title: Sleep Apnea Is Associated with Hearing Impairment: The Hispanic Community Health Study/Study of Latinos.
abstract: Sleep apnea (SA) may promote hearing impairment (HI) through ischemia and inflammation of the cochlea. Our objective was to assess an independent association between SA and HI in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants.
  
  
  
  We used data from the HCHS/SOL, a multicenter population-based study of self- identifying Hispanic/Latinos 18- to 74-y-old adults from four US urban communities. We performed home SA testing and in-clinic audiometry testing in all participants. SA was defined as an apnea-hypopnea index (AHI) ≥ 15 events/h. HI was defined as a mean hearing threshold > 25 dB hearing level in either ear at the frequencies: 3,000 to 8,000 Hz for high-frequency HI (HF-HI) and 500 to 2,000 Hz for low-frequency HI (LF-HI). Combined-frequency HI (CF-HI) was defined as both conditions present, and Any-HI was considered as HI in either low or high frequencies.
  
  
  
  Of 13,967 participants, 9.9% had SA and 32.3% had Any-HI. Adjusted for risk factors for HI, those with SA had a 30% higher odds of Any-HI (95% confidence interval [CI] = 8% to 57%), 26% higher odds of HF-HI (CI = 3% to 55%), 127% higher odds of LF-HI (CI = 21% to 326%), and 29% higher odds of CF-HI (CI = 0% to 65%). A dose-response association was observed between AHI severity and Any-HI (versus no SA, OR for AHI ≥ 15 and < 30 = 1.22, CI = 0.96 to 1.54, and OR for AHI ≥ 30 = 1.46, CI = 1.11 to 1.91, p = 0.002).
  
  
  
  SA is associated with HF-HI and LF-HI, independent of snoring and other confounders.
  
  
  
  A commentary on this article appears in this issue on page 641.
authors.affiliation: Albany Medical Center, Albany, NY.
authors.forename: Amit
authors.initials: A
authors.lastname: Chopra
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Molly
authors.initials: M
authors.lastname: Jung
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Kaplan
authors.affiliation: Montefiore Medical Center; Bronx, NY.
authors.forename: David W
authors.initials: DW
authors.lastname: Appel
authors.affiliation: Montefiore Medical Center; Bronx, NY.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Dinces
authors.affiliation: Northwestern University, Evanston, IL.
authors.forename: Sumitrajit
authors.initials: S
authors.lastname: Dhar
authors.affiliation: Northwestern University, Evanston, IL.
authors.forename: Phyllis C
authors.initials: PC
authors.lastname: Zee
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Franklyn
authors.initials: F
authors.lastname: Gonzalez
authors.affiliation: University of Miami, Miami, FL.
authors.forename: David J
authors.initials: DJ
authors.lastname: Lee
authors.affiliation: University of Miami, Miami, FL.
authors.forename: Alberto R
authors.initials: AR
authors.lastname: Ramos
authors.affiliation: National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, MD.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Hoffman
authors.affiliation: Harvard Medical School, Boston, MA.
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
authors.affiliation: University of Wisconsin, Madison, WI.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Cruickshanks
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Neomi A
authors.initials: NA
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D034381:Hearing Loss / Q000150:complications*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications*; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
keywords: hearing impairment; sleep apnea