title: Evaluation of peripheral auditory pathways and brainstem in obstructive sleep apnea.
abstract: BACKGROUND
  Obstructive sleep apnea causes changes in normal sleep architecture, fragmenting it chronically with intermittent hypoxia, leading to serious health consequences in the long term. It is believed that the occurrence of respiratory events during sleep, such as apnea and hypopnea, can impair the transmission of nerve impulses along the auditory pathway that are highly dependent on the supply of oxygen. However, this association is not well established in the literature.
  
  
  OBJECTIVE
  To compare the evaluation of peripheral auditory pathway and brainstem among individuals with and without obstructive sleep apnea.
  
  
  METHODS
  The sample consisted of 38 adult males, mean age of 35.8 (±7.2), divided into four groups matched for age and Body Mass Index. The groups were classified based on polysomnography in: control (n=10), mild obstructive sleep apnea (n=11) moderate obstructive sleep apnea (n=8) and severe obstructive sleep apnea (n=9). All study subjects denied a history of risk for hearing loss and underwent audiometry, tympanometry, acoustic reflex and Brainstem Auditory Evoked Response. Statistical analyses were performed using three-factor ANOVA, 2-factor ANOVA, chi-square test, and Fisher's exact test. The significance level for all tests was 5%.
  
  
  RESULTS
  There was no difference between the groups for hearing thresholds, tympanometry and evaluated Brainstem Auditory Evoked Response parameters. An association was observed between the presence of obstructive sleep apnea and changes in absolute latency of wave V (p=0.03). There was an association between moderate obstructive sleep apnea and change of the latency of wave V (p=0.01).
  
  
  CONCLUSIONS
  The presence of obstructive sleep apnea is associated with changes in nerve conduction of acoustic stimuli in the auditory pathway in the brainstem. The increase in obstructive sleep apnea severity does not promote worsening of responses assessed by audiometry, tympanometry and Brainstem Auditory Evoked Response.
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Fonoaudiologia, Fisioterapia e Terapia Ocupacional, São Paulo, SP, Brazil.
authors.forename: Erika
authors.initials: E
authors.lastname: Matsumura
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Fonoaudiologia, Fisioterapia e Terapia Ocupacional, São Paulo, SP, Brazil.
authors.forename: Carla Gentile
authors.initials: CG
authors.lastname: Matas
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Fonoaudiologia, Fisioterapia e Terapia Ocupacional, São Paulo, SP, Brazil.
authors.forename: Fernanda Cristina Leite
authors.initials: FCL
authors.lastname: Magliaro
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Fonoaudiologia, Fisioterapia e Terapia Ocupacional, São Paulo, SP, Brazil.
authors.forename: Raquel Meirelles
authors.initials: RM
authors.lastname: Pedreño
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina, Laboratório do Sono, Divisão de Pneumologia, Instituto do Coração (InCor), São Paulo, Brazil.
authors.forename: Geraldo
authors.initials: G
authors.lastname: Lorenzi-Filho
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Fonoaudiologia, Fisioterapia e Terapia Ocupacional, São Paulo, SP, Brazil.
authors.forename: Seisse Gabriela Gandolfi
authors.initials: SGG
authors.lastname: Sanches
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Fonoaudiologia, Fisioterapia e Terapia Ocupacional, São Paulo, SP, Brazil. Electronic address: renamaca@usp.br.
authors.forename: Renata Mota Mamede
authors.initials: RMM
authors.lastname: Carvallo
keywords: Apneia obstrutiva do sono; Auditory brainstem response; Audição; Hearing test; Hipóxia; Hypoxia; Obstructive sleep apnea; Potenciais Evocados Auditivos do Tronco Encefálico