the body’s levels of inflammatory proteins and the risk of arteriosclerosis, sleep apnea may also increase the risk of hearing impairment. 

Implications of this research

  • First, the findings broaden the outcomes that may be affected by sleep apnea to include hearing loss.
  • Second, audiologists caring for patients with hearing loss should screen their patients for symptoms of unrecognized sleep, apnea-especially if other sleep apnea risk factors are present.
  • Third, patients with sleep apnea who experience hearing problems should discuss this with their doctors.

Treating Sleep Apnea & Preventing Hearing Loss

How can you treat sleep apnea to prevent hearing loss? To begin, losing weight helps. Also, cease alcohol consumption and smoking to promote health. As a temporary fix, change the position you sleep in to improve breathing; sleeping on your back is the worst position because it constricts airflow. Your doctor may also recommend surgery or a CPAP (continuous positive airway pressure) machine to help keep your airways open and facilitate breathing.  

The best way to prevent hearing loss from sleep apnea is to directly treat sleep apnea itself. Currently, the medical community recognizes Continuous Positive Airway Pressure (CPAP) therapy as the best treatment for those who suffer from sleep apnea.

CPAP works by increasing blood oxygen levels and blood flow, lowering the risk of sleep apnea-related hearing problems. While there is no conclusive evidence that CPAP will prevent hearing problems, anecdotal evidence reported by those undergoing the treatment indicates an improvement in tinnitus symptoms.

If you or someone you know struggles with sleep apnea, seeking treatment from a physician and a healthy lifestyle could improve your quality of life and even minimize the odds of sustaining permanent hearing loss. ISD Health Solutions has been leading the Caribbean in sleep health for over a decade; we can health you too. The first step in conquering your sleep health, is a free risk assessment

Sources 

  1. Lowest Oxyhemoglobin Saturation May Be an Independent Factor Influencing Auditory Function in Severe Obstructive Sleep Apnea. Journal of Clinical Sleep Medicine, Volume 12, Issue 05.
  2. Auditory Function of Patients with Obstructive Sleep Apnea Syndrome: A Study. National Library Of Medicine. 2020 Jun;52(2):176-179. doi: 10.5152/eurasianjmed.2019.18373. Epub 2020 Jun 4. Eurasian J Med.
  3. The evaluation of the auditory system in obstructive sleep apnea syndrome (OSAS) patients.  2016 Jul-Aug;37(4):299-303. DOI: 10.1016/j.amjoto.2016.03.004. Epub 2016 Mar 29. Am J Otolaryngol.