title: Acute stress induces hyperacusis in women with high levels of emotional exhaustion.
abstract: BACKGROUND
  Hearing problems is one of the top ten public health disorders in the general population and there is a well-established relationship between stress and hearing problems. The aim of the present study was to explore if an acute stress will increase auditory sensitivity (hyperacusis) in individuals with high levels of emotional exhaustion (EE).
  
  
  METHODS
  Hyperacusis was assessed using uncomfortable loudness levels (ULL) in 348 individuals (140 men; 208 women; age 23-71 years). Multivariate analyses (ordered logistic regression), were used to calculate odds ratios, including interacting or confounding effects of age, gender, ear wax and hearing loss (PTA). Two-way ANCOVAs were used to assess possible differences in mean ULLs between EE groups pre- and post-acute stress task (a combination of cold pressor, emotional Stroop and Social stress/video recording).
  
  
  RESULTS
  There were no baseline differences in mean ULLs between the three EE groups (one-way ANOVA). However, after the acute stress exposure there were significant differences in ULL means between the EE-groups in women. Post-hoc analyses showed that the differences in mean ULLs were between those with high vs. low EE (range 5.5-6.5 dB). Similar results were found for frequencies 0.5 and 1 kHz. The results demonstrate that women with high EE-levels display hyperacusis after an acute stress task. The odds of having hyperacusis were 2.5 (2 kHz, right ear; left ns) and 2.2 (4 kHz, right ear; left ns) times higher among those with high EE compared to those with low levels. All these results are adjusted for age, hearing loss and ear wax.
  
  
  CONCLUSIONS
  Women with high levels of emotional exhaustion become more sensitive to sound after an acute stress task. This novel finding highlights the importance of including emotional exhaustion in the diagnosis and treatment of hearing problems.
authors.affiliation: Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden. dan.hasson@ki.se
authors.forename: Dan
authors.initials: D
authors.lastname: Hasson
authors.forename: Töres
authors.initials: T
authors.lastname: Theorell
authors.forename: Jonas
authors.initials: J
authors.lastname: Bergquist
authors.forename: Barbara
authors.initials: B
authors.lastname: Canlon
mesh_terms: D000328:Adult; D000368:Aged; D001309:Auditory Threshold; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006309:Hearing; D006801:Humans; D012001:Hyperacusis / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D005222:Mental Fatigue / Q000150:complications*; D008875:Middle Aged; D015999:Multivariate Analysis; D009622:Noise; D016017:Odds Ratio; D012044:Regression Analysis; D012737:Sex Factors; D013256:Steroids / Q000378:metabolism; D013315:Stress, Psychological / Q000150:complications*; D055815:Young Adult
chemical_list: D013256:Steroids