The effect of obstructive Sleep Apnea on hearing impairment: A Cross-Sectional Study among Noise-Exposed Worker

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Abstract

Purpose. The principal goal of this investigation was to assess how obstructive sleep apnea affects hearing impairments in workers who are regularly exposed to occupational noise.

Materials and methods. In this investigation, we assessed 920 noise-exposure workers in one of the metal industries in Iran. Noise-induced, high-frequency, and low-frequency hearing loss were classified based on the mean hearing thresholds of more than 25 dB at 500–2000 Hz, 300–8000 Hz, and 4000 Hz, respectively. We used the STOP-Bang questionnaire for screening for sleep apnea, and a score of ≥3 indicated a high risk of obstructive sleep apnea.  Multivariable logistic regression analyses were used to evaluate the correlation between hearing impairment and obstructive sleep apnea risk.

Results. The mean hearing thresholds at 3000–8000 Hz and specifically at 4000 Hz were significantly higher among workers at high risk for obstructive sleep apnea compared to those at low risk (p-value <0.05). Following the multivariate logistic regression analysis and the confounding factor adjustment, individuals with high obstructive sleep apnea risk showed a higher incidence of noise-induced hearing loss (p = 0.002, OR = 1.85, 95% CI = 1.28–2.36) and high-frequency hearing loss (p = 0.02, OR = 2.05, 95% CI = 1.28–2.16) compared to those with low risk.

Limitations. The cross-sectional design and use of a subjective screening method instead of objective methods such as polysomnography for evaluating obstructive sleep apnea are weaknesses of this study.

Conclusion. The current study showed obstructive sleep apnea in noise-exposed workers increased the risk of developing high-frequency hearing loss and hearing impairment from noise. So, identifying and managing workers with obstructive sleep apnea risk, early hearing screening, and periodic audiometry can help to prevent hearing loss in the primary stage.

Compliance with ethical standards. The data related to this manuscript is part of the information about the residency thesis for Marjan Amini MD at Iran University of Medical Sciences (relationship between smoke and noise-induced hearing loss). The protocol was reviewed and approved by the ethical committee of Iran University of Medical Sciences and Health Services (protocol no. 1395.9411308001).

Consent for publication. All participants gave informed voluntary written consent to participate in the study.

Availability of data and material. Data will be made available on reasonable request.

Contributions:
Elaheh Kabir-Mokamelkhah – Concept, Design of study, literature search, data analysis and Manuscript preparation;
Mashallah Aghilinejad – Concept, Design of study;
Omid asghari – data analysis, and Manuscript preparation;
Marjan Amini – literature search, Data acquisition and Manuscript preparation.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgment. This study was conducted with support from the Deputy for Research at Iran University of Medical Sciences (IUMS). The study had no sponsorship.

Received: February 8, 2024 / Revised: July 25, 2024 / Accepted: December 3, 2024 / Published: January 31, 2025

About the authors

Elaheh Kabir-Mokamelkhah

Occupational Medicine Research Center, Occupational Medicine Department, Faculty of Medicine, Iran University of Medical Sciences

Email: kabir.e@iums.ac.ir

Associated professor, Occupational Medicine Research Center, Occupational Medicine Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, 1449614535, Iran

e-mail: kabir.e@iums.ac.ir

Mashallah Aghilinejad

Occupational Medicine Research Center, Occupational Medicine Department, Faculty of Medicine, Iran University of Medical Sciences

Email: iranomrc@gmail.com

Professor, Occupational Medicine Research Center, Occupational Medicine Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, 1449614535, Iran

e-mail: iranomrc@gmail.com

Asghari Omid

Occupational Medicine Research Center, Occupational Medicine Department, Faculty of Medicine, Iran University of Medical Sciences

Email: dr_asghariomid@yahoo.com

MD, Occupational Medicine Specialist, Occupational Medicine Research Center, Occupational Medicine Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, 1449614535, Iran

e-mail: dr_asghariomid@yahoo.com

Marjan Amini

Occupational Medicine Research Center, Occupational Medicine Department, Faculty of Medicine, Iran University of Medical Sciences

Author for correspondence.
Email: ma.amimi45@yahoo.com

MD, MD, Occupational Medicine specialist, Occupational Medicine Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, 1449614535, Iran

e-mail: ma.amimi45@yahoo.com

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