Matsumura Erika, Matas Carla Gentile, Magliaro Fernanda Cristina Leite, Pedreño Raquel Meirelles, Lorenzi-Filho Geraldo, Sanches Seisse Gabriela Gandolfi, Carvallo Renata Mota Mamede
Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Fonoaudiologia, Fisioterapia e Terapia Ocupacional, São Paulo, SP, Brazil.
Universidade de São Paulo (USP), Faculdade de Medicina, Laboratório do Sono, Divisão de Pneumologia, Instituto do Coração (InCor), São Paulo, Brazil.
Braz J Otorhinolaryngol. 2016 Nov 25;84(1):51-7. doi: 10.1016/j.bjorl.2016.10.014.
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.
To compare the evaluation of peripheral auditory pathway and brainstem among individuals with and without obstructive sleep apnea.
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%.
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).
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.
阻塞性睡眠呼吸暂停会导致正常睡眠结构发生变化，长期使其因间歇性缺氧而碎片化，从长远来看会导致严重的健康后果。据信，睡眠期间呼吸事件的发生，如呼吸暂停和呼吸不足，会损害沿高度依赖氧气供应的听觉通路的神经冲动传递。然而，这种关联在文献中尚未得到充分证实。
比较有和没有阻塞性睡眠呼吸暂停的个体的外周听觉通路和脑干评估。
样本包括38名成年男性，平均年龄35.8（±7.2）岁，分为四组，按年龄和体重指数匹配。根据多导睡眠图将这些组分类为：对照组（n = 10）、轻度阻塞性睡眠呼吸暂停组（n = 11）、中度阻塞性睡眠呼吸暂停组（n = 8）和重度阻塞性睡眠呼吸暂停组（n = 9）。所有研究对象均否认有听力损失风险史，并接受了听力测定、鼓室图、声反射和脑干听觉诱发电位检查。使用三因素方差分析、双因素方差分析、卡方检验和费舍尔精确检验进行统计分析。所有检验的显著性水平为5%。
各组之间在听力阈值、鼓室图和评估的脑干听觉诱发电位参数方面没有差异。观察到阻塞性睡眠呼吸暂停的存在与V波绝对潜伏期的变化之间存在关联（p = 0.03）。中度阻塞性睡眠呼吸暂停与V波潜伏期的变化之间存在关联（p = 0.01）。
阻塞性睡眠呼吸暂停的存在与脑干听觉通路中声刺激的神经传导变化有关。阻塞性睡眠呼吸暂停严重程度的增加不会导致听力测定、鼓室图和脑干听觉诱发电位评估的反应恶化。
