Jiang Kening, Spira Adam P, Gottesman Rebecca F, Full Kelsie M, Lin Frank R, Lutsey Pamela L, Garcia Morales Emmanuel E, Punjabi Naresh M, Reed Nicholas S, Sharrett A Richey, Deal Jennifer A
Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA.
Sleep Health. 2023 Oct;9(5):742-750. doi: 10.1016/j.sleh.2023.06.011. Epub 2023 Aug 5.
This study investigated associations of late midlife sleep characteristics with late-life hearing, which adds to the existing cross-sectional evidence and is novel in examining polysomnographic sleep measures and central auditory processing.
A subset of Atherosclerosis Risk in Communities Study participants underwent sleep assessment in the Sleep Heart Health Study in 1996-1998 and hearing assessment in 2016-2017. Peripheral hearing thresholds (0.5-4kHz) assessed by pure-tone audiometry were averaged to calculate speech-frequency pure-tone average in better-hearing ear (higher pure-tone average=worse hearing). Central auditory processing was measured by the Quick Speech-in-Noise Test (lower score=worse performance). Sleep was measured using polysomnography (time spent in stage 1, stage 2, stage 3/4, rapid eye movement sleep; sleep-disordered breathing [apnea-hypopnea index ≥5]) and self-report (habitual sleep duration; excessive daytime sleepiness [Epworth Sleepiness Scale 10]). Linear regression models adjusted for demographic and lifestyle factors with additional adjustment for cardiovascular factors.
Among 719 Atherosclerosis Risk in Communities-Sleep Heart Health Study participants (61 ± 5years, 54% female, 100% White), worse speech-frequency pure-tone average was found with sleep-disordered breathing (2.51dB, 95% confidence interval: 0.27, 4.75) and excessive daytime sleepiness (3.35 dB, 95% confidence interval: 0.81, 5.90). Every additional hour of sleep when sleeping >8 hours was associated with worse Quick Speech-in-Noise score (1.61 points, 95% confidence interval: 0.03, 3.19). Every 10-minute increase in rapid eye movement sleep was associated with 0.14-point better Quick Speech-in-Noise score (95% confidence interval: 0.02, 0.25).
Sleep abnormalities might be risk factors for late-life hearing loss. Future longitudinal studies are needed to confirm these novel findings and clarify the mechanisms.
本研究调查了中年后期睡眠特征与老年听力之间的关联，这补充了现有的横断面证据，并且在检查多导睡眠图睡眠指标和中枢听觉处理方面具有创新性。
社区动脉粥样硬化风险研究的一部分参与者在1996 - 1998年的睡眠心脏健康研究中接受了睡眠评估，并在2016 - 2017年接受了听力评估。通过纯音听力测定法评估的外周听力阈值（0.5 - 4kHz）进行平均，以计算听力较好耳的言语频率纯音平均值（纯音平均值越高 = 听力越差）。通过快速噪声言语测试测量中枢听觉处理能力（得分越低 = 表现越差）。使用多导睡眠图测量睡眠（在1期、2期、3/4期、快速眼动睡眠阶段所花费的时间；睡眠呼吸紊乱[呼吸暂停低通气指数≥5]）以及自我报告（习惯性睡眠时间；日间过度嗜睡[爱泼华嗜睡量表≥10]）。线性回归模型对人口统计学和生活方式因素进行了调整，并对心血管因素进行了额外调整。
在719名社区动脉粥样硬化风险 - 睡眠心脏健康研究参与者中（年龄61±5岁，54%为女性，100%为白人），发现睡眠呼吸紊乱（2.51dB，95%置信区间：0.27，4.75）和日间过度嗜睡（3.35dB，95%置信区间：0.81，5.90）与较差的言语频率纯音平均值有关。当睡眠时间>8小时时，每多睡一小时与较差的快速噪声言语测试得分相关（1.61分，95%置信区间：0.03，3.19）。快速眼动睡眠每增加10分钟与快速噪声言语测试得分提高0.14分相关（95%置信区间：0.02，0.25）。
睡眠异常可能是老年听力损失的危险因素。未来需要进行纵向研究以证实这些新发现并阐明其机制。
